Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 11:77:2.
doi: 10.1186/s13690-018-0326-9. eCollection 2019.

Contribution of chronic diseases to educational disparity in disability in France: results from the cross-sectional "disability-health" survey

Clémence Palazzo  1   2 , Renata T C Yokota  2   3 , Jean Tafforeau  2 , Jean-François Ravaud  4 , Emmanuelle Cambois  5 , Serge Poiraudeau  6 , Herman Van Oyen  2   7 , Wilma J Nusselder  1
Affiliations

Contribution of chronic diseases to educational disparity in disability in France: results from the cross-sectional "disability-health" survey

Clémence Palazzo et al. Arch Public Health. .

Abstract

Background: This study aimed 1) to assess whether the contribution of chronic conditions to disability varies according to the educational attainment, 2) to disentangle the contributions of the prevalence and of the disabling impact of chronic conditions to educational disparities.

Methods: Data of the 2008-09 Disability Health Survey were examined (N = 23,348). The disability indicator was the Global Activity Limitation Indicator (GALI). The attribution method based on an additive hazard model was used to estimate educational differences in disabling impacts and in the contributions of diseases to disability. Counterfactual analyses were used to disentangle the contribution of differences in disease prevalence vs. disabling impact.

Results: In men, the main contributors to educational difference in disability prevalence were arthritis (contribution to disability prevalence: 5.7% (95% CI 5.4-6.0) for low-educated vs. 3.3% (3.0-3.9) for high-educated men), spine disorders (back/neck pain, deformity) (3.8% (3.6-4.0) vs. 1.9% (1.8-2.1)), chronic obstructive pulmonary diseases (2.4% (2.3-2.6) vs. 0.6% (0.5-0.7)) and ischemic heart /peripheral artery diseases (4.1% (3.9-4.3) vs. 2.4% (2.2-3.0)). In women, arthritis (9.5% (9.1-9.9) vs. 4.5%, (4.1-5.2)), spine disorders (4.5% (4.3-4.7) vs. 2.1% 1.9-2.3) and psychiatric diseases (3.1% (3.0-3.3) vs. 1.1% (1.0-1.3)) contributed most to education gap in disability. The educational differences were equally explained by differences in the disease prevalence and in their disabling impact.

Conclusions: Public health policies aiming to reduce existing socioeconomic disparities in disability should focus on musculoskeletal, pulmonary, psychiatric and ischemic heart diseases, reducing their prevalence as well as their disabling impact in lower socioeconomic groups.

Keywords: Chronic diseases; Disability; Educational attainment; Socioeconomic status.

PubMed Disclaimer

Conflict of interest statement

HVO is the editor in chief of the journal but he was blinded of the submission process. No other competing interest was declared.This study was planned as a research project. It was performed in collaboration with the French National Institute of Statistics. This study was declared of public interest by the CNIS (Conseil National d’Information Statistique) and was approved by the CNIL (Commission Nationale de l’Informatique et des Liberte’s, French law no. 78–17). According to the French law, written informed consent was not required for this type of study.Not applicable.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Prevalence of disability according to age groups and educational level for men and women
Fig. 2
Fig. 2
Age-standardized absolute contribution of chronic conditions and background to the prevalence of disability according to educational level
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Krahn GL, Walker DK, Correa-De-Araujo R. Persons with disabilities as an unrecognized health disparity population. Am J Public Health. 2015;105(Suppl 2):S198–S206. - PMC - PubMed
    1. Hosseinpoor AR, Stewart Williams JA, Gautam J, Posarac A, Officer A, Verdes E, et al. Socioeconomic inequality in disability among adults: a multicountry study using the world health survey. Am J Public Health. 2013;103:1278–1286. - PMC - PubMed
    1. Klijs B, Nusselder WJ, Looman CW, Mackenbach JP. Educational disparities in the burden of disability: contributions of disease prevalence and disabling impact. Am J Public Health. 2014;104:e141–e148. - PMC - PubMed
    1. Sainio P, Martelin T, Koskinen S, Heliövaara M. Educational differences in mobility: the contribution of physical workload, obesity, smoking and chronic conditions. J Epidemiol Community Health. 2007;61:401–408. - PMC - PubMed
    1. Cambois E, Solé-Auró A, Brønnum-Hansen H, Egidi V, Jagger C, Jeune B, et al. Educational differentials in disability vary across and within welfare regimes: a comparison of 26 European countries in 2009. J Epidemiol Community Health. 2016;70:331–338. - PubMed

LinkOut - more resources