Descriptive analysis of the final sample.

Functional limitation represents a major health concern among older adults, with its incidence increased based on personal characteristics such as being a woman, having minor levels of education, and lower socioeconomic status, leading to health inequities. Addressing these inequities requires comprehensive frameworks like intersectionality to provide a broader perspective. This study analyzes health inequities in functional limitation among Mexican older adults using data from the 2021 round of the Mexican Health and Aging Study (MHAS) within an intersectional framework. The Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) technique, recognized as the gold standard in quantitative intersectionality research, was employed. Six variables were assessed: age, sex, education, social engagement, economic status, and access to health services. The results indicate that age, social engagement, and economic status were the main variables that explain functional limitation. Enhancing social engagement emerges as a practical short-term strategy to improve functionality and reduce inequities. Contrary to prior evidence, sex was not directly associated with functional limitation. Therefore, higher rates of functionality loss previously reported in the literature may not simply be linked to being a woman but rather to the societal implications of being a woman in contemporary contexts. Similarly, access to health services did not show a significant relationship with functional limitation despite the health system being a critical intermediate social determinant of health with the potential to address inequities. This research underscores the importance of intersectionality in understanding inequality, offering a nuanced perspective on overlapping systems of oppression and privilege to address disparities in Mexican older adults.

功能受限是老年人面临的主要健康问题之一，其发病风险会因女性身份、受教育程度较低、社会经济地位低下等个体特征而升高，进而引发健康不公平问题。要解决这类健康不公平问题，需借助交叉性（intersectionality）等综合性分析框架以获得更全面的研究视角。本研究基于交叉性分析框架，利用2021年墨西哥健康与老龄化研究（Mexican Health and Aging Study, MHAS）的调研数据，分析了墨西哥老年人功能受限相关的健康不公平问题。本研究采用了个体异质性与判别准确性多水平分析（Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy, MAIHDA）方法，该方法被公认为定量交叉性研究的金标准。本次研究共纳入6项分析变量：年龄、性别、受教育程度、社会参与度、经济状况以及医疗服务可及性。研究结果显示，年龄、社会参与度与经济状况是解释功能受限发生的核心变量。提升社会参与度可作为改善老年人功能状态、缓解健康不公平问题的短期可行策略。与既往研究结论相悖的是，性别与功能受限并无直接关联。因此，既往文献中报道的女性功能丧失率更高的现象，未必直接源于女性这一性别身份，而是与当代社会中女性所面临的社会结构性处境相关。同样，尽管医疗体系作为健康的关键中间社会决定因素，具备缓解健康不公平的潜力，但医疗服务可及性与功能受限并未呈现显著关联。本研究强调了交叉性视角在理解健康不公平问题中的重要性，为解析墨西哥老年人面临的多重压迫与特权叠加体系带来了精细化视角，助力解决该群体的健康差异问题。