A Study On The Relationship Between Socioeconomic Status And The Equity Of The Elderly Health Status

Objective:Through the survey of the elderly health status in Suzhou, Jiangsu Province, weaimed to explore the status of chronic illnesses，the activity of daily life (ADL)，mentalhealth condition, behavior and lifestyle and activity life expectancy (ALE) of theelderly， research the equity of health among the elderly with different socioeconomicstatus (SES)， and provide the basis for the future health reform and allocation of healthresources in Suzhou.Methods:4635people aged over60years, from the selected8communities in Suzhou, weresurveyed by using multi-stage stratified random cluster sampling method. The effectivequestionnaires were4624, a returning rate of95.7%. All the data were input into thedatabase of Epidata3.02, and analysed by using the statistical software of SPSS17.0,according to related health statistics method and sociological theory. The statisticalmethods included general description, t-test, and Chi-square test methods to analyze theelderly condition of chronic illnesses, ADL, mental health condition, behavior andlifestyle. In order to research the health equality of the elderly, the software of Excel2003was used to calculate some indexes (including the range, population attributeproportion and concentration index).Results:1. The rate of chronic diseases for the elderly in Suzhou was69.8%,68.4%formale, and71.0%for female. The top rates among chronic diseases were hypertension(51.3%), diabetes mellitus (14.0%), and cardiopathy (11.2%). People with a chronicdisease were1850, accounting for57.4%of the chronic patients, people with two chronic diseases were910, accounting for28.2%, and people with three or more chronicdiseases were466, accounting for14.4%. The equality of chronic diseases is wellbetween the elderly with different SES. Inequality exists in different kinds of chronicdiseases, in three top diseases, the equality of hypertension was the best, and the nextwas diabetes mellitus, the equality of cardiopathy was the worst. Inequality also existsin different number of chronic diseases. The kinds of disease were more, the equal wasworse.2. The rate of ADL problems for the elderly was10.6%,9.4%for male, and13.0%for female). There was significant difference in different genders (P<0.05). Theinequality of ADL problems exists in the elderly with different gender and different SES,the rate of ADL problems tends to the elderly with lower SES. The ADL problems formen that related to income and cultural levels were more inequal than women. But therate of women that related to occupation was more inequal than men. And the influencedegree of income and culture levels to the equality of ADL problems was bigger thanoccupation.3. The rate of depression in the elderly was44.6%,43.2%for male, and45.7%forfemale. People with mild, moderate and severe depressive symptoms were1202,812and46respectively, accounting for58.3%,39.5%and2.2%. The inequality ofdepression symptom exists in the elderly with different gender and different SES, therate of depression symptom tends to the elderly with lower SES. The depressionsymptom rate of men that related to the indicators of SES was more inequal thanwomen. Inequality also exists in people with different degree of depression severity.The depression was more serious, the equal was worse.4. The rate of smoking and drinking were37.8%and33.5%for the elderly men.The inequality of smoking and drinking existed in the elderly with different SES, andboth of the rates tended to the elderly with lower SES. The influence degree of incometo the equality of smoking and drinking were bigger than other indicators of SES5. The impact of ALE was different by different SES and different gender. To themen, education had the greatest impact on ALE and with smaller age-ralated changes.The difference was basically maintained at about1year. To the women, occupation hadthe greatest impact on ALE and the difference was about2years, and the next wasculture level, the smallest impact was income.Conclusions: 1. The elderly with different SES indicators in Suzhou was different in healthstatus. Inequality of health status existed in people with different SES. All of the ratestend to the elderly with lower SES except the rate of chronic diseases.2. The influence degree of SES to the equality of health status was different. Theequality of chronic diseases was the best, and the equality of ADL problems, depressionand behavior of lifestyle were worse for the eldlerly.3. Although the rate of depression symptoms of male was slightly lower than thefemale, the equality of depression symptoms was worse than female. The resultssuggested that we should put stress on the mental health of the male elderly populationwith lower SES.4. The men’ life quality was better than women’. To the famale, occupation hadbigger impact on ALE than male, and to the male, culture level had bigger impact onALE than female.