Regression Models 1, 2A-2F, and 3.

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.功能受限是老年人群面临的主要健康关切问题，其发病率会因女性身份、低受教育水平、社会经济地位较低等个人特征而升高，进而引发健康不公平。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。本研究基于交叉性框架，利用2021轮次的墨西哥健康与老龄化研究（Mexican Health and Aging Study, MHAS）数据，分析了墨西哥老年人群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）技术，该方法被公认为定量交叉性研究的金标准。本次研究共评估了六个变量：年龄、性别、受教育水平、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群体功能状态、缓解健康不公平的切实可行的短期策略。与既往研究证据相反，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，未必单纯与女性身份相关，而是与当代社会中女性身份所承载的社会意义息息相关。同样，尽管医疗体系是影响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表现出显著关联。本研究凸显了交叉性框架在理解健康不公平中的重要价值，为解析叠加性压迫与特权体系提供了精细化视角，以助力解决墨西哥老年人群的健康差异问题。