Research Paper
Socioeconomic determinants of disability in Chile

https://doi.org/10.1016/j.dhjo.2011.06.002Get rights and content

Abstract

Background

Disability is a worldwide public health priority. A shift from a biomedical perspective of dysfunction to a broader social understanding of disability has been proposed. Among many different social factors described in the past, socioeconomic position remains as a key multidimensional determinant of health. The study goal was to analyze the relationship between disability and different domains of socioeconomic position in Chile.

Methods

Cross-sectional analysis of an anonymized population-based survey conducted in Chile in 2006. Any disability (dichotomous variable) and 6 different types of disability were analyzed on the bases of their relationship with income quintiles, occupational status, educational level, and material living standards (quality of the housing, overcrowding rate and sanitary conditions). Confounding and interaction effects were explored using R statistical program.

Results

Income, education, occupation, and material measures of socioeconomic position, along with some sociodemographic characteristics of the population, were independently associated with the chance of being disabled in Chile. Interestingly, classic measures of socioeconomic position (income, education, and occupation) were consistently associated with any disability in Chile, whereas material living conditions were partially confounded by these classic measures. In addition to this, each type of disability showed a particular pattern of related social determinants, which also varied by age group.

Conclusions

This study contributed to the understanding of disability in Chile and how different domains of socioeconomic position might be associated with this prevalent condition. Disability remains a complex multidimensional public health problem in Chile that requires the inclusion of a wide range of risk factors, of which socioeconomic position is particularly relevant.

Section snippets

Population and sample

We conducted a cross-sectional analysis of a nationally representative survey conducted in Chile in 2006 (CASEN) [48]. This anonymous population-based survey has been carried out by the Chilean Ministry of Planning every 3 years since 1987 [27]. It describes the socioeconomic situation, as well as the impact of social programs on living conditions, for the Chilean population [37], [49].

The CASEN survey used multistage probabilistic sampling with 2 phases (county and household), stratified by

Sample description and prevalence of any disability in Chile

Characteristics of population are presented in Table 1. The mean age was 33.0 years old (SD = 0.14). Fifty-one percent of the population were male and most were either single (50.6%) or married (40.8%). Only 12.9% of the population were living in a rural area. Over 70% of the population reported having primary and high school level education, compared to less than 10% with a university degree. The average income of the wealthiest quintile was 14.3 times higher than the average income of the

Summary of key findings

In our knowledge this is the first study exploring the relationship between disability (any and each type of disability) and socioeconomic position in Chile. Income, education, occupation, and material measures of socioeconomic position, along with some sociodemographic characteristics of the population, were independently associated with the chance of being disabled in Chile. Interestingly, each classic measures of socioeconomic position (income, education, and occupation) were independently

Acknowledgments

The authors thank the Chilean Ministry of Planning for providing the data collected through CASEN survey 2006 and those people from the Chilean population who answered the CASEN survey in 2006. They also acknowledge Miss Philippa Bird for her valuable comments to this paper and the comments and review of Professor Kate E. Pickett, University of York, UK. Finally, the authors acknowledge all the comments and suggestions from three anonymous peer reviewers of this manuscript.

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