# Contribution of chronic diseases to educational disparity in disability in France: Results from the cross-sectional "Disability-Health" survey

Clémence Palazzo, Renata T.C. Yokota, Jean Tafforeau, Wilma J. Nusselder, Serge Poiraudeau, Jean-François Ravaud, Herman van Oyen

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## To cite this version:

Clémence Palazzo, Renata T.C. Yokota, Jean Tafforeau, Wilma J. Nusselder, Serge Poiraudeau, et al. Contribution of chronic diseases to educational disparity in disability in France: Results from the cross-sectional "Disability-Health" survey. Annals of Physical and Rehabilitation Medicine, 2017, 60, pp.e102. 10.1016/j.rehab.2017.07.069. hal-03966615

HAL Id: hal-03966615

https://hal.science/hal-03966615

Submitted on 31 Jan 2023

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# Therapeutic education

## CO267

### Contribution of chronic diseases to educational disparity in disability in France: Results from the cross-sectional "Disability-Health" survey

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CrossMark

Palazzo Clémence ¹,*, Renata Yokota², Tafforeau Jean², Wilma Nusselder ¹, Serge Poiraureau³, Jean-François Ravaud ⁴, Herman Van Oyen²

¹ Erasmus MC, Department of Public Health, Rotterdam, The Netherlands

² Scientific Institute of Public Health, Department of Public Health and Surveillance, Bruxelles, Belgique

³ Inserm UMR 1153, Centre of Research in Epidemiology and Statistics, Paris Sorbonne Cité, ECaMO Team, Paris, France

⁴ Inserm U988/CNRS UMR 8211, Villejuif, France

* Corresponding author.

E-mail address: clemence.palazzo@gmail.com (P. Clémence)

**Objective** The contribution of diseases to educational disparities has been largely studied in mortality but not in disability. We aimed:

- to assess whether the contribution of chronic diseases to disability varies according to the educational attainment in France;

- to analyze if those differences are due to differences in the prevalence or in the disabling impact of diseases.

If educational disparities are mainly explained by differences of prevalence, a higher attention should be paid on the prevention of diseases in the lowest educated. If they are mainly due to differences of disabling impact, the governments should facilitate health care focusing on diseases management.

**Material/patients and methods** The data were from the 2008–2009 Disability-Health survey, a cross-sectional population-based survey that included people living in households and in institutions. We considered the 31,972 respondents 25 years and older. A weighting method allowed for estimating representative results at a national level. Diseases, disabilities and educational attainment were self-reported. We considered 13 groups of chronic conditions. The disability indicator was the Global Activity Limitation Indicator (GALI). The attribution method was used to estimate the disabling impact and the contribution of chronic conditions to disability prevalence across educational-level groups.

**Results** The disability prevalence was 48.2% (95% CI 46.4–50.4), 32.6% (31.0–34.8), and 25.7% (23.4–28.6) for men with a primary, secondary and tertiary education, respectively. The largest

differences between men with a primary and a tertiary education were observed for psychiatric diseases, neurologic conditions (excluding dementia and stroke) and chronic obstructive pulmonary diseases (the differences were 4.8 percentages points, 2.9 and 1.7, respectively). The disability prevalence was 48.7%, 31.2%, and 30.7% for women with a primary, secondary and tertiary education, respectively. The largest differences between women with a primary and a tertiary education were observed for psychiatric diseases, arthritis and neurologic conditions (excluding dementia and stroke) (the differences were 3.9, 3.0 and 1.5 percentages points, respectively). The impact of the differences in the prevalence or in the disabling impact of diseases will be discussed.

**Discussion – conclusion** Psychiatric diseases, arthritis, chronic obstructive pulmonary diseases and neurologic conditions (excluding dementia and stroke) mainly contribute to educational disparities in disability in France. The differences between the lowest- and the highest-educated people were gender- and age-specific.

**Keywords** Disability; Chronic disease; Socioeconomic; Education; Epidemiology; Attribution

**Disclosure of interest** The authors have not supplied their declaration of competing interest.

http://dx.doi.org/10.1016/j.rehab.2017.07.069

## CO269

### Mobile application development through qualitative research in education program for chronic low back patients

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CrossMark

Alexander Arefyev¹, Jean-Baptiste Lechauve¹, Chloé Gay¹, Laurent Gerbaud², Marie Sophie Chérillat³, Isabelle Tavares Figueiredo⁴, Anne Plan-Paquet¹, Emmanuel Coudeyre ¹,*

¹ CHU de Clermont-Ferrand, service de médecine physique et de réadaptation, Clermont-Ferrand, France

² Équipe PEPRADE, université Clermont-Auvergne, Clermont-Ferrand, France

³ Unité transversale d'éducation du patient, service d'épidémiologie et de santé publique, CHU de Clermont-Ferrand, Clermont-Ferrand, France

⁴ CHU de Montpellier, CHU Lapeyronie, département de médecine physique et de réadaptation, Montpellier, France

* Corresponding author.

E-mail address: ecoudeyre@chu-clermontferrand.fr (E. Coudeyre)