Prevalencia de la discapacidad en España por Comunidades Autónomas: el papel de los factores individuales y del entorno geográfico en su variabilidad / Prevalence of the disability in Spain for autonomous communities: the paper of the individual factors and the geographical environment in the variability

Fundamento: La prevalencia de discapacidad en la poblacióngeneral presenta una gran variabilidad geográfica, de manera queidentificar aquellos factores que pudieran explicarla será importantepara la planificación de políticas sociales. En este trabajo se analizala variabilidad de la discapacidad por comunidades autónomasdesde una doble vertiente, los factores individuales y del entorno.Métodos: Los datos proceden principalmente de la Encuestade Discapacidad, Deficiencias y Estado de Salud de 1999 y delInebase, ambas del Instituto Nacional de Estadística (INE). Secalculó la prevalencia de discapacidad simple y ajustada por edadde las CCAA. Se analizan los factores individuales asociados a ladiscapacidad mediante una regresión logística y los factores individualesy de la comunidad autónoma conjuntamente con unaregresión logística de dos niveles.Resultados: La prevalencia de discapacidad muestra una diferenciamáxima de 5,75 puntos entre las comunidades autónomas.En la regresión logística la comunidad de residencia fue estadísticamentesignificativa (OR: 3,35 en la de mayor prevalencia respectoa la de menor) junto con otras variables individuales: edad (ORde 40-64= 1,78 OR de 65-79= 1,87 y OR de >79= 3,34), sexo (ORmujer= 0,66), situación laboral (OR sin trabajo=2,25 OR amascasa/estudiante=1,39 y OR otros=2,03), estado de salud (OR regular=1,69 OR malo/muy malo= 2,05) y enfermedades crónicas (OR1-3=1,56 OR4-6=1,82 OR>6=2,59). En la regresión de dos niveleslas variables individuales explican poca varianza (s=0,261) y ningunade las variables relativas a las CCAA mejora el modelo.Conclusiones: Las características individuales no explicansuficientemente la variabilidad de la discapacidad entre CCAA yno se han identificado variables del entorno que sean significativas(AU)

Background: The prevalence of disability shows a highgeographical variability and the identification of factors that couldexplain these variations can be usuful to the heath and socialwelfare planning. Here the analysis of disability variations amongautonomous regions in Spain is made taking into accountindividual and geographical setting factors together.Methods: Data come from the Spanish Disability,Impairment and Health Status survey of 1999 and from Inebaseboth of the National Institute for Statistics. The prevalence ofdisability crude and adjusted by age was calculated for eachautonomous region. Individual factors related to disability areidentified by means of a logistic regression. The analysisaccounting for both, individual and geographical setting factorswas performed by means of a logistic regression of two levels.Results: Disability prevalence showed a maximum differenceof 5.75 points among regions. In a logistic regression the region ofresidence was statistically significant (OR: 3.35 in the highestrated region related to the lowest) beside several individual factors:age (OR 40-64= 1,78 OR 65-79= 1,87 and OR >79= 3,34), sex(OR women= 0,66), working status (OR unemployment=2,25 ORhousewife/student=1,39 y OR other=2,03), health status (ORregular= 1,69 OR bad/very bad= 2,05) and chronic diseases (OR1-3=1,56 OR 4-6=1,82 OR >6=2,59). Individual factors accountedfor a very few variance at the two levels regression model(s=0,261) and none of the regional variables improved the model.Conclusions: Individual factors do not explain enough theobserved disability variations among the regions and none factorrelated to the geographical setting has been identified asstatistically significant(AU)

[Dependence profile in Spain: an analysis from the disability survey of 1999]. / El perfil de la dependencia en España: un análisis de la encuesta de discapacidades de 1999.

BACKGROUND: In the next future an important demographical ageing will imply a rise in the levels of co morbidity, disability and dependence of the population. The objective if this work was to estimate the dependences profile by means of assessing the levels of severity of the disability in the Spanish general population. METHODS: Data come from the disease, disability and health status survey of 1999 of the Spanish Institute for Statistics, which includes 36 limitations with an score of severity (from 0= absence to 4= unable). These limitations were grouped in five kinds of disability, the mean score of severity was computed for each one, and grouped in five levels of dependence. To check the relationship between limitations and severity an analysis of correspondence was performed. To identify the pattern of dependence a multiple correspondence and a clusters analysis were computed using the variables of age, sex, kind of disability and level of dependence. RESULTS: There is a relationship between severity and some limitations (being the limitation on daily activities associated to the highest severity). Five groups of dependent people were identified. Those with lower dependence were middle aged, men and having sensorial disabilities and those with higher dependence were mainly women, older than 80 and with disabilities on mobility and on the activities of daily living. CONCLUSIONS: There are five groups of dependent population and this study allows estimating its frequency among the general population what will be very useful to evaluate the amount of resources necessary to take care of them.