Physical Functioning Trends among US Women and Men Age 45–64 by Education Level

Chen

et al. 2018

PeerJ

BackgroundNon-communicable disease (NCD) risk factors can co-exist with disability and cause a greater burden on the health status of adults with disabilities. A lack of egalitarian social policies in China may result in gender disparities in the NCD risk factors of adults with disabilities. However, little is known about the gender disparities in the association between socio-demographics and NCD risk factors among adults with disabilities in China; consequently, we examined this association among adults with disabilities in Shanghai, China.MethodsWe used the health examination data of 44,896 adults with disabilities in Shanghai in 2014. Descriptive analyses and logistic regression models were conducted to estimate gender disparities in the association between socio-demographics, disability characteristics, and four selected NCD risk factors among adults with disabilities—including high blood pressure, high blood glucose, high blood lipids, and being overweight. We estimated marginal effects (MEs) on NCD risk factors between gender and other confounders.ResultsWomen with disabilities were about 11.6 percentage points more likely to suffer from high blood lipids and less likely to develop the other three risk factors than men were. The association of age group, residence permit, education level, marital status, and disability type with health outcomes varied by gender among adults with disabilities. The difference in age effects between men and women was more pronounced in older age groups. Urban residence was associated with less risk of high blood pressure risk among women (ΔME = − 0.035, p < 0.01), but no significant difference in other NCD risk factors. Education remained a major protective factor against high blood pressure, high blood glucose and being overweight among women with disabilities (MEs < 0, p < 0.05); however, this did not hold for men. The difference in marriage effects between men and women was observed in high blood lipids (ΔME = − 0.048 for the married group and −0.054 for the divorced or widowed group) and overweight individuals (ΔME = − 0.091 for the married group and −0.114 for the divorced or widowed group). Women with intellectual disabilities or mental disabilities reported worse health conditions than men did.DiscussionPreventive strategies and interventions on NCD risk factors for adults with disabilities should take into account gender disparities in these socio-demographic effects. Rural women or poorly educated women with disabilities can be a vulnerable population that requires more health education and promotion strategies. Health education for caregivers of women with intellectual or mental disabilities may also play a vital role in preventing their NCD risk factors.

Section: Discussionmentioning

confidence: 99%

Gender disparities in the association between socio-demographics and non-communicable disease risk factors among adults with disabilities in Shanghai, China

Chen

et al. 2018

PeerJ

“…From 2000 to 2008, the prevalence of difficulty performing one or more ADLs increased from 15 to 16% among people aged 55–64 [ 9 ], an increase of approximately 420,000 people, and this upward trend continued through 2016 [ 12 ]. While needing help with ADLs remains relatively rare in middle age [ 7 , 9 , 11 , 12 ], developing difficulty with these activities represents a key step on the pathway towards needing help and strongly predicts adverse outcomes [ 13 , 14 ]. Recent research shows that developing ADL difficulty in middle age is associated with outcomes similar to those seen in late life, including hospitalization, nursing home admission, and death [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Moving prevention of functional impairment upstream: is middle age an ideal time for intervention?

Brown

Covinsky

2020

womens midlife health

To live independently, individuals must be able to perform basic activities of daily living (ADLs), including bathing, dressing, and transferring out of a bed or chair. When older adults develop difficulty or the need for help performing ADLs, they experience decreased quality of life and an increased risk of acute care utilization, nursing home admission, and death. For these reasons, slowing or preventing the progression to functional problems is a key focus of the care of older adults. While preventive efforts currently focus mainly on older people, difficulty performing basic ADLs (“functional impairment”) affects nearly 15% of middle-aged adults, and this prevalence is increasing. People who develop functional impairment in middle age are at increased risk for adverse outcomes similar to those experienced by older adults. Developing ADL impairment in middle age also impacts work force participation and health expenditures, not just in middle age but also older age. Middle-aged adults have a high capacity for recovery from functional impairment, and many risk factors for developing functional impairment in middle and older age have their roots in mid-life. Taken together, these findings suggest that middle age may be an ideal period to intervene to prevent or delay functional impairment. To address the rising prevalence of functional impairment in middle age, we will need to work on several fronts. These include developing improved prognostic tools to identify middle-aged people at highest risk for functional impairment and developing interventions to prevent or delay impairment among middle-aged people. More broadly, we need to recognize functional impairment in middle age as a problem that is as prevalent and central to health outcomes as many chronic medical conditions.

“…As a result of the segregated labor markets for people with disabilities, women who are more educated may have more opportunities to get jobs, earn more money, and obtain healthier food, and they may also be more likely to take advantage of comprehensive rehabilitation policies and health care utilities [32][33]. Men with disabilities of different educational backgrounds may not differ regarding these circumstances above [34]. Poorly educated women with disabilities can be a vulnerable population that needs more health education and promotion strategies.…”

Section: Discussionmentioning

confidence: 99%

Peer Review #1 of "Gender disparities in the association between socio-demographics and non-communicable disease risk factors among adults with disabilities in Shanghai, China (v0.1)"

Pranic¹

2018

Background. Non-communicable disease (NCD) risk factors can co-exist with disability and cause a greater burden on the health status of adults with disabilities. A lack of egalitarian social policies in China may result in gender disparities in the NCD risk factors of adults with disabilities. However, little is known about the gender disparities in the association between socio-demographics and NCD risk factors among adults with disabilities in China; consequently, we examined this association among adults with disabilities in Shanghai, China. Methods. We used the health examination data of 44,896 adults with disabilities in Shanghai in 2014. Descriptive analyses and logistic regression models were conducted to estimate gender disparities in the association between socio-demographics, disability characteristics, and four selected NCD risk factors among adults with disabilities-including high blood pressure, high blood glucose, high blood lipids, and overweight. We estimated marginal effects (MEs) on NCD risk factors between gender and other confounders. Results. Women with disabilities were about 11.6 percentage points more likely to suffer from high blood lipids and less likely to develop the other three risk factors than men were. The association of age group, residence permit, education level, marital status, and disability type with health outcomes varied by gender among adults with disabilities. The difference in age effects between men and women was more pronounced in older age groups. Urban residence was associated with less risk of high blood pressure risk among women (ΔME =-0.035, p < 0.01), but no significant difference in other NCD risk factors. Education remained a major protective factor against high blood pressure, high blood glucose and overweight among women with disabilities (MEs < 0, p < 0.05); however, this did not hold for men. The difference in marriage effects between men and women was observed in high blood lipids (ΔME =-0.048 for the married group and-0.054 for the divorced or widowed group) and overweight individuals (ΔME =-0.091 for the married group and-0.114 for the divorced or widowed group). Women with intellectual disabilities or mental disabilities reported worse health conditions than men did. Discussion. Preventive strategies and interventions on NCD risk factors for adults with disabilities should take into account gender disparities in these socio-demographic effects. Rural women or poorly educated women with disabilities can be a vulnerable population that requires more health education and promotion strategies. Health education for caregivers of women with intellectual or mental disabilities may also play a vital role in preventing their NCD risk factors.