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Income inequality and elderly health: a longitudinal multilevel analysis of a sample of the Municipality of São Paulo

Grant number: 12/09717-2
Support type:Scholarships in Brazil - Post-Doctorate
Effective date (Start): September 01, 2012
Effective date (End): July 31, 2013
Field of knowledge:Health Sciences - Collective Health - Epidemiology
Principal Investigator:Ruy Laurenti
Grantee:Alexandre Dias Porto Chiavegatto Filho
Home Institution: Faculdade de Saúde Pública (FSP). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Associated research grant:09/53778-3 - SABE Study –2010: Health, well-being and aging, AP.TEM


Local presence of low income has been constantly associated with worst health in a variety of settings. On the other hand, the effect of income inequality on health has been so far inconclusive. The present study aims to test the association between income inequality (measured by the Gini coefficient) and health in the Municipality of São Paulo, by analyzing a sample of elderly residents. The current project will use the results of the Saúde, Bem-Estar e Envelhecimento Study (SABE) from the years 2000, 2006 and 2010, when 2143 older individuals from 49 distritos of the Municipality of São Paulo were analyzed by answering questionnaires and taking part in physical, cognitive and anthropometric tests. Multilevel models will be fitted with the presence of diseases (hypertension, diabetes, pulmonary diseases, cancer and heart diseases), cognitive evaluation, physical condition and functional capability as the outcome variables, in order to test the effects of local inequality in health, after controlling for individual characteristics (sex, age, income, education, Body Mass Index (BMI) and smoking). Afterwards, longitudinal multilevel models will be fitted where the year of the analysis (2000, 2006 and 2010) will be entered as a third level. By the calculation of growth curve models for each outcome variable, it will be tested if the health conditions change differently depending on the level of inequality of the distrito of residence. The residuals of the multilevel models will help to determine for which distritos the health factors (and its changes between the interview periods) are more influenced by income inequality. The study will be supervised by Prof. Ruy Laurenti and will have the collaboration and evaluation of Prof. Maria Lúcia Lebrão, Prof. Ichiro Kawachi and Prof. S.V. Subramanian.

Scientific publications (5)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
CHIAVEGATTO FILHO, ALEXANDRE D. P.; KAWACHI, ICHIRO. Income inequality is associated with adolescent fertility in Brazil: a longitudinal multilevel analysis of 5,565 municipalities. BMC PUBLIC HEALTH, v. 15, FEB 7 2015. Web of Science Citations: 7.
PORTO CHIAVEGATTO FILHO, ALEXANDRE DIAS; BELTRAN-SANCHEZ, HIRAM; KAWACHI, ICHIRO. Racial Disparities in Life Expectancy in Brazil: Challenges From a Multiracial Society. American Journal of Public Health, v. 104, n. 11, p. 2156-2162, NOV 2014. Web of Science Citations: 11.
PORTO CHIAVEGATTO FILHO, ALEXANDRE DIAS; KAWACHI, ICHIRO; WANG, YUAN PANG; VIANA, MARIA CARMEN; SILVEIRA GUERRA ANDRADE, LAURA HELENA. Does income inequality get under the skin? A multilevel analysis of depression, anxiety and mental disorders in Sao Paulo, Brazil. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, v. 67, n. 11, p. 966-972, NOV 2013. Web of Science Citations: 19.
PABAYO, ROMAN; CHIAVEGATTO FILHO, ALEXANDRE D. P.; LEBRAO, MARIA LUCIA; KAWACHI, ICHIRO. Income Inequality and Mortality: Results From a Longitudinal Study of Older Residents of Sao Paulo, Brazil. American Journal of Public Health, v. 103, n. 9, p. E43-E49, SEP 2013. Web of Science Citations: 5.
ALEXANDRE DIAS PORTO CHIAVEGATTO FILHO; RUY LAURENTI. Disparidades étnico-raciais em saúde autoavaliada: análise multinível de 2.697 indivíduos residentes em 145 municípios brasileiros. Cadernos de Saúde Pública, v. 29, n. 8, p. 1572-1582, Ago. 2013.

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