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Aging and self-reported health in 114 Latin American cities: gender and socio-economic inequalities
Journal article   Open access   Peer reviewed

Aging and self-reported health in 114 Latin American cities: gender and socio-economic inequalities

Marianela Castillo-Riquelme, Goro Yamada, Ana Diez Roux, Tania Alfaro, Sandra Flores-Alvarado, Tonatiuh Barrientos, Camila Teixeira Vaz, Andrés Trotta, Olga Sarmiento and Mariana Lazo
BMC public health, v 22(1), pp 1-1499
01 Jan 2022
DOI: https://doi.org/10.1186/s12889-022-13752-2
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1186/s12889-022-13752-2View
Published, Version of Record (VoR)CC BY V4.0,  Open

Abstract

Access to education Adults Age Aging Chronic illnesses Cities Education GDP Gender Gender differences Gross Domestic Product Households Indicators Men Metropolitan areas Morbidity Mortality Older people Population Quality of life Risk assessment Self report Socioeconomic factors Socioeconomics Urban areas Urban environments Women Womens health
Background Understanding how urban environments influence people’s health, especially as individuals age, can help identify ways to improve health in the rapidly urbanizing and rapidly aging populations. Objectives To investigate the association between age and self-reported health (SRH) in adults living in Latin-American cities and whether gender and city-level socioeconomic characteristics modify this association. Methods Cross-sectional analyses of 71,541 adults aged 25–97 years, from 114 cities in 6 countries (Argentina, Brazil, Colombia, Chile, El Salvador, and Guatemala), as part of the Salud Urbana en America Latina (SALURBAL) Project. We used individual-level age, gender, education, and self-reported health (SRH) data from harmonized health surveys. As proxies for socioeconomic environment we used a city-level socioeconomic index (SEI) calculated from census data, and gross domestic product (GDP) per-capita. Multilevel Poisson models with a robust variance were used to estimate relative risks (RR), with individuals nested in cities and binary SRH (poor SHR vs. good SRH) as the outcome. We examined effect modification by gender and city-level socioeconomic indicators. Results Overall, 31.4% of the sample reported poor SRH. After adjusting for individual-level education, men had a lower risk of poor SRH (RR = 0.76; CI 0.73–0.78) compared to women, and gender modified the association between age and poor SRH (p-value of interaction < 0.001). In gender stratified models, the association between older age and poor SRH was more pronounced in men than in women, and in those aged 25–65 than among those 65+ (RR/10 years = 1.38 vs. 1.10 for men, and RR/10 years = 1.29 vs. 1.02 for women). Living in cities with higher SEI or higher GDP per-capita was associated with a lower risk of poor SRH. GDP per-capita modified the association between age (25–65) and SRH in men and women, with SEI the interaction was less clear. Conclusions Across cities in Latin America, aging impact on health is significant among middle-aged adults, and among men. In both genders, cities with lower SEI or lower GDP per-capita were associated with poor SRH. More research is needed to better understand gender inequalities and how city socioeconomic environments, represented by different indicators, modify exposures and vulnerabilities associated with aging.

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13 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#10 Reduced Inequalities

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Public, Environmental & Occupational Health
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