Socioeconomic inequalities in health in older adults in Brazil and England.
OBJECTIVE
We examined socioeconomic inequalities in health among older adults in England and Brazil.


METHODS
We analyzed nationally representative samples of residents aged 50 years and older in 2008 data from the Brazilian National Household Survey (n = 75,527) and the English Longitudinal Study of Ageing (n = 9589). We estimated prevalence ratios for self-rated health, functional limitations, and reported chronic diseases, by education level and household income tertiles.


RESULTS
Brazilians reported worse health than did English respondents. Country-specific differences were higher among the poorest, but also affected the wealthiest persons. We observed a strong inverse gradient of similar magnitude across education and household income levels for most health indicators in each country. Prevalence ratios (lowest vs highest education level) of poor self-rated health were 3.24 in Brazil and 3.50 in England; having 2 or more functional limitations, 1.81 in Brazil and 1.96 in England; and having 1 or more diseases, 1.14 in Brazil and 1.36 in England.


CONCLUSIONS
Socioeconomic inequalities in health affect both populations, despite a less pronounced absolute difference in household income and education in Brazil than in England.
Instituto René Rachou, Fundação Oswaldo Cruz and the Department of Social and Preventive Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. lima-costa@cpqrr.fiocruz.br
M Fernanda
MF
Lima-Costa
Cesar
C
De Oliveira
James
J
Macinko
Michael
M
Marmot
D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D004522:Educational Status; D004739:England / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D015995:Prevalence; D012923:Social Class