노년기 건강의 사회적 요인의 성별 차이 = Gender Differences in Social Factors of Health in Later Life

다국어 초록 (Multilingual Abstract)

This study was to examine the differential impacts of social experiences and conditions on health among men and women aged 65 years or older, using data of the "Survey on Living Profiles and Welfare Service Needs of Older Persons in Korea 2004". The outcome variables were any disability, self-rated health, multiple morbidity, and self-rated quality of life. Multiple Classification Analysis was used to test the differential exposure to social factors contributes to gender difference in health. Gender differences in vulnerability of each individual socioeconomic, psycho-social, and behavioral factors for health were assessed by comparing logit coefficients in men and women. I found that gender difference in exposure to social factors contribute to inequalities in health between older men and women, however, gender inequalities remained after controlling for differential exposure except in case of quality of life. In addition, gender differences in health were further explained by differential vulnerabilities to social factors between men and women. Findings of this study may affirm the importance of further and deeper investigation of gender differences in health in later life. Gender sensitive approach in health planning and polices for the elderly is also suggested.

국문 초록 (Abstract)

본 연구는 노년기 건강의 성별차이에 사회적 요인의 남녀노출차이가 어느 정도 기여하는지, 또한 사회적 요인에의 반응이 남녀 노인에서 어느 정도 다른지 탐색한 연구이다. 『2004년 노인생활실태 및 복지욕구조사』자료를 사용하였으며, 신체적 활동제한, 복합만성질환, 주관적 건강 및 주관적 삶의 질을 결과변수로 사용하였다. 사회적 요인에는 사회경제적 요인, 사회심리적 요인, 건강행태 요인이 포함되었다. 사회적 요인에의 남녀노출차이의 기여는 중분류분석을, 사회적 요인에의 남녀반응(또는 취약성)의 차이의 기여는 다중회귀분석 및 Wald chi-square test를 사용하여 검정하였다. 노년기 건강의 성별차이는 사회적 요인에의 남녀 노출차이를 보정함으로써 신체적 활동제한, 복합만성질환 유병 및 주관적 불건강 수준에서 성별차이가 47%-69% 감소하였으며 주관적 삶의 질에 있어서는 성별차이가 사라지는 것으로 나타났다. 사회적 요인에의 반응에 있어서의 남녀차이를 살펴본 결과, 사회경제적 요인(교육, 소득수준)의 영향은 남성노인에서 더 크게 나타났고, 무배우 상태 역시 남성노인의 삶의 질에 더 큰 영향을 주었다. 결론적으로 남녀노인이 서로 다른 사회적 조건에 속해 있는 것뿐만 아니라 이러한 사회적 조건들에 달리 반응하는 특성이 건강의 성별차이에 기여한다고 할 수 있다. 이런 점에서 향후 노인보건복지 관련 연구 및 정책수립과 집행에 있어서 성인지적 관점의 접근이 요구된다.

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