Measuring health inequalities: implications of choosing different socioeconomic indicators

• Published in: Cadernos de saúde pública Vol. 38; no. 1; p. e00035521
• Main Authors: Fagundes, Maria Laura Braccini, Amaral Júnior, Orlando Luiz do, Menegazzo, Gabriele Rissotto, Hugo, Fernando Neves, Giordani, Jessye Melgarejo do Amaral
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz 2022; Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz
• Subjects: Aged; Brazil - epidemiology; Cohort Studies; Cross-Sectional Studies; Health Policy & Services; Health Status Disparities; Health Surveys; Humans; Longitudinal Studies; Middle Aged; Research Design; Social Determinants of Health; Socioeconomic Factors; Brazil; Determinantes Sociais da Saúde; Encuestas Epidemiológicas; Factores Socioeconómicos; Social Determinants of Health; Health Surveys; Proyectos de Investigación; Fatores Socioeconômicos; Inquéritos Epidemiológicos; Research Design; Socioeconomic Factors; Projetos de Pesquisa; Determinantes Sociales de la Salud
• ISSN: 0102-311X; 1678-4464; 1678-4464
• DOI: 10.1590/0102-311X00035521

We aimed to verify the association between different socioeconomic indicators and self-rated health in a nationally representative sample of older adults. This cross-sectional study analyzed the baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), a population-based cohort study of persons aged 50 years or older. Data was collected using a household and an individual questionnaire at participants' households. Self-rated health was assessed by a global self-rating item. Three socioeconomic indicators were assessed: individual income, per capita household income, and wealth index. Poisson regression models were performed to estimate the prevalence ratio (PR) and 95% confidence intervals (95%CI) of self-rated health and each socioeconomic indicator, adjusting for covariates. In total, 9,390 older adults answered the outcome question. Whilst for the individual income indicator only the richest quintile showed a statistically significant association with the outcome (PR: 0.90; 95%CI: 0.87; 0.93), for the per capita household income, the fourth (PR: 0.95; 95%CI: 0.91; 0.98) and the fifth quintiles (PR: 0.90; 95%CI: 0.86; 0.94) remained associated with the outcome. Regarding the wealth index, only the second quintile was not associated with the outcome, with lower prevalence of poor self-rated health as richer was the quintile, showing a social gradient. The wealth index seems to be a more adequate indicator, as it reflects resources accumulated over the life course.