title: Social capital and under-utilization of medication for financial reasons among elderly women: evidence from two Brazilian health surveys.
abstract: This cross-sectional study assesses the prevalence and examines the role of social and demographic factors, health conditions, health system characteristics and contextual factors of under-utilization of medication for financial reasons among elderly women. Participants in the Greater Metropolitan Belo Horizonte Health Survey (GMBH) and the eleventh phase of the Bambuí Cohort Study of the Elderly were assessed. Among elderly women in the GMBH, the prevalence of under-utilization was 11.4%, and in Bambuí, the rate was 5.4%. Self-perception of health (OR, 3.46; 95%CI, 1.32_9.10); daily life limitations (OR, 2.75; 95% CI, 1.31-5.78) and perception of help (OR, 2.36; 95% CI, 1.07-5.25) had independent associations with under-utilization among GMBH residents. A poor perception of both cohesion in the neighborhood (OR, 2.38; 95% CI, 1.02-5.56) and the physical environment (OR, 2.58; 95% CI, 1.10-6.03) significantly increased the likelihood of under-utilization among Bambuí residents. These results provide important clues to identifying possible risk factors for under-utilization, highlighting the need to develop strategies targeting the amplification of the involvement between elderly women and their community to reduce the extent of under-utilization in later life.
authors.forename: Tatiana Chama Borges
authors.initials: TC
authors.lastname: Luz
authors.forename: Antônio Ignácio
authors.initials: AI
authors.lastname: de Loyola Filho
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Lima-Costa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D066270:Social Capital; D012959:Socioeconomic Factors; D016903:Drug Monitoring