{"title":"Socioeconomic inequalities in frailty distribution: A cross-national comparison of the United States and England.","authors":"Rachel Z Wilkie, Jennifer A Ailshire","doi":"10.1093/geronb/gbae157","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To examine differences in socioeconomic gradients (i.e., education, income, and wealth) in frailty by gender in the US and England.</p><p><strong>Methods: </strong>We used harmonized data from the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) in 2016. Frailty status was determined from measured and self-reported signs and symptoms in five domains: unintentional weight loss, exhaustion, low physical activity, slow walking speed, and weakness. Respondents were classified as robust (no signs or symptoms of frailty), pre-frail (signs or symptoms in 1-2 domains), or frail (signs or symptoms in 3 or more domains). Gender-stratified multinomial logistic regression models were used to assess the relationship between educational attainment, household income, and household wealth with the risk of frailty and pre-frailty, with and without covariates. We also calculated the slope index of inequalities on the predicted probabilities of frailty by income and wealth quintiles.</p><p><strong>Results: </strong>We found socioeconomic gradients in pre-frailty and frailty by education, income, and wealth. Furthermore, the educational gradient in frailty was significantly steeper for US women compared to English women, and the income gradient was steeper for US men and women compared to English men and women. The between-country differences were not accounted for by adjusting for race/ethnicity and behavioral factors.</p><p><strong>Discussion: </strong>Socioeconomic gradients in pre-frailty and frailty differ by country setting and gender, suggesting contextual factors such as cultural norms, healthcare access and quality, and economic policy may contribute to the effect of different measures of socioeconomic status on pre-frailty and frailty risk.</p>","PeriodicalId":56111,"journal":{"name":"Journals of Gerontology Series B-Psychological Sciences and Social Sciences","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journals of Gerontology Series B-Psychological Sciences and Social Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/geronb/gbae157","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: To examine differences in socioeconomic gradients (i.e., education, income, and wealth) in frailty by gender in the US and England.
Methods: We used harmonized data from the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) in 2016. Frailty status was determined from measured and self-reported signs and symptoms in five domains: unintentional weight loss, exhaustion, low physical activity, slow walking speed, and weakness. Respondents were classified as robust (no signs or symptoms of frailty), pre-frail (signs or symptoms in 1-2 domains), or frail (signs or symptoms in 3 or more domains). Gender-stratified multinomial logistic regression models were used to assess the relationship between educational attainment, household income, and household wealth with the risk of frailty and pre-frailty, with and without covariates. We also calculated the slope index of inequalities on the predicted probabilities of frailty by income and wealth quintiles.
Results: We found socioeconomic gradients in pre-frailty and frailty by education, income, and wealth. Furthermore, the educational gradient in frailty was significantly steeper for US women compared to English women, and the income gradient was steeper for US men and women compared to English men and women. The between-country differences were not accounted for by adjusting for race/ethnicity and behavioral factors.
Discussion: Socioeconomic gradients in pre-frailty and frailty differ by country setting and gender, suggesting contextual factors such as cultural norms, healthcare access and quality, and economic policy may contribute to the effect of different measures of socioeconomic status on pre-frailty and frailty risk.
期刊介绍：
The Journal of Gerontology: Psychological Sciences publishes articles on development in adulthood and old age that advance the psychological science of aging processes and outcomes. Articles have clear implications for theoretical or methodological innovation in the psychology of aging or contribute significantly to the empirical understanding of psychological processes and aging. Areas of interest include, but are not limited to, attitudes, clinical applications, cognition, education, emotion, health, human factors, interpersonal relations, neuropsychology, perception, personality, physiological psychology, social psychology, and sensation.
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