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

• Published in: BMC public health 2022-08, Vol.22 (1), p.1499-14, Article 1499
• Main Authors: Castillo-Riquelme, Marianela, Yamada, Goro, Diez Roux, Ana V, Alfaro, Tania, Flores-Alvarado, Sandra, Barrientos, Tonatiuh, Teixeira Vaz, Camila, Trotta, Andrés, Sarmiento, Olga L, Lazo, Mariana
• Format: Article
• Language: English
• Subjects: Access to education; Adult; Adults; Age; Aging; Chronic illnesses; Cities; Cross-Sectional Studies; Economic aspects; Education; Female; GDP; Gender; Gender differences; Gender equality; Gross Domestic Product; Health aspects; Hispanic or Latino; Households; Humans; Indicators; Latin America; Male; Management; Men; Metropolitan areas; Middle Aged; Morbidity; Mortality; Multilevel analysis; Older people; Physiological aspects; Population; Public health; Quality of life; Risk assessment; Self Report; Self-reported health; Social aspects; Socioeconomic Factors; Socioeconomics; Urban areas; Urban environments; Urban health; Urbanization; Women; Womens health
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-022-13752-2

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. 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. 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. 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