Health inequalities among older adults in Spain: the importance of gender, the socioeconomic development of the region of residence, and social support.

BACKGROUND: This study analyzes health inequalities among older adults in Spain by adopting a conceptual framework that globally considers two dimensions of health determinants (gender and the socioeconomic development of the region of residence) and the mediating influence of social support, taking into account individual socioeconomic position.
METHODS: Data came from the 2006 Spanish National Health Interview Survey. A subsample of people aged 65 to 85 years with no paid work living in two socioeconomically developed regions situated in the north of Spain and in two less developed ones situated in the south was selected. The health outcomes analyzed were self-rated health status and poor mental health status. Multiple logistic regression models were fitted and covariates (age, socioeconomic position, household type, and social support) were added in subsequent steps.
FINDINGS: Self-rated health status among older adults was poorer in the less socioeconomically developed regions, but especially among women, whereas the poorest mental health status was found in one of the most socioeconomically developed regions, especially for men. Social support was an important determinant of health status, regardless of the socioeconomic development of the region. Gender inequalities in health did not differ by regional socioeconomic development with one exception regarding poor self-rated health.
CONCLUSION: These results show the importance of implementing stronger gender equity policies, as well as reducing socioeconomic inequalities among regions and strengthen social support among older adults.