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      Gender, childhood and adult socioeconomic inequalities in functional disability among Chinese older adults

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          Abstract

          Background

          Gender difference and life-course socioeconomic inequalities in functional disability may exist among older adults. However, the association is less well understood among Chinese older population. The objective is to provide empirical evidences on this issue by exploring the association between gender, childhood and adult socioeconomic inequalities in functional disability.

          Methods

          Data from the 2013 wave of the China Health and Retirement Longitudinal Study (CHARLS) was utilized. Functional disability was assessed by the activities of daily living (ADL) and instrumental activities of daily living (IADL). Childhood socioeconomic status (SES) was measured by birthplace, father’s education and occupation. Adult SES was measured in terms of education and household income. Multivariate logistic regressions were conducted to assess the association between gender, childhood and adult SES and functional disability.

          Results

          Based on a sample of 18,448 older adults aged 45 years old and above, our results showed that the prevalence of ADL and IADL disability was higher among women than men, but gender difference disappeared after adult SES and adult health were controlled. Harsh conditions during childhood were associated with functional disability but in multivariate analyses only father’s education was associated with IADL disability (OR for no education = 1.198; 95% CI = 1.062–1.353). Current SES such as higher education and good economic situation are protective factors of functional disability.

          Conclusions

          Childhood and adult SES were both related to functional disability among older adults. Our findings highlight the need for policies and programs aimed at decreasing social inequalities during childhood and early adulthood, which could reduce socioeconomic inequalities in functional disability in later life.

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          Most cited references34

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          Dichotomous or categorical response? Analysing self-rated health and lifetime social class.

          Self-rated health is a commonly used measure of health status, usually having three to five categories. The measure is often collapsed into a dichotomous variable of good versus less than good health. This categorization has not yet been justified. Using data from the 1958 British birth cohort, we examined the relationship between socioeconomic conditions, indicated by occupational class at four ages, and self-rated health. Results obtained for a dichotomous variable using logistic regression were compared with alternative methods for ordered categorical variables including polytomous regression, cumulative odds, continuation ratio and adjacent categories models. Findings concerning the relationship between socioeconomic position and self-rated health yielded by a logistic regression model were confirmed by alternative statistical methods which incorporate the ordered nature of self-rated health. Similarity of results was found regarding size and significance of main effects, type of association and interactive effects.
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            The Impact of Childhood and Adult SES on Physical, Mental, and Cognitive Well-Being in Later Life

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              Life course health development: an integrated framework for developing health, policy, and research.

              The life course health development (LCHD) framework organizes research from several fields into a conceptual approach explaining how individual and population health develops and how developmental trajectories are determined by interactions between biological and environmental factors during the lifetime. This approach thus provides a construct for interpreting how people's experiences in the early years of life influence later health conditions and functional status. By focusing on the relationship between experiences and the biology of development, the LCHD framework offers a better understanding of how diseases occur. By suggesting new strategies for health measurement, service delivery, and research, as well as for improving health outcomes, this framework also supports health care-purchasing strategies to develop health throughout life and to build human health capital.
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                Author and article information

                Contributors
                xiaochaihu589@163.com
                86-531-88383870 , wangjiannan@sdu.edu.cn
                stephen.nicholas@newcastle.edu.au
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                2 September 2017
                2 September 2017
                2017
                : 16
                : 165
                Affiliations
                [1 ]ISNI 0000 0000 9530 8833, GRID grid.260483.b, School of Public Health, Nantong University, ; 9 Seyuan Road, Nantong, 210029 Jiangsu People’s Republic of China
                [2 ]ISNI 0000 0004 1761 1174, GRID grid.27255.37, School of Public Health, Shandong University, ; 44 Wenhuaxi Road, Jinan, 250012 Shandong People’s Republic of China
                [3 ]ISNI 0000 0001 0193 3951, GRID grid.412735.6, School of Management and School of Commerce, Tianjin Normal University, ; West Bin Shui Avenue, Tianjin, 300074 People’s Republic of China
                [4 ]ISNI 0000 0001 2301 6433, GRID grid.440718.e, Guangdong Research Institute for International Strategies, Guangdong University of Foreign Studies, ; 2 Baiyun North Avenue, Baiyun, Guangzhou, Guangdong, 510420 People’s Republic of China
                [5 ]GRID grid.443245.0, School of International Business, Beijing Foreign Studies University, ; 19 North Xisanhuan Avenue, Haidian, Beijing, 100089 People’s Republic of China
                [6 ]ISNI 0000 0000 8831 109X, GRID grid.266842.c, University of Newcastle, ; Newcastle, NSW 2308 Australia
                Article
                662
                10.1186/s12939-017-0662-3
                5581446
                28865465
                4d1b44a4-e1bb-43ec-b359-0e28b74211a8
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 March 2017
                : 24 August 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 71603136
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100005054, Nantong University;
                Award ID: 03080878
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Health & Social care
                gender,socioeconomic status,inequality,functional disability
                Health & Social care
                gender, socioeconomic status, inequality, functional disability

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