Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective
Abstract
:1. Introduction
2. Methods
2.1. Data Source
2.2. Ethics Approval
2.3. Outcomes
2.4. Exposure of Interest
2.5. Other Covariates
2.6. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Adulthood Factors | Number of People | Percentage | Childhood Factors | Number of People | Percentage |
---|---|---|---|---|---|
Age group | Hunger experience | ||||
0-Age 45–54 | 2159 | 27.9% | 0-None of the three periods | 2192 | 28.3% |
1-Age 55–64 | 3068 | 39.7% | 1-Period 1, any one of the three periods | 2650 | 34.3% |
2-Age 65–74 | 1910 | 24.7% | 2-Period 2, any two of the three periods | 1265 | 16.4% |
3-Age ≥ 75 | 597 | 7.7% | 3-Period 3, all of the three periods | 1627 | 21.0% |
Gender | Vaccine | ||||
0-Female | 4109 | 53.1% | 0-No | 1244 | 16.1% |
1-Male | 3625 | 46.9% | 1-Yes | 6490 | 83.9% |
Marriage | Daily medical source | ||||
0-Married | 6804 | 88.0% | 0-No | 895 | 11.6% |
1-Divoced | 930 | 12.0% | 1-Yes | 6839 | 88.4% |
Hukou | Childhood health | ||||
0-Agricultural hukou | 6012 | 77.7% | 0-Much healthier | 1173 | 15.2% |
1-Non-agricultural hukou | 1722 | 22.3% | 1-Somewhat healthier | 1428 | 18.5% |
Urban | 2-Average | 3991 | 51.6% | ||
0-No | 4831 | 62.5% | 3-Less healthy | 675 | 8.7% |
1-Yes | 2903 | 37.5% | 4-Much less healthy | 467 | 6.0% |
Education level | |||||
0-Illiteracy | 1988 | 25.7% | |||
1-Primary school | 3354 | 43.4% | |||
2-Middle school | 1542 | 19.9% | |||
3-High school | 850 | 11.0% | |||
Insurance coverage | |||||
0-Non-coverage | 225 | 2.9% | |||
1-Basic health insurance | 7150 | 92.5% | |||
2-Business health insurance | 359 | 4.6% | |||
Ethnic group | |||||
0-Minority ethnics | 628 | 8.1% | |||
1-Han ethnic | 7,106 | 91.9% | |||
Alcohol consumption | |||||
0-Yes | 5204 | 67.3% | |||
1-No | 2530 | 32.7% | |||
Tobacco consumption | |||||
0-No | 4960 | 64.1% | |||
1-Yes | 2774 | 35.9% | |||
Party member | |||||
0-No | 6889 | 89.1% | |||
1-Yes | 845 | 10.9% | |||
Household size | |||||
0- members 1–2 | 491 | 6.4% | |||
1- members 3–4 | 4170 | 53.9% | |||
2- members 5–6 | 2099 | 27.1% | |||
3- members >=7 | 974 | 12.6% |
Quantiles of Economic Status | ADL Disability | ADL Score | IADL Disability | IADL Score | ||||
---|---|---|---|---|---|---|---|---|
Frequency | Percentage | Mean | Std. Dev. | Frequency | Percentage | Mean | Std. Dev. | |
Quantile_1 (Poorest) # | 388 | 25.08 | 0.749 | 1.987 | 385 | 24.89 | 1.034 | 2.354 |
Quantile_2 (Poorer) | 349 | 22.56 | 0.644 | 1.835 | 317 | 20.49 | 0.743 | 1.999 |
Quantile_3 (Middle) | 301 | 19.46 | 0.500 | 1.477 | 298 | 19.26 | 0.633 | 1.714 |
Quantile_4 (Richer) | 284 | 18.36 | 0.473 | 1.455 | 235 | 15.19 | 0.548 | 1.709 |
Quantile_5 (Richest) | 259 | 16.75 | 0.462 | 1.530 | 254 | 16.43 | 0.597 | 1.828 |
Overall | 1581 | 20.44 | 0.566 | 1.674 | 1,489 | 19.25 | 0.711 | 1.943 |
Concentration Index (CI) | −0.085 | −0.109 | −0.095 | −0.120 |
Factors | ADLs Disability | ADLs Score | IADLs Disability | IADLs Score | ||||
---|---|---|---|---|---|---|---|---|
dF/dx | Std. Err. | dF/dx | Std. Err. | dF/dx | Std. Err. | dF/dx | Std. Err. | |
Family consumption | ||||||||
Quantile_2 (Poorer) | −0.007 | 0.014 | −0.130 | 0.101 | −0.023 | 0.015 | −0.320 *** | 0.123 |
Quantile_3 (Middle) | −0.025 ** | 0.012 | −0.307 *** | 0.105 | −0.016 | 0.013 | −0.357 *** | 0.104 |
Quantile_4 (Richer) | −0.020 | 0.022 | −0.313 *** | 0.108 | −0.046 *** | 0.016 | −0.396 ** | 0.161 |
Quantile_5 (Richest) | −0.020 | 0.012 | −0.263 ** | 0.112 | −0.017 | 0.015 | −0.344 *** | 0.126 |
Age group | ||||||||
55–64 | 0.054 *** | 0.015 | 0.500 *** | 0.089 | 0.047*** | 0.013 | 0.389 *** | 0.139 |
65–74 | 0.136 *** | 0.017 | 0.828 *** | 0.101 | 0.127*** | 0.016 | 0.876 *** | 0.140 |
≥75 | 0.240 *** | 0.036 | 1.266 *** | 0.148 | 0.253*** | 0.029 | 1.492 *** | 0.145 |
Household size | ||||||||
3–4 | −0.002 | 0.022 | 0.035 | 0.158 | 0.019 | 0.027 | 0.244 | 0.202 |
5–6 | −0.017 | 0.024 | −0.092 | 0.161 | 0.026 | 0.031 | 0.251 | 0.202 |
≥7 | 0.010 | 0.026 | 0.023 | 0.178 | 0.012 | 0.033 | 0.260 | 0.187 |
Male | −0.042 *** | 0.014 | −0.074 | 0.092 | −0.028 * | 0.016 | 0.094 | 0.106 |
Marriage | 0.024 * | 0.015 | 0.005 | 0.117 | 0.002 | 0.017 | −0.099 | 0.105 |
Hukou | −0.005 | 0.017 | −0.026 | 0.107 | −0.029* | 0.015 | −0.121 | 0.121 |
Urban | −0.032 | 0.021 | −0.233*** | 0.087 | −0.016 | 0.016 | −0.072 | 0.116 |
Education level | ||||||||
Primary school | −0.012 | 0.011 | −0.084 | 0.086 | −0.033 *** | 0.011 | −0.383 *** | 0.074 |
Middle school | −0.046 ** | 0.019 | −0.159 | 0.112 | −0.045 ** | 0.017 | −0.412 *** | 0.153 |
High school and above | −0.074 *** | 0.021 | −0.579 *** | 0.146 | −0.086 *** | 0.014 | −0.735 *** | 0.106 |
Insurance coverage | ||||||||
Basic insurance | −0.021 | 0.025 | −0.150 | 0.190 | −0.035 | 0.028 | −0.049 | 0.230 |
Business insurance | −0.036 | 0.027 | −0.509** | 0.252 | −0.071** | 0.024 | −0.318 | 0.278 |
Ethnic group | 0.003 | 0.015 | −0.068 | 0.135 | −0.005 | 0.034 | −0.061 | 0.199 |
Alcohol consumption | −0.008 | 0.005 | −0.188 *** | 0.044 | −0.031 *** | 0.006 | −0.327 *** | 0.053 |
Tobacco consumption | −0.004 | 0.016 | 0.006 | 0.088 | 0.007 | 0.015 | 0.060 | 0.092 |
Party member | −0.044 *** | 0.015 | −0.199 * | 0.118 | −0.030 ** | 0.011 | −0.190 | 0.150 |
Hunger experience | ||||||||
Period 1 | 0.041 ** | 0.019 | 0.288 *** | 0.088 | 0.028 ** | 0.013 | 0.218 *** | 0.104 |
Period 2 | 0.039 ** | 0.020 | 0.117 | 0.106 | 0.037 * | 0.020 | 0.129 | 0.157 |
Period 3 | 0.054 *** | 0.021 | 0.309 *** | 0.100 | 0.050 *** | 0.016 | 0.325 *** | 0.119 |
Vaccine | −0.007 | 0.012 | −0.288 *** | 0.090 | −0.029 ** | 0.012 | −0.218 ** | 0.098 |
Daily medical source | −0.021 * | 0.012 | −0.030 | 0.102 | −0.041 *** | 0.014 | −0.124 | 0.093 |
Childhood health | ||||||||
Somewhat healthier | −0.004 | 0.018 | −0.054 | 0.114 | 0.006 | 0.014 | 0.007 | 0.105 |
Average | −0.014 | 0.011 | −0.237 ** | 0.096 | −0.002 | 0.014 | −0.122 *** | 0.090 |
Less healthy | −0.008 | 0.018 | −0.165 | 0.140 | 0.025 | 0.021 | 0.120 | 0.141 |
Much less healthy | 0.057 *** | 0.022 | 0.201 | 0.154 | 0.081 *** | 0.022 | 0.290 ** | 0.105 |
Factors | ADLs Disability | ADLs Score | IADLs Disability | IADLs Score | ||||
---|---|---|---|---|---|---|---|---|
Cont. | Percentage | Cont. | Percentage | Cont. | Percentage | Cont. | Percentage | |
Family consumption | ||||||||
Quantile_2 (Poorer) | 0.010 | −12.20 | 0.019 | −17.00 | 0.038 | −40.59 | 0.038 | −31.37 |
Quantile_3 (Middle) | −0.001 | 0.93 | −0.001 | 0.83 | −0.001 | 0.59 | −0.001 | 0.86 |
Quantile_4 (Richer) | −0.033 | 38.80 | −0.046 | 42.55 | −0.082 | 86.87 | −0.047 | 39.63 |
Quantile_5 (Richest) | −0.061 | 71.70 | −0.070 | 64.31 | −0.054 | 56.60 | -0.073 | 60.86 |
Age group | ||||||||
55–64 | −0.001 | 1.04 | −0.001 | 0.75 | −0.001 | 0.91 | −0.001 | 0.67 |
65–74 | −0.053 | 62.72 | −0.035 | 31.82 | −0.056 | 58.60 | −0.030 | 25.01 |
≥75 | −0.049 | 57.71 | −0.031 | 28.70 | −0.057 | 59.78 | −0.026 | 21.66 |
Household size | ||||||||
3–4 | 0.000 | 0.57 | 0.001 | −1.10 | 0.008 | −8.08 | 0.006 | −5.19 |
5–6 | 0.000 | −0.58 | 0.000 | −0.23 | −0.001 | 0.85 | 0.000 | 0.41 |
≥7 | −0.002 | 2.93 | −0.001 | 0.51 | −0.003 | 3.40 | −0.005 | 4.22 |
Male | −0.005 | 6.29 | −0.001 | 0.84 | −0.004 | 4.21 | 0.001 | −0.67 |
Marriage | −0.010 | 11.52 | 0.000 | 0.20 | −0.001 | 0.76 | 0.003 | −2.32 |
Hukou | −0.007 | 8.84 | −0.003 | 2.44 | −0.036 | 37.52 | −0.010 | 8.33 |
Urban | −0.033 | 38.84 | −0.022 | 20.11 | −0.017 | 18.33 | −0.006 | 4.64 |
Education level | ||||||||
Primary school | 0.004 | −4.46 | 0.002 | −2.15 | 0.011 | −11.41 | 0.009 | −7.92 |
Middle school | −0.022 | 25.73 | −0.007 | 6.23 | −0.023 | 24.63 | −0.014 | 11.77 |
High school and above | −0.052 | 61.00 | −0.035 | 31.82 | −0.070 | 73.56 | −0.035 | 29.51 |
Insurance coverage | ||||||||
Basic insurance | 0.004 | −4.39 | 0.003 | −2.34 | 0.006 | −6.83 | 0.001 | −0.59 |
Business insurance | −0.010 | 11.74 | −0.012 | 10.94 | −0.022 | 23.64 | −0.006 | 4.93 |
Ethnic group | −0.001 | 0.71 | 0.001 | −1.06 | 0.001 | −1.13 | 0.001 | −0.70 |
Alcohol consumption | −0.006 | 7.29 | −0.014 | 12.92 | −0.027 | 28.25 | −0.019 | 15.51 |
Tobacco consumption | 0.000 | 0.09 | 0.000 | −0.01 | 0.000 | −0.15 | 0.000 | 0.02 |
Party member | −0.017 | 20.31 | −0.007 | 6.67 | −0.013 | 13.74 | −0.006 | 4.70 |
Hunger experience | ||||||||
Period 1 | −0.003 | 3.27 | −0.002 | 1.71 | −0.002 | 2.20 | −0.001 | 1.20 |
Period 2 | 0.000 | −0.37 | 0.000 | −0.08 | 0.000 | −0.35 | 0.000 | −0.07 |
Period 3 | −0.012 | 14.73 | −0.007 | 6.55 | −0.013 | 13.33 | −0.006 | 4.76 |
Vaccine | −0.003 | 2.96 | −0.010 | 8.74 | −0.011 | 11.21 | −0.006 | 4.63 |
Daily medical source | −0.003 | 4.02 | 0.000 | 0.45 | −0.007 | 7.75 | −0.002 | 1.31 |
Childhood health | ||||||||
Somewhat healthier | −0.001 | 0.74 | −0.001 | 0.69 | 0.001 | −0.94 | 0.000 | −0.07 |
Average | 0.002 | −2.66 | 0.003 | −3.21 | 0.000 | −0.39 | 0.001 | −1.23 |
Less healthy | 0.000 | −0.12 | 0.000 | −0.16% | 0.000 | 0.32 | 0.000 | 0.15 |
Much less healthy | −0.003 | 3.40 | −0.001 | 0.98% | −0.004 | 4.66 | −0.001 | 1.02 |
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Hu, H.; Si, Y.; Li, B. Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective. Int. J. Environ. Res. Public Health 2020, 17, 2559. https://doi.org/10.3390/ijerph17072559
Hu H, Si Y, Li B. Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective. International Journal of Environmental Research and Public Health. 2020; 17(7):2559. https://doi.org/10.3390/ijerph17072559
Chicago/Turabian StyleHu, Han, Yafei Si, and Bingqin Li. 2020. "Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective" International Journal of Environmental Research and Public Health 17, no. 7: 2559. https://doi.org/10.3390/ijerph17072559