Income inequality and elderly self-rated health in São Paulo, Brazil.

Abstract:

PURPOSE:To test the association between income inequality and elderly self-rated health and to propose a pathway to explain the relationship. METHODS:We analyzed a sample of 2143 older individuals (60 years of age and over) from 49 distritos of the Municipality of São Paulo, Brazil. Bayesian multilevel logistic models were performed with poor self-rated health as the outcome variable. RESULTS:Income inequality (measured by the Gini coefficient) was found to be associated with poor self-rated health after controlling for age, sex, income and education (odds ratio, 1.19; 95% credible interval, 1.01-1.38). When the practice of physical exercise and homicide rate were added to the model, the Gini coefficient lost its statistical significance (P > .05). We fitted a structural equation model in which income inequality affects elderly health by a pathway mediated by violence and practice of physical exercise. CONCLUSIONS:The health of older individuals may be highly susceptible to the socioeconomic environment of residence, specifically to the local distribution of income. We propose that this association may be mediated by fear of violence and lack of physical activity.

journal_name

Ann Epidemiol

journal_title

Annals of epidemiology

authors

Chiavegatto Filho AD,Lebrão ML,Kawachi I

doi

10.1016/j.annepidem.2012.09.009

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

863-7

issue

12

eissn

1047-2797

issn

1873-2585

pii

S1047-2797(12)00369-9

journal_volume

22

pub_type

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