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Terveyden parantuessa maailmanlaajuisesti ovat erot ihmisryhmien välillä lisääntyneet. Iäkkäiden ihmisten terveyseroja eri sosioekonomisten ryhmien välillä on tutkittu vähän. Tässä Pro gradu -tutkielmassa tutkitaan mahdollisia eroja itsearvioidussa terveydessä, kävelynopeudessa ja puristusvoimassa 1910- ja 1930–1940-lukujen välillä syntyneiden 75- ja 80-vuotiaiden kohorttien välillä eri koulutustasoilla. Lisäksi tarkastellaan sukupuolieroja esiintyneissä kohorttieroissa.
Tutkimuksessa hyödynnetään 2017–2018 kerättyä AGNES ja 1989–1990 kerättyä Ikivihreät väestöaineistoja, joihin osallistui jyväskyläläisiä kotona-asuvia 75- ja 80-vuotiaita henkilöitä. Koettua terveyttä ja koulutuksen pituutta kysyttiin kotihaastattelussa sekä puristusvoimaa ja kävelynopeutta mitattiin laboratoriossa. AGNES-aineistosta tiedot olivat saatavilla 779 ja Ikivihreät-aineistossa 592 osallistujalle, jotka muodostivat tämän tutkimuksen analyyttisen otoksen. Kohortteja verrattiin kolmeluokkaisen koulutusvuosi-muuttujan perusteella, jossa katkaisupisteet määriteltiin tertiilien mukaisesti. Koulutusvuodet olivat Ikivihreissä alimmassa tertiilissä 0–4 vuotta, keskitertilissä 5–6 vuotta ja ylimmässä tertiilissä yli 6 vuotta, ja AGNES.n alimmassa tertiilissä 0–9 vuotta, keskitertilissä 10–13 vuotta ja ylimmässä tertiilissä yli 13 vuotta. Tuloksia tarkasteltiin erikseen sukupuolen mukaan. Analyysit tehtiin ANOVA- ja khiin neliötestin avulla. Lopuksi syntymäkohorttien sisäiset ryhmävertailut koulutusryhmien välillä vakioitiin ANCOVA-analyysilla taustamuuttujilla ikä, koettu taloudellinen tilanne, masennusoireet, vapaa-ajan aktiivisuus ja tupakointi.
Myöhemmin syntyneellä kohortilla oli parempi lihasvoima, koettu terveys ja kävelynopeus verrattuna aiemmin syntyneisiin kaikissa koulutusryhmissä. Myöhemmin syntyneiden alimman koulutusryhmän arvot olivat paremmalla tai lähes samalla tasolla verrattuna aiemmin syntyneen kohortin korkeimpaan koulutusryhmään. Aiemmin syntyneiden koulutusvuosien määrä oli vähäisempi verrattuna myöhemmin syntyneisiin osallistujiin. Aiemmin syntyneessä kohortissa pidempään kouluttautuneilla miehillä oli nopeampi kävelyvauhti (p=0,033) ja parempi koettu terveys (p=0,005) verrattuna vähemmän kouluttautuneisiin. Myöhemmin syntyneessä kohortissa pidempään kouluttautuneilla miehillä oli nopeampi kävelyvauhti (p<0,001) ja parempi koettu terveys (p=0,017) sekä parempi puristusvoima (p=0,038) ja naisilla nopeampi kävelyvauhti (p<0,001) verrattuna vähemmän kouluttautuneisiin. Taustatekijöiden vakioinnin jälkeen ryhmäerot eri koulutusluokkien välillä oli havaittavissa myöhemmin syntyneiden miesten ja naisten kävelynopeudessa.
Nykyisillä iäkkäillä henkilöillä on nähtävissä suurempia koulutusryhmien välisiä terveyseroja, kuin aiemmin eläneillä iäkkäillä henkilöillä, mikä voi johtua osittain koulutuksen suuremmasta hajonnasta verrattuna aiempiin sukupolviin. Vaikka terveyseroja on enemmän, koettu terveys, puristusvoima ja kävelynopeus ovat parantuneet 30 vuodessa kaikissa sosioekonomisissa luokissa ja nykyisin matalammin koulutettujen terveys ja toimintakyky ovat paremmalla tai lähes samalla tasolla verrattuna aiemman syntymäkohortin korkeimmin koulutettujen ryhmään.
As global health has improved, disparities between groups of people have increased. Health inequalities among older people in different socioeconomic groups have been studied minimally. This master's thesis examines potential differences in self-rated health, walking speed, and grip strength between cohorts born between the 1910s and 1930s-1940s at ages 75 and 80, across various levels of education. Additionally, sex differences in cohort differences are examined.
The study utilized the AGNES data collected in 2017–2018 and the Evergreen data collected in 1989–1990, which included home-dwelling 75- and 80-year-old individuals from Jyväskylä. Self-rated health and years of education were assessed through home interviews, and grip strength and walking speed were measured in a laboratory. Data were available for 779 participants from the AGNES dataset and 592 participants from the Evergreen dataset, forming the analytical sample for this study. The cohorts were compared based on a three-class educational years variable, with cut-off points defined according to tertiles. In the Evergreen cohort, the lowest tertile had 0–4 years of education, the middle tertile had 5–6 years, and the highest tertile had more than 6 years. In the AGNES cohort, the lowest tertile had 0–9 years of education, the middle tertile had 10–13 years, and the highest tertile had more than 13 years. Results were examined separately by gender: 1. Male and 2. Female. Analyses were performed using ANOVA and Chi-square tests. Finally, within-cohort group comparisons between educational groups were adjusted using ANCOVA analysis, controlling for background variables such as age, perceived financial situation, depressive symptoms, leisure-time activity, and smoking.
The later-born cohort had better perceived health, muscle strength, and walking speed compared to the earlier-born cohort across all education groups. Values for the lowest education group of the later-born cohort were equal to or better than those of the highest education group of the earlier-born cohort. In the earlier-born cohort, men with longer education had faster walking speed (p=0,033) and better perceived health (p=0,005) compared to those with less education. In the later-born cohort, men with longer education had faster walking speed (p<0,001) and better perceived health (p=0,017), as well as better grip strength (p=0,038), and women had faster walking speed (p<0,001) compared to those with less education. After adjusting for background factors, group differences between educational classes were observed in the walking speed of both men and women born later.
Current elderly individuals exhibit greater health inequalities between education groups, which may be partially due to greater educational heterogeneity compared to previous generations. Although there are more health inequalities, perceived health, grip strength, and walking speed have improved over 30 years across all socioeconomic classes, and the health and functional capacity of those with lower education levels are equal to or better than those of the highest educated group in the earlier birth cohort.
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[{"key": "dc.contributor.advisor", "value": "Koivunen, Kaisa", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Tiilikainen, Essi", "language": "", "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2024-06-24T06:27:14Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2024-06-24T06:27:14Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2024", "language": "", "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/96099", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Terveyden parantuessa maailmanlaajuisesti ovat erot ihmisryhmien v\u00e4lill\u00e4 lis\u00e4\u00e4ntyneet. I\u00e4kk\u00e4iden ihmisten terveyseroja eri sosioekonomisten ryhmien v\u00e4lill\u00e4 on tutkittu v\u00e4h\u00e4n. T\u00e4ss\u00e4 Pro gradu -tutkielmassa tutkitaan mahdollisia eroja itsearvioidussa terveydess\u00e4, k\u00e4velynopeudessa ja puristusvoimassa 1910- ja 1930\u20131940-lukujen v\u00e4lill\u00e4 syntyneiden 75- ja 80-vuotiaiden kohorttien v\u00e4lill\u00e4 eri koulutustasoilla. Lis\u00e4ksi tarkastellaan sukupuolieroja esiintyneiss\u00e4 kohorttieroissa. \n\nTutkimuksessa hy\u00f6dynnet\u00e4\u00e4n 2017\u20132018 ker\u00e4tty\u00e4 AGNES ja 1989\u20131990 ker\u00e4tty\u00e4 Ikivihre\u00e4t v\u00e4est\u00f6aineistoja, joihin osallistui jyv\u00e4skyl\u00e4l\u00e4isi\u00e4 kotona-asuvia 75- ja 80-vuotiaita henkil\u00f6it\u00e4. Koettua terveytt\u00e4 ja koulutuksen pituutta kysyttiin kotihaastattelussa sek\u00e4 puristusvoimaa ja k\u00e4velynopeutta mitattiin laboratoriossa. AGNES-aineistosta tiedot olivat saatavilla 779 ja Ikivihre\u00e4t-aineistossa 592 osallistujalle, jotka muodostivat t\u00e4m\u00e4n tutkimuksen analyyttisen otoksen. Kohortteja verrattiin kolmeluokkaisen koulutusvuosi-muuttujan perusteella, jossa katkaisupisteet m\u00e4\u00e4riteltiin tertiilien mukaisesti. Koulutusvuodet olivat Ikivihreiss\u00e4 alimmassa tertiiliss\u00e4 0\u20134 vuotta, keskitertiliss\u00e4 5\u20136 vuotta ja ylimm\u00e4ss\u00e4 tertiiliss\u00e4 yli 6 vuotta, ja AGNES.n alimmassa tertiiliss\u00e4 0\u20139 vuotta, keskitertiliss\u00e4 10\u201313 vuotta ja ylimm\u00e4ss\u00e4 tertiiliss\u00e4 yli 13 vuotta. Tuloksia tarkasteltiin erikseen sukupuolen mukaan. Analyysit tehtiin ANOVA- ja khiin neli\u00f6testin avulla. Lopuksi syntym\u00e4kohorttien sis\u00e4iset ryhm\u00e4vertailut koulutusryhmien v\u00e4lill\u00e4 vakioitiin ANCOVA-analyysilla taustamuuttujilla ik\u00e4, koettu taloudellinen tilanne, masennusoireet, vapaa-ajan aktiivisuus ja tupakointi. \n\nMy\u00f6hemmin syntyneell\u00e4 kohortilla oli parempi lihasvoima, koettu terveys ja k\u00e4velynopeus verrattuna aiemmin syntyneisiin kaikissa koulutusryhmiss\u00e4. My\u00f6hemmin syntyneiden alimman koulutusryhm\u00e4n arvot olivat paremmalla tai l\u00e4hes samalla tasolla verrattuna aiemmin syntyneen kohortin korkeimpaan koulutusryhm\u00e4\u00e4n. Aiemmin syntyneiden koulutusvuosien m\u00e4\u00e4r\u00e4 oli v\u00e4h\u00e4isempi verrattuna my\u00f6hemmin syntyneisiin osallistujiin. Aiemmin syntyneess\u00e4 kohortissa pidemp\u00e4\u00e4n kouluttautuneilla miehill\u00e4 oli nopeampi k\u00e4velyvauhti (p=0,033) ja parempi koettu terveys (p=0,005) verrattuna v\u00e4hemm\u00e4n kouluttautuneisiin. My\u00f6hemmin syntyneess\u00e4 kohortissa pidemp\u00e4\u00e4n kouluttautuneilla miehill\u00e4 oli nopeampi k\u00e4velyvauhti (p<0,001) ja parempi koettu terveys (p=0,017) sek\u00e4 parempi puristusvoima (p=0,038) ja naisilla nopeampi k\u00e4velyvauhti (p<0,001) verrattuna v\u00e4hemm\u00e4n kouluttautuneisiin. Taustatekij\u00f6iden vakioinnin j\u00e4lkeen ryhm\u00e4erot eri koulutusluokkien v\u00e4lill\u00e4 oli havaittavissa my\u00f6hemmin syntyneiden miesten ja naisten k\u00e4velynopeudessa. \n\nNykyisill\u00e4 i\u00e4kk\u00e4ill\u00e4 henkil\u00f6ill\u00e4 on n\u00e4ht\u00e4viss\u00e4 suurempia koulutusryhmien v\u00e4lisi\u00e4 terveyseroja, kuin aiemmin el\u00e4neill\u00e4 i\u00e4kk\u00e4ill\u00e4 henkil\u00f6ill\u00e4, mik\u00e4 voi johtua osittain koulutuksen suuremmasta hajonnasta verrattuna aiempiin sukupolviin. Vaikka terveyseroja on enemm\u00e4n, koettu terveys, puristusvoima ja k\u00e4velynopeus ovat parantuneet 30 vuodessa kaikissa sosioekonomisissa luokissa ja nykyisin matalammin koulutettujen terveys ja toimintakyky ovat paremmalla tai l\u00e4hes samalla tasolla verrattuna aiemman syntym\u00e4kohortin korkeimmin koulutettujen ryhm\u00e4\u00e4n.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "As global health has improved, disparities between groups of people have increased. Health inequalities among older people in different socioeconomic groups have been studied minimally. This master's thesis examines potential differences in self-rated health, walking speed, and grip strength between cohorts born between the 1910s and 1930s-1940s at ages 75 and 80, across various levels of education. Additionally, sex differences in cohort differences are examined. \n\nThe study utilized the AGNES data collected in 2017\u20132018 and the Evergreen data collected in 1989\u20131990, which included home-dwelling 75- and 80-year-old individuals from Jyv\u00e4skyl\u00e4. Self-rated health and years of education were assessed through home interviews, and grip strength and walking speed were measured in a laboratory. Data were available for 779 participants from the AGNES dataset and 592 participants from the Evergreen dataset, forming the analytical sample for this study. The cohorts were compared based on a three-class educational years variable, with cut-off points defined according to tertiles. In the Evergreen cohort, the lowest tertile had 0\u20134 years of education, the middle tertile had 5\u20136 years, and the highest tertile had more than 6 years. In the AGNES cohort, the lowest tertile had 0\u20139 years of education, the middle tertile had 10\u201313 years, and the highest tertile had more than 13 years. Results were examined separately by gender: 1. Male and 2. Female. Analyses were performed using ANOVA and Chi-square tests. Finally, within-cohort group comparisons between educational groups were adjusted using ANCOVA analysis, controlling for background variables such as age, perceived financial situation, depressive symptoms, leisure-time activity, and smoking. \n\nThe later-born cohort had better perceived health, muscle strength, and walking speed compared to the earlier-born cohort across all education groups. Values for the lowest education group of the later-born cohort were equal to or better than those of the highest education group of the earlier-born cohort. In the earlier-born cohort, men with longer education had faster walking speed (p=0,033) and better perceived health (p=0,005) compared to those with less education. In the later-born cohort, men with longer education had faster walking speed (p<0,001) and better perceived health (p=0,017), as well as better grip strength (p=0,038), and women had faster walking speed (p<0,001) compared to those with less education. After adjusting for background factors, group differences between educational classes were observed in the walking speed of both men and women born later. \n\nCurrent elderly individuals exhibit greater health inequalities between education groups, which may be partially due to greater educational heterogeneity compared to previous generations. Although there are more health inequalities, perceived health, grip strength, and walking speed have improved over 30 years across all socioeconomic classes, and the health and functional capacity of those with lower education levels are equal to or better than those of the highest educated group in the earlier birth cohort.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by Miia Hakanen (mihakane@jyu.fi) on 2024-06-24T06:27:14Z\nNo. of bitstreams: 0", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2024-06-24T06:27:14Z (GMT). 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