Socio-economic inequalities in health-related quality of life and the contribution of cognitive impairment in Australia: A decomposition analysis

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Social Science & Medicine Pub Date : 2024-10-04 DOI:10.1016/j.socscimed.2024.117399

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Abstract

Background

The distributional effects of cognitive impairment on inequalities in health-related quality of life (HRQoL) are not well studied. This relationship has not been studied in any Australian health inequality literature. Therefore, this study aims to examine how cognitive impairment affects the distribution of HRQoL across various socio-economic classes amongst older Australians.

Methods

Data for this study was collected from the Household, Income and Labour Dynamics in Australia (HILDA) survey. The final analysis consisted of 5,247 and 5,614 unique individuals from wave 2012 and wave 2016, respectively. An ordinary least squares (OLS) regression model was used to investigate the relationship between cognitive impairment and HRQoL. Additionally, the Wagstaff-Doorslaer-Watanabe standard concentration index was used to examine socioeconomic inequality in HRQoL.

Results

The findings revealed pro-rich inequalities in HRQoL, as indicated by the concentration indices of 0.029 and 0.025 for wave 12 and wave 16, respectively. Additionally, the results showed that mild cognitive impairment accounted for 7.60% and 9.03%, respectively, of pro-rich socioeconomic inequality in HRQoL in 2012 and 2016.

Conclusion

People from lower socioeconomic status (SES) groups tend to have lower HRQoL compared to those from higher SES. This leads to a greater disparity in HRQoL based on SES. Cognitive impairment positively contributed to this inequality in HRQoL. Therefore, it is critical to incorporate cognitive impairment into the design of interventions to reduce socioeconomic inequality in HRQoL.

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澳大利亚与健康有关的生活质量方面的社会经济不平等以及认知障碍的影响：分解分析。

背景：认知障碍对健康相关生活质量（HRQoL）不平等的分布影响尚未得到充分研究。澳大利亚的健康不平等文献也没有研究过这种关系。因此，本研究旨在探讨认知障碍如何影响不同社会经济阶层澳大利亚老年人的 HRQoL 分布：本研究的数据来自澳大利亚家庭、收入和劳动力动态调查（HILDA）。最终分析包括来自2012年和2016年的5247和5614名独特个体。研究人员使用普通最小二乘法（OLS）回归模型来研究认知障碍与 HRQoL 之间的关系。此外，研究还使用了Wagstaff-Doorslaer-Watanabe标准浓度指数来考察HRQoL中的社会经济不平等现象：结果：研究结果表明，第 12 波和第 16 波的集中指数分别为 0.029 和 0.025，表明在 HRQoL 方面存在亲富不平等现象。此外，结果显示，轻度认知障碍在 2012 年和 2016 年的 HRQoL 中分别占 7.60% 和 9.03%：结论：与社会经济地位较高的人群相比，社会经济地位较低人群的 HRQoL 往往较低。这导致基于社会经济地位的 HRQoL 差异更大。认知障碍对这种 HRQoL 的不平等起到了积极作用。因此，在设计干预措施以减少 HRQoL 中的社会经济不平等时，将认知障碍纳入其中至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

9.10

自引率

5.60%

发文量

762

审稿时长

38 days

期刊介绍： Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.