中国老年人社会经济地位与视力障碍的相关性

doi:10.19723/j.issn.1671-167X.2025.06.018

摘要/Abstract

摘要：

目的: 分析中国65岁及以上老年人的社会经济地位与视力障碍的相关性, 并比较2008-2018年的变化情况。方法: 使用2008年和2018年"中国老年人健康长寿影响因素调查"的横断面数据, 分别纳入12970名和9702名受访者。构建Logistic回归模型, 采用逐步进入法依次加入控制变量, 分析2008年和2018年中国老年人家庭收入、受教育程度、退休前职业与视力障碍之间的关联。结果: 2008年中国65岁及以上老年人视力障碍患病率为16.92%(95%CI: 15.91%~17.98%), 2018年该患病率上升至18.45%(95%CI: 17.41%~19.53%)。与低收入群体相比, 2008年高收入和中高收入群体患视力障碍的风险较低, 2018年仅中高收入群体患视力障碍的风险较低(OR=0.761, 95%CI: 0.603~0.961), 且差距缩小。与文盲相比, 2008年小学、初中及以上学历群体患视力障碍的风险较低, 2018年小学组与文盲组的差距增大, 初中及以上组与文盲组、小学组的差距缩小, 控制其他因素后, 初中及以上组的患病风险高于小学组(OR=0.691, 95%CI: 0.533~0.896;OR=0.592, 95%CI: 0.494~0.708)。与退休前从事专业技术或管理类职业群体相比, 2008年从事农业、家务劳动群体患视力障碍的风险较高, 2018年这一现象依旧存在(OR=1.707, 95%CI: 1.319~2.210;OR=1.925, 95%CI: 1.310~2.829), 且两个群体间的差距有所增大。结论: 中国老年人视力障碍的患病率在2008-2018年间有所上升, 家庭收入、受教育程度、退休前职业与视力障碍之间存在关联。2008-2018年, 不同家庭收入群体患视力障碍的风险差距缩小; 不同受教育程度群体的患病风险差距整体缩小, 但小学学历群体与文盲群体的差距增大; 退休前各职业类型群体的患病风险差距增大。

关键词: 视力障碍, 社会经济地位, 老年人, 相关性研究

Abstract:

Objective: To assess the association between socioeconomic status and vision impairment (Ⅵ) among Chinese elderly aged 65 years and above, and explore its comparison and contrast from 2008 to 2018. Methods: Using the 2008 and 2018 waves of cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which included 12970 and 9702 participants, respectively. Logistic regression models with a stepwise forward approach were employed to assess the association between the household income, educated level, job before retirement and Ⅵ. Results: In 2008, the prevalence of Ⅵ among the elderly aged 65 years and above in China was 16.92% (95%CI: 15.91%-17.98%), which increased to 18.45% (95%CI: 17.41%-19.53%) in 2018. In terms of household income, the highest and upper middle income groups had lower odds of Ⅵ compared with the lowest one in 2008. By 2018, only the upper middle had lower odds (OR=0.761, 95%CI: 0.603-0.961), with its disparity narrowing compared with 2008. For educated level, in 2008, individuals with primary school education, and those with junior high school education or above had lower odds of Ⅵ compared with illiterate individuals. By 2018, the disparity in Ⅵ between the illiterate individuals and those with primary school education widened, while the gap between the illiterate ones and those with junior high school education or above decreased. In addition, after controlling for other factors, the odds of Ⅵ for the individuals educated by junior high school and above was higher than for those educated by primary school (OR=0.691, 95%CI: 0.533-0.896; OR=0.592, 95%CI: 0.494-0.708). Regarding job before retirement, in 2008, compared with the professional, technical or managerial personnel, those engaged in agriculture or domestic work had higher odds of Ⅵ. In 2018, this disparity persisted (OR=1.707, 95%CI: 1.319-2.210; OR=1.925, 95%CI: 1.310-2.829), with the gaps widening compared with the reference group. Conclusion: The prevalence of Ⅵ among Chinese elderly increased from 2008 to 2018, with socioeconomic status, specifically household income, educated level, and job before retirement, demonstrating associations with Ⅵ. To be specific, the gap in the odds of Ⅵ across household income strata decreased from 2008 to 2018; disparities among different educated levels generally diminished, while the gap between illiterate individuals and ones educated by primary school widened; and job-before-retirement groups exhibited expanding disparities over time.

Key words: Vision disorders, Socioeconomic status, Aged, Correlational research

中图分类号:

R197.1

魏粤晖, 简伟研. 中国老年人社会经济地位与视力障碍的相关性[J]. 北京大学学报（医学版）, 2025, 57(6): 1136-1144.

Yuehui WEI, Weiyan JIAN. Association between socioeconomic status and vision impairment among Chinese elderly[J]. Journal of Peking University (Health Sciences), 2025, 57(6): 1136-1144.

图/表 4

表1

研究对象的基本特征"

Variables	Year 2008 (n=12 970), n (%)	Year 2018 (n=9 702), n (%)
Age/years
65-74	2 485 (19.16)	2 392 (24.65)
75-84	2 576 (19.86)	2 401 (24.75)
85 and above	7 909 (60.98)	4 909 (50.60)
Gender
Female	7 340 (56.59)	5 350 (55.14)
Male	5 630 (43.41)	4 352 (44.86)
Marital status
Others	8 255 (63.65)	5 167 (53.26)
Currently married	4 715 (36.35)	4 535 (46.74)
Household income quintile
Lowest	2 857 (22.03)	1 970 (20.31)
Lower middle	2 926 (22.56)	1 973 (20.34)
Middle	2 442 (18.83)	1 861 (19.18)
Upper middle	2 472 (19.06)	2 000 (20.61)
Highest	2 273 (17.53)	1 898 (19.56)
Educated level
Illiterate	8 024 (61.87)	4 678 (48.22)
Primary school	3 653 (28.16)	3 140 (32.36)
Junior high school and above	1 293 (9.97)	1 884 (19.42)
Job before retirement
Professional, technical or managerial personnel	956 (7.37)	1 084 (11.17)
Commercial, service or industrial worker	1 734 (13.37)	1 403 (14.46)
Self-employed	249 (1.92)	181 (1.87)
Agriculture	8 592 (66.25)	5 980 (61.64)
Houseworker	1 075 (8.29)	655 (6.75)
Military personnel	85 (0.66)	90 (0.93)
Never worked	86 (0.66)	143 (1.47)
Others	193 (1.49)	166 (1.71)
Residence
Rural	7 771 (59.92)	4 173 (43.01)
Urban	5 199 (40.08)	5 529 (56.99)
Location
East	5 202 (40.11)	4 554 (46.94)
Middle	3 200 (24.67)	2 166 (22.33)
West	3 510 (27.06)	2 514 (25.91)
North-east	1 058 (8.16)	468 (4.82)
Smoking
Never	8 610 (66.38)	6 688 (68.93)
Past or current	4 360 (33.62)	3 014 (31.07)
Drinking
Never	8 953 (69.03)	7 080 (72.97)
Past or current	4 017 (30.97)	2 622 (27.03)
Regular exercising
Never	7 812 (60.23)	5 919 (61.01)
Past or current	5 158 (39.77)	3 783 (38.99)
Fruit
Not often	7 704 (59.40)	5 222 (53.82)
Often	5 266 (40.60)	4 480 (46.18)

表1

表2

表3

表4

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Variables	Year 2008, n (%)^a	Year 2018, n (%)^a
Household income quintile
Lowest	1 237 (19.87)	774 (20.59)
Lower middle	1 218 (17.87)	807 (20.73)
Middle	981 (16.37)	654 (17.45)
Upper middle	881 (14.73)	728 (15.73)
Highest	802 (15.70)	611 (17.75)
	F=2.924^b, P=0.020	F=3.218^b, P=0.012
Educated level
Illiterate	3 855 (22.99)	2 388 (28.49)
Primary school	1 029 (14.24)	816 (14.82)
Junior high school and above	235 (9.53)	370 (13.47)
	F=46.582^b, P < 0.001	F=69.762^b, P < 0.001
Job before retirement
Professional, technical or managerial personnel	215 (11.69)	245 (12.37)
Commercial, service or industrial worker	499 (13.70)	414 (15.33)
Self-employed	88 (12.46)	60 (17.14)
Agriculture	3 574 (18.61)	2 380 (19.94)
Houseworker	606 (26.24)	321 (23.44)
Military personnel	23 (13.62)	25 (17.51)
Never worked	45 (21.32)	78 (22.85)
Others	69 (13.84)	51 (18.23)
	F=5.804^b, P < 0.001	F=4.356^b, P < 0.001
Residence
Rural	3 142 (17.30)	1 631 (19.63)
Urban	1 977 (16.50)	1 943 (17.29)
	F=0.556^b, P=0.456	F=4.789^b, P=0.029
Location
East	2 048 (17.02)	1 639 (17.24)
Middle	1 291 (17.83)	830 (18.77)
West	1 394 (16.97)	972 (20.76)
North-east	386 (14.10)	133 (16.61)
	F=1.086^b, P=0.353	F=2.531^b, P=0.055

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