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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

Socioeconomic status (SES) gradients in mortality and poor self-rated health (SRH). Costa Rican elderly. Rates or proportions relative to total population, controlled for age, sex, and marital status with regression: logistic for proportions and Gompertz hazard for rates.
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fig3: Socioeconomic status (SES) gradients in mortality and poor self-rated health (SRH). Costa Rican elderly. Rates or proportions relative to total population, controlled for age, sex, and marital status with regression: logistic for proportions and Gompertz hazard for rates.

Mentions: Within Costa Rica, there is not a clear SES gradient in adult mortality or, if anything, the gradient is contrary to expectations. Table 3 and Figure 3 show that in our sample, there are slight increases in mortality with higher levels of education and wealth, net of other influences, and the least developed lowlands have lower mortality than the more developed highlands. Only the more developed capital city behaves according to expectations, showing lower mortality, although by a small margin.


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)

Socioeconomic status (SES) gradients in mortality and poor self-rated health (SRH). Costa Rican elderly. Rates or proportions relative to total population, controlled for age, sex, and marital status with regression: logistic for proportions and Gompertz hazard for rates.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: Socioeconomic status (SES) gradients in mortality and poor self-rated health (SRH). Costa Rican elderly. Rates or proportions relative to total population, controlled for age, sex, and marital status with regression: logistic for proportions and Gompertz hazard for rates.
Mentions: Within Costa Rica, there is not a clear SES gradient in adult mortality or, if anything, the gradient is contrary to expectations. Table 3 and Figure 3 show that in our sample, there are slight increases in mortality with higher levels of education and wealth, net of other influences, and the least developed lowlands have lower mortality than the more developed highlands. Only the more developed capital city behaves according to expectations, showing lower mortality, although by a small margin.

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