Korean Public Health Research (대한보건연구)

The Korean Public Health Association (대한보건협회)
권호 표지

A Gender analysis of the association between Self-rated Health and Disability of daily living among Korean Elderly

주관적 건강 수준은 노인의 일상생활 수행 능력 정도를 예측할 수 있는가: 성별 비교를 중심으로

  • 박금령 (한국보건사회연구원 보건정책연구실) ;
  • 최병호 (서울시립대학교 도시보건대학원)
  • Received : 2018.05.11
  • Accepted : 2018.09.18
  • Published : 2018.11.30

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Abstract

Objective : This study aimed to examine the association Self-Rated Health(hereafter SRH) and Activities of Daily Living(hereafter ADL), Independent Activities of Daily Living(hereafter IADL) among Korean elderly. Methods : Using nationally representative cross sectional studies called 2014 Survey of living conditions and welfare needs of Korean elder persons. We used SRH as an independent variable, disabilities of ADL and IADL as dependent variables. Logistic regression was implemented and potential confounders such as socio-economic status, demographic characteristics and others were adjusted. Results : It was revealed that people who were female(than male) and 75 or more years old(than less than 75 years old) were shown to have poor SRH and disabilities of both ADL and IADL. In logistic regression model, poor SRH was associated with ADL and IADL disabilities. Especially, their association was more remarkable among male than among female. It can be understood that socio-economic contexts affect quality of life among elderly and SRH can be differently perceived by gender. Conclusions : Our notable findings showed that gender perspective is needed to understand SRH and daily living among elderly.

연구목적: 노인의 주관적 건강 수준과 ADL(Activities of Daily Living), IADL(Instrumental Activities of Daily Living)의 관계를 통해 집단 간 동질성과 이질성을 살펴보고자 한다. 연구방법: 2014년도 노인실태조사를 이용하여 주관적 건강 수준을 독립변수로 ADL과 IADL의 제한을 종속변수로 설정하였다. 로지스틱 회귀분석을 실시하였으며 성별로 비교하였다. 연구결과: 남성 노인에 비해 여성 노인이, 사회경제적 수준이 낮고 연령이 높은 노인일수록 주관적 건강 수준이 낮으며 ADL과 IADL의 제한이 있었다. 주관적 건강 수준이 낮을수록 ADL과 IADL에서 제한을 가질 확률이 높은 것으로 관찰되었다. 특히 그 관계는 여성 노인에 비해 남성 노인에서 뚜렷이 나타난다. 연구 결과를 통해 여성 노인의 취약성을 파악하는 한편, 중증도가 높은 질병에 국한해 본인의 건강 수준을 인지하는 남성 노인의 특성을 이해할 수 있었다. 결론: 노인의 삶을 이해하고 노인 정책을 시행하는데 있어 성인지적 접근과 더불어 주관적 건강 수준을 비롯한 다양한 지표를 활용하는 노력이 필요하다.

Keywords

References

  1. Sunwoo D, Policy issues in Elderly health and Long-Term Care Policy. Health Welfare Forum, 2016; 34-48.
  2. Oh Y, Bae H, Kim Y. A study on physical and mental function affecting self-perceived health of older persons in Korea, Korean Gerontol Soc, 2006;26(3); 461-476.
  3. Park K, Gender Differences in the Life Satisfaction of Elderly, Korean Gerontol Soc, 2004;24(3);13-29.
  4. Maddox GL, Douglass E,B. Self assessment of health: a longitudinal study of elderly subjects, J Health Soc Behav, 1973;14(1);87-93. https://doi.org/10.2307/2136940
  5. Kim I, Bahk J, Yon S, Khang Y. Income gaps in self-rated poor health and its association with life expectancy in 245 districts of Korea. Epidemiol Health, 2007;39;e2017011
  6. Jung M, Viswanath K. Does community capacity influence self-rated health? Multilevel contextual effects in Seoul, Korea. Soc Sci Med, 2013;77; 60-69. https://doi.org/10.1016/j.socscimed.2012.11.005
  7. Bardage C, Pluijim S, Pedersen N, Deeg D, Jylha M, Blumstein T, Otero A. Self-rated health among older adults: a cross-national comparison. Eur J Ageing, 2005;2(2): 149-158. https://doi.org/10.1007/s10433-005-0032-7
  8. Bombak A, E. Self-Rated Health and Public Health: A Critical Perspective. Front Public Health, 2013;1:15.
  9. Kang H, Cho Y. Socioeconomic Status, Social integration and health inequalities of Elderly Koreans, Korean J Soc, 2007;41(4);164-201.
  10. Mossey J, M, Shapiro E,S. Self-rated health: A predictor of mortality among the elderly, Am J Public Health, 1982;72(8);800-808. https://doi.org/10.2105/AJPH.72.8.800
  11. Ponzetto M, Maero B, Marina P, Rosato R, Ciccone G et al. Risk factors for early and late mortality in hospitalized older patients: the continuing importance of functional status. J Gerontol A Biol Sci Med Sci, 2003;58;1049-1054. https://doi.org/10.1093/gerona/58.11.M1049
  12. He S, Craig B, Xu H, Covinsky K, Stallard E et al. Unmet need for ADL assistance is associated with mortality among older adults with mild disability, J Gerontol A Biol Soci Med Sci, 2015;70(9); 1128-1132. https://doi.org/10.1093/gerona/glv028
  13. Fernandez-Ruiz M, Guerra-Vales JM, Trincado R, Ferna ndez R, Medrano MJ et al. The ability of self-rated health to predict mortality among community-dwelling elderly individuals differs according to the specific cause of death: data from the NEDICES cohort. Gerontol, 2013;59(4); 368-377. https://doi.org/10.1159/000348781
  14. Fujiwara Y, Yoshida H, Amano H, Fkaya T, Liang, J et al. Predictors of improvement or decline in instrumental activities of daily living among community-dwelling older japanese, Gerontol, 2008; 54:373-380. https://doi.org/10.1159/000151221
  15. Tomioka K, Kurumatani N, Hosoi H. Self-rated health predicts decline in instrumental activities of daily living among high-functioning community-dwelling older people, Age Ageing, 2017;46: 265-227.
  16. Idler EL, Kasl SV. Self ratings of health: do they also predict change in functional ability? J Gerontol B Psychol Sci Soc Sci, 1995;50(6);S344-353.
  17. Giron, P. Time Trends in Self-Rated Health and Disability in Older Spanish People: Differences by Gender and Age. Iran J Public Health, 2016;45(3): 289-296.
  18. Yoo D, Yeo I. Relationship among subjective health recognition, activities of daily living, exercise capability and social support on the elderly. Korean J Physic Edu, 2013;52(1):351-361.
  19. Kim J, Lee S, Lee S. The relationship between health behaviors, health status, activities of daily living and health-related quality of life in the elderly, Korean Gerontol Soc, 2010;30(2): 471-484.
  20. Choi Y. Is subjective health reliable as a proxy variable for true health? Health Soc Welfare Review, 2006;36(4):431-459.
  21. Song M, Lim W, Kim J. Gender based health inequality and impacting factors, Korean J Women Health Nurs, 2015;21(2): 150-159. https://doi.org/10.4069/kjwhn.2015.21.2.150
  22. An O, Lee J. Self-rated health among older adults: a cross-national comparison. J Korean Acad Fundam Nurs, 2008;15(3): 284-290.
  23. Chung K, Oh Y, Kang E, Kim J, Sunwoo D, Oh M et al. 2014 Survey of living conditions and welfare needs of Korean elder persons, 2014, Ministry of Health and Welfare, Korea institute for Health and Social Affairs.
  24. Borg V, Kristensen TS. Social class and self-rated health: can the gradient be explained by differences in life style or work environment? Soc Sci Med, 2000;51(7);1019-1030. https://doi.org/10.1016/S0277-9536(00)00011-3
  25. Borrell C, Muntaner C, Benach J, Artazcoz L. Social class and self-reported health status among men and women; what is the role of work organization, household material standards and household labour? Soc Sci Med, 2004,58(10); 1869-1887. https://doi.org/10.1016/S0277-9536(03)00408-8
  26. Antonovosky A. The salutogenic model as a theory to guide health promotion, Health Promotion Int, 1996;11-18.
  27. Murtagh K, Huber H. Gender differences in physical disability among an elderly cohort. Am J Public Health. 2004;Aug;94(8):1406-11. https://doi.org/10.2105/AJPH.94.8.1406
  28. Kim J. Women and health in Korea: Women as medical service beneficiaries and providers. Ewha Med J, 2017;40(3):108-114. https://doi.org/10.12771/emj.2017.40.3.108
  29. Takeda, Y, Kawachi I, Yamagata Z, Hashimoto S, Matsumura Y, Oguri S et al. Multigenerational family structure in Japanese society: Impacts on stress and health behaviors among women and men. Soc Sci Med, 2004;59;69-81. https://doi.org/10.1016/j.socscimed.2003.10.003
  30. Benyanini Y, Leventhal EA, Leventhal H. Gender differences in processing information for making self-assessments of health, Psychosom Med, 2000;62(3);354-364. https://doi.org/10.1097/00006842-200005000-00009
  31. Assari S. Gender differences in the predictive role of self-rated health on short-term risk of mortality among older adults. SAGE Open Med. 2006;4;1-8.
  32. Shin H, Shin M, Rhee J. Gender differences in the association between self-rated health and hypertension in a Korean adult population. BMC Public Health, 2012;12:134 https://doi.org/10.1186/1471-2458-12-134