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.
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.
Authors: Juliana Mara Andrade; Flávia Cristina Drumond Andrade; Yeda Aparecida de Oliveira Duarte; Fabíola Bof de Andrade Journal: Qual Life Res Date: 2020-02-04 Impact factor: 4.147
Authors: Alexandre Dias Porto Chiavegatto Filho; Yuan-Pang Wang; Ana Maria Malik; Julia Takaoka; Maria Carmen Viana; Laura Helena Andrade Journal: Rev Saude Publica Date: 2015-02-27 Impact factor: 2.106
Authors: Kaio Henrique Correa Massa; Roman Pabayo; Maria Lúcia Lebrão; Alexandre Dias Porto Chiavegatto Filho Journal: BMJ Open Date: 2016-09-06 Impact factor: 2.692