Socioeconomic Inequalities in Health in Older Adults in Brazil and England

Lima-Costa, M.F., C. De Oliveira, J. Macinko, and M. Marmot
American Journal of Public Health: August 2012, Vol. 102, No. 8, pp. 1535-1541. doi: 10.2105/AJPH.2012.300765

Objectives. We examined socioeconomic inequalities in health among older adults in England and Brazil.

Methods. We analyzed nationally representative samples of residents aged 50 years and older in 2008 data from the Brazilian National Household Survey (n = 75 527) and the English Longitudinal Study of Ageing (n = 9589). We estimated prevalence ratios for self-rated health, functional limitations, and reported chronic diseases, by education level and household income tertiles.

Results. Brazilians reported worse health than did English respondents. Country-specific differences were higher among the poorest, but also affected the wealthiest persons. We observed a strong inverse gradient of similar magnitude across education and household income levels for most health indicators in each country. Prevalence ratios (lowest vs highest education level) of poor self-rated health were 3.24 in Brazil and 3.50 in England; having 2 or more functional limitations, 1.81 in Brazil and 1.96 in England; and having 1 or more diseases, 1.14 in Brazil and 1.36 in England.

Conclusions. Socioeconomic inequalities in health affect both populations, despite a less pronounced absolute difference in household income and education in Brazil than in England.