摘要：Objectives. We examined the relationship between socioeconomic position (SEP) and sensory impairment. Methods. We used data from the 2007 to 2010 National Health Interview Surveys (n = 69 845 adults). Multivariable logistic regressions estimated odds ratios (ORs) for associations of educational attainment, occupational class, and poverty–income ratio with impaired vision or hearing. Results. Nearly 20% of respondents reported sensory impairment. Each SEP indicator was negatively associated with sensory impairment. Adjusted odds of vision impairment were significantly higher for farm workers (OR = 1.41; 95% confidence interval [CI] = 1.01, 2.02), people with some college (OR = 1.29; 95% CI = 1.16, 1.44) or less than a high school diploma (OR = 1.36; 95% CI = 1.19, 1.55), and people from poor (OR = 1.35; 95% CI = 1.20, 1.52), low-income (OR = 1.28; 95% CI = 1.14, 1.43), or middle-income (OR = 1.19; 95% CI = 1.07, 1.31) families than for the highest-SEP group. Odds of hearing impairment were significantly higher for people with some college or less education than for those with a college degree or more; for service groups, farmers, and blue-collar workers than for white-collar workers; and for people in poor families. Conclusions. More research is needed to understand the SEP–sensory impairment association. Working-aged adults (defined as people aged 25–64 years) accounted for 53% of the US population in 2010, and the number of Americans in this age group increased by 11.3% in a decade, from 147 million in 2000 to 164 million in 2010. 1 In 2007, nearly 39% of US adults aged 18 to 64 years had at least 1 chronic condition, and 13% of these lacked health insurance. 2,3 In addition, workers with poor health or health problems are less productive and have increased risk of future disability and illness. 4 The prevalence of sensory impairment is increasing in the US adult population. 5,6 The number of US adults with hearing impairment has doubled, from 13.2 million in 1971 to 28.6 million in 2000. 7 According to the National Eye Institute, approximately 4 million US adults aged 40 years or older had vision impairment in 2010, and this number is projected to reach 13 million by 2050. 8 Sensory impairment has been associated with diminished quality of life, physical function limitations, mental health problems, and loss of productivity. 9–13 In addition, use of health care and rehabilitation services and lost productivity attributable to chronic conditions such as sensory impairments may impose considerable societal costs. 7,14,15 In the United States, hearing impairment among adults aged 18 years or older was estimated to cost $4.6 billion in 1998, 7 and vision impairment and blindness among those older than 40 years were estimated to cost $5.5 billion annually in 1996 to 2004. 15 Socioeconomic position (SEP), whether measured as education, family income, or occupational class, shows an inverse gradient in risk of mortality and several chronic conditions, including heart disease, cancer, and diabetes, and in access to health care. 16,17 In both developed and developing countries, middle-aged and older people with low SEP were more likely than their more advantaged counterparts to have vision impairment 18–21 or hearing impairment. 22–27 Persons with low SEP lack the knowledge and resources necessary to protect themselves against the onset and progression of sensory impairment. 28 They are more likely to develop diseases related to vision impairment 29 or hearing impairment 5,30 and to live and work in noisy environments. 22 They are also less likely to seek eye care and to be aware of the need for such care and more likely to report lack of eye care insurance coverage and cost as barriers to seeking care. 28 Few studies have addressed the association between SEP and sensory impairment among younger adults of working age; therefore, we examined this relationship among US adults aged 25 to 64 years.
