A higher level of education amplifies the inverse association between income and disability in the Spanish elderly

Abstract

Background and aims: This paper aims to estimate if the education level modifies the association of income with disability prevalence in the elderly. Education can have a confounding effect on income or interact with it as a health determinant. It is important to analyze the relationship between socio-economic status and disability in older people, because it helps to better understand health inequalities and organize appropriate social policies. Methods: The study is based on the Survey on Disability, Personal Autonomy and Dependency Situations (Spanish National Statistics Institute). Binary logistic regression models are adjusted (bivariate, adjusted for gender and age, with all variables and with the interaction between income and education levels). A bad adjustment of the model is detected and a scobit link is added, which helps to differentiate disabled and non-disabled individuals better. Results: People with difficulty in carrying out activities of daily living are much older, frequently women and with low education and income levels. The significant interaction between education level and income means that the odds of being disabled is 43 % less in people of high income compared with people of low income if they are well educated, while it is only 21 %, among those with low education. Conclusion: A higher education level amplifies significantly the inverse association between income and disability in the Spanish elderly, what suggests that those with higher education will profit more than those with lower education from universal economic benefits policies aimed at the disabled, increasing health inequalities between groups.