Socioeconomic status and ADL disability of the older adults: Cumulative health effects, social outcomes and impact mechanisms

PLoS One. 2022 Feb 10;17(2):e0262808. doi: 10.1371/journal.pone.0262808. eCollection 2022.

Abstract

Introduction: Socioeconomic status (SES) is one of the important indicators affecting individual's social participation and resource allocation, and it also plays an important role in the health shock of individuals. Faced by the trend of aging society, more and more nations across the world began to pay attention to prevent the risk of health shock of old adults.

Methods: Based on the data of China Health and Retirement Longitudinal Study (CHARLS) in 2013, 2015 and 2018, this study uses path analysis and ologit model to empirically estimate the effects of SES and health shock on the activities of daily living (ADL) disability of old adults.

Results: As a result, first, it was found that SES has significant impact on the disability of old adults. Specifically, economic conditions (income) plays dominant role. Economic status affects the risk of individual disability mainly through life security and health behavior. Secondly, SES significantly affecting health shock, with education and economic status showing remarkable impact, and there is an apparent group inequality. Furthermore, taking high education group as reference, the probability of good sight or hearing ability of the low education group was only 49.76% and 63.29% of the high education group, respectively, while the rates of no pain and severe illness were 155.50% and 54.69% of the high education group. At last, the estimation of path effect of SES on ADL disability indicates evident group inequality, with health shock plays critical mediating role.

Conclusions: SES is an important factor influencing residents' health shock, and health shocks like cerebral thrombosis and cerebral hemorrhage will indirectly lead to the risk of individual ADL disability. Furthermore, among the multi-dimensional indicators of SES, individual income and education are predominant factors affecting health shock and ADL disability, while occupation of pre-retirement have little impact.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Disabled Persons* / statistics & numerical data
  • Educational Status
  • Female
  • Health Inequities*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Models, Theoretical
  • Risk Factors
  • Social Class*
  • Social Participation*
  • Socioeconomic Factors

Grants and funding

The authors are very grateful for the financial support of National Natural Science Fund of China (71904167;42001179) awarded to Dr. Huan Liu and Dr. Meng Wang, Natural Science Foundation of Zhejiang Province (LQ20G030018) awarded to Dr. Meng Wang, The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.