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Surprising SES Gradients in mortality, health, and biomarkers in a Latin American population of adults.

Rosero-Bixby L, Dow WH - J Gerontol B Psychol Sci Soc Sci (2009)

Bottom Line: The ultimate health indicator, mortality, as well as the metabolic syndrome, reveals that better educated and wealthier individuals are worse off.Traditional cardiovascular risk factors such as diabetes and cholesterol are not significantly related to SES, but hypertension and obesity are worse among high-SES individuals.But negative SES gradients in healthy years of life persist.

View Article: PubMed Central - PubMed

Affiliation: Central American Population Center and Institute for Health Research, University of Costa Rica, San Pedro, San José, Costa Rica. lrosero@ccp.ucr.ac.cr

ABSTRACT

Background: To determine socioeconomic status (SES) gradients in the different dimensions of health among elderly Costa Ricans.

Hypothesis: SES disparities in adult health are minimal in Costa Rican society.

Methods: Data from the Costa Rican Study on Longevity and Healthy Aging study: 8,000 elderly Costa Ricans to determine mortality in the period 2000-2007 and a subsample of 3,000 to determine prevalence of several health conditions and biomarkers from anthropometry and blood and urine specimens.

Results: The ultimate health indicator, mortality, as well as the metabolic syndrome, reveals that better educated and wealthier individuals are worse off. In contrast, quality of life-related measures such as functional and cognitive disabilities, physical frailty, and depression all clearly worsen with lower SES. Overall self-reported health (SRH) also shows a strong positive SES gradient. Traditional cardiovascular risk factors such as diabetes and cholesterol are not significantly related to SES, but hypertension and obesity are worse among high-SES individuals. Reflecting mixed SES gradients in behaviors, smoking and lack of exercise are more common among low SES, but high calorie diets are more common among high SES.

Conclusions: Negative modern behaviors among high-SES groups may be reversing cardiovascular risks across SES groups, hence reversing mortality risks. But negative SES gradients in healthy years of life persist.

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Related in: MedlinePlus

Framework for studying health indicators in three levels.
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fig1: Framework for studying health indicators in three levels.

Mentions: This article follows a simple framework (Figure 1) to organize the different dimensions and indicators of health (Crimmins & Seeman, 2004). General health outcomes such as mortality and physical functioning are the end points of the framework. Proximate determinants very close to these outcomes are specific biological risk factors, usually measured by biomarkers such as blood pressure, obesity, and glucose levels. Then, one step back in the explanation hierarchy, there are health behaviors (diet, smoking, exercising) and health care services. This article analyzes the SES gradient for these three levels of health dimensions. Some demographic factors, such as age, sex, and marital status, are considered at the same hierarchical level and SES, and therefore their confounding effects must be controlled for.


Surprising SES Gradients in mortality, health, and biomarkers in a Latin American population of adults.

Rosero-Bixby L, Dow WH - J Gerontol B Psychol Sci Soc Sci (2009)

Framework for studying health indicators in three levels.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2654981&req=5

fig1: Framework for studying health indicators in three levels.
Mentions: This article follows a simple framework (Figure 1) to organize the different dimensions and indicators of health (Crimmins & Seeman, 2004). General health outcomes such as mortality and physical functioning are the end points of the framework. Proximate determinants very close to these outcomes are specific biological risk factors, usually measured by biomarkers such as blood pressure, obesity, and glucose levels. Then, one step back in the explanation hierarchy, there are health behaviors (diet, smoking, exercising) and health care services. This article analyzes the SES gradient for these three levels of health dimensions. Some demographic factors, such as age, sex, and marital status, are considered at the same hierarchical level and SES, and therefore their confounding effects must be controlled for.

Bottom Line: The ultimate health indicator, mortality, as well as the metabolic syndrome, reveals that better educated and wealthier individuals are worse off.Traditional cardiovascular risk factors such as diabetes and cholesterol are not significantly related to SES, but hypertension and obesity are worse among high-SES individuals.But negative SES gradients in healthy years of life persist.

View Article: PubMed Central - PubMed

Affiliation: Central American Population Center and Institute for Health Research, University of Costa Rica, San Pedro, San José, Costa Rica. lrosero@ccp.ucr.ac.cr

ABSTRACT

Background: To determine socioeconomic status (SES) gradients in the different dimensions of health among elderly Costa Ricans.

Hypothesis: SES disparities in adult health are minimal in Costa Rican society.

Methods: Data from the Costa Rican Study on Longevity and Healthy Aging study: 8,000 elderly Costa Ricans to determine mortality in the period 2000-2007 and a subsample of 3,000 to determine prevalence of several health conditions and biomarkers from anthropometry and blood and urine specimens.

Results: The ultimate health indicator, mortality, as well as the metabolic syndrome, reveals that better educated and wealthier individuals are worse off. In contrast, quality of life-related measures such as functional and cognitive disabilities, physical frailty, and depression all clearly worsen with lower SES. Overall self-reported health (SRH) also shows a strong positive SES gradient. Traditional cardiovascular risk factors such as diabetes and cholesterol are not significantly related to SES, but hypertension and obesity are worse among high-SES individuals. Reflecting mixed SES gradients in behaviors, smoking and lack of exercise are more common among low SES, but high calorie diets are more common among high SES.

Conclusions: Negative modern behaviors among high-SES groups may be reversing cardiovascular risks across SES groups, hence reversing mortality risks. But negative SES gradients in healthy years of life persist.

Show MeSH
Related in: MedlinePlus