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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: 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.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.

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

Age-specific death rates. Costa Rica sample, Japan, and United States.
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fig2: Age-specific death rates. Costa Rica sample, Japan, and United States.

Mentions: Turning to the SES gradient issue, the exceptionally good health indicators of the Costa Rican population are by themselves a challenge to the notion of an inevitable SES gradient. Death rates of Costa Rican adults in the CRELES sample are lower than in the United States and not very different than in Japan, especially at higher ages (Figure 2), in spite of the substantially lower SES of the Latin American population measured by any traditional indicator such as education, income, or health expenditure. It is remarkable that a population with a per capita income that is one fifth of the United States' and per capita health expenditures that are one tenth of the United States' can have lower death rates than the United States. Life expectancy at age 60 implicit in the mortality rates in Figure 2 is 22.4 years for men and 24.8 for women in the Costa Rican sample. The corresponding values are 20.2 and 23.4 for the United States and 21.9 and 27.3 for Japan.


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)

Age-specific death rates. Costa Rica sample, Japan, and United States.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig2: Age-specific death rates. Costa Rica sample, Japan, and United States.
Mentions: Turning to the SES gradient issue, the exceptionally good health indicators of the Costa Rican population are by themselves a challenge to the notion of an inevitable SES gradient. Death rates of Costa Rican adults in the CRELES sample are lower than in the United States and not very different than in Japan, especially at higher ages (Figure 2), in spite of the substantially lower SES of the Latin American population measured by any traditional indicator such as education, income, or health expenditure. It is remarkable that a population with a per capita income that is one fifth of the United States' and per capita health expenditures that are one tenth of the United States' can have lower death rates than the United States. Life expectancy at age 60 implicit in the mortality rates in Figure 2 is 22.4 years for men and 24.8 for women in the Costa Rican sample. The corresponding values are 20.2 and 23.4 for the United States and 21.9 and 27.3 for Japan.

Bottom Line: 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.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.

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