노인의 일상생활수행능력 관련변인 메타분석: 건강형평성 관점에서 사회경제적 지위, 심리사회적 요인 중심으로 = A Meta-Analysis of the Variables Related with Activities of Daily Living among Older Adults: focused on Socioeconmic Status and Psychosocial factor from Perspectives on Health Equity

다국어 초록 (Multilingual Abstract)

The purpose of this study was to carry out from a health equity perspective a meta-analysis of the effects of socioeconomic status and psychosocial factors on activities of daily living among older adults. We employed meta-regression analysis to examine whether those effects have been affected by certain moderators. We analysed a total of 377 effect sizes computed from 56 studies published in Korea before 2014. Our meta-analysis revealed that psychosocial factors have more effects than socioeconomic status on activities of daily living among the elderly. In the socioeconomic status variables, “occupation” showed the largest effect size, while among the psychological variables, “social activities” had the largest effect size. Meta-regression reported that the effect of “functional support” on the elderly was larger for women and rural dwellers. The effect of “earned income” was larger for those living in small-and medium-sized cities than for the rest. The more recent the survey, the larger the effect size of non-family` support. The findings suggest the following. Firstly, social support should be provided first in the elderly. Secondly, infrastructures need to be expanded to better support the elderly in their work and social activities. Third, each of social policy supports should be enforced according to gender, residential area and survey date.

참고문헌 (Reference)

1 정여진, "한국인의 성공적 노화 관련변인에 관한 메타분석" 한국노년학회 34 (34): 781-797, 2014

2 임소영, "한국 노인의 사회관계망 유형과 건강상태의 관계: 남녀집단별 분석" 한국노인복지학회 (59) : 281-308, 2013

3 Littell, J. H., "체계적 문헌고찰과 메타분석" 수문사 2011

4 전소자, "일개지역 노인의 일상생활수행능력과 우울에 관한 연구" 37 : 53-63, 2011

5 김명숙, "여가활동이 노인건강에 미치는 영향과가족지지의 매개역할" 한국노인복지학회 (60) : 35-54, 2013

6 황성동, "알기 쉬운 메타분석의 이해" 학지사 2014

7 조유향, "소안도의 고령화와 노인의 건강상태" 5 (5): 179-193, 2003

8 남상호, "소득분위별 소득·자산의 결합분포 분석 : 중·고령자 가구를 대상으로" 290 : 1-8, 2015

9 엄선희, "소득계층에 따른 보건의료의 형평성:『한국노동패널』자료를 중심으로" 한국보건경제정책학회 16 (16): 35-61, 2010

10 박지용, "빈곤과 건강보험법" 2 (2): 72-101, 2013

11 윤태호, "보건의료개혁의 새로운 모색" 한울 아카데미 305-358, 2006

12 오성삼, "메타분석의 이론과 실제" 건국대학교 출판부 2002

13 백혜영, "노인복지관 이용노인의 사회적 지지가 심리적 복지감에 미치는 영향 : 여가활동 만족의 매개효과를 중심으로" 사회과학연구소 28 (28): 73-92, 2012

14 강이주, "노인들의 노동시장 참여형태와 동거유형이 건강수준 및 주관적 삶의 만족도에 미치는 영향 연구" 한국생활과학회 19 (19): 1031-1044, 2010

15 Schoeni, R. F., "Why is late life disability declining?" 86 (86): 47-89, 2008

16 Sen, A., "Why health equity?" 11 : 659-666, 2002

17 Braveman, P., "What is health equity: and how does a life-course approach take us further toward it?" 18 (18): 366-372, 2014

18 Baker, L., "Use of the internet and e-mail for health care information : results from a national survey" 289 : 2400-2406, 2003

19 Gallo, L. C., "Understanding the association between socioeconomic status and physical health: do negative emotions play a role?" 129 (129): 10-51, 2003

20 Martin, L. G., "Trends and inequalities in late-life health and functioning in England" 66 (66): 874-880, 2012

21 Aloe, A. M., "The synthesis of partial effect sizes" 4 (4): 390-405, 2013

22 Grundy, E., "The socioeconomic status of older adults: how should we measure it in studies of health inequalities?" 55 : 895-904, 2001

23 Davies, P., "The relevance of systematic reviews to educational policy and practice" 26 (26): 365-378, 2000

24 Adamson, J. A., "The psychosocial versus material hypothesis to explain observed inequality in disability among older adults:data from the West of Scotland Twenty-07 Study" 60 (60): 974-980, 2006

25 Wilkinson, R. G., "The impact of inequality" 73 (73): 711-732, 2006

26 Cooper, H., "The handbook of research synthesis and meta-analysis" Russell Sage Foundation 2010

27 Whitehead, M., "The concepts and principles of equity and health"

28 Cohen, J., "Statistical power analysis for the behavioral sciences" Routledge 1988

29 Matthews, R. J., "Socioeconomic factors associated with the onset of disability in older age : a longitudinal study of people aged 75 years and over" 61 (61): 1567-1575, 2005

30 Golden, J., "Social support network structure in older people: underlying dimensions and association with psychological and physical health" 14 (14): 280-290, 2009

31 Cobb, S., "Social support as a moderator of life stress" 38 (38): 300-314, 1976

32 Avlund, K., "Social relations as determinant of onset of disability in aging" 38 : 85-89, 2004

33 Wahrendorf, M., "Social productivity and well-being of older people: baseline results from the SHARE study" 3 (3): 67-73, 2006

34 de Leon, C. F. M., "Social engagement and disability in a community population of older adults : the New Haven EPESE" 157 : 633-642, 2003

35 Graham, H., "Social determinants and their unequal distribution : clarifying policy understandings" 82 (82): 101-124, 2004

36 Link, B. G., "Social conditions as fundamental causes of disease" 35 (35): 80-94, 1995

37 Rothstein, H. R., "Publication bias as a threat to the validity of meta-analytic results" 4 (4): 61-81, 2008

38 Lipsey, M. W., "Practical meta-analysis" Sage Publications 2001

39 Macintyre, S., "Place effects on health: how can we conceptualise, operationalise and measure them?" 55 (55): 125-139, 2002

40 Schoeni, R. F., "Persistent and growing socioeconomic disparities in disability among the elderly : 1982-2002" 95 : 2065-2070, 2005

41 McMunn, A., "Participation in socially-productive activities, reciprocity and wellbeing in later life : baseline results in England" 29 (29): 765-782, 2009

42 Kawachi, I., "Neighborhoods and health" Oxford University Press 2003

43 Sarah Dury, "Municipality and Neighborhood Influences on Volunteering in Later Life" SAGE Publications 35 (35): 601-626, 2016

44 Pickett, K. E., "Multi-level analyses of neighbourhood socioeconomic context and health outcomes : a critical review" 55 (55): 111-122, 2001

45 Cheung, M. W. L., "Meta-analysis: a brief introduction"

46 Coppin, A. K., "Low socioeconomic status and disability in old age : evidence from the Inchianti study for the medicating role of physiological impairments" 61 : 86-91, 2006

47 Tommi Sulander, "Longitudinal changes in functional capacity: effects of socio-economic position among ageing adults" Springer Nature 11 (11): 78-, 2012

48 Macleod, J., "Is subjective social status a more important determinant of health than objective social status? Evidence from a prospective observational study of Scottish men" 61 (61): 1916-1929, 2005

49 Borenstein, M., "Introduction to meta-analysis" A Jon Wiley & Sons 2009

50 Pinquart, M., "Influences of socioeconomic status, social network, and competence on subjective well-being in later life : a meta-analysis" 15 (15): 187-224, 2000

51 Lynch, J., "Income inequality & mortality : importance to health of individual income, psychosocial environment, or material conditions" 320 (320): 1200-1204, 2000

52 Roehrig, B., "How many and which items of activities of daily living(ADL)and instrumental activities of daily living(IADL)are necessary for screening" 62 (62): 164-171, 2007

53 Gallo, W. T., "Health effects of involuntary job loss among older workers findings from the health and retirement survey" 55 (55): S131-S140, 2000

54 Braveman, P., "Health disparities and health equity: the issue is justice" 101 (101): 149-155, 2011

55 Braveman, P., "Health disparities and health equity : concepts and measurement" 27 : 167-194, 2006

56 DiMatteo, M. R., "Health beliefs, disease severity, and patient adherence : a meta-analysis" 45 (45): 521-528, 2007

57 Minkler, M., "Gradient of disability across the socioeconomic spectrum in the united states" 355 (355): 695-703, 2006

58 McDonough, P., "Gender and health : Reassessing patterns and explanations" 52 (52): 547-559, 2001

59 Marmot, M. G., "From black to acheson : two decades of concern with inequalities in health : a celebration of the 90th birthday of professor Jerry Morris" 30 (30): 1165-1171, 2001

60 Hunter, J. E., "Fixed effects vs. random effects meta analysis models : implications for cumulative research knowledge" 8 (8): 275-292, 2000

61 Zimmer, Z., "Education, income, and functional limitation transitions among american adults : contrasting onset and progression" 32 (32): 1089-1097, 2003

62 de Leon, C. F. M., "Disability as a function of social networks and support in elderly african americans and whites: The Duke EPESE 1986-1992" 56 (56): S179-S190, 2001

63 Braveman, P., "Defining equity in health" 57 (57): 254-258, 2003

64 Cockerham, W. C., "Conceptualizing contemporary health lifestyles" 38 (38): 321-342, 1997

65 Lustig, D. C., "Causal relationships between poverty and disability" 50 (50): 194-202, 2007

66 Cavanaugh, J. C., "Adult development and aging" Thomson Learning 2006

67 Duval, S., "A nonparametric"trim and fill"method of accounting for publication bias in meta-analysis" 95 (95): 89-98, 2000

68 Kawachi, I., "A Glossary for health inequalities" 56 (56): 647-652, 2002