Income Inequality and Mortality: Results From a Longitudinal Study of Older Residents of Sao Paulo, Brazil

Author(s)

Pabayo, Roman ^[1] ; Chiavegatto Filho, Alexandre D. P. ^[2] ; Lebrao, Maria Lucia ^[2] ; Kawachi, Ichiro ^[1]

Affiliation

^[1] Harvard Univ, Sch Publ Hlth, Dept Social & Behav Sci, Boston, MA 02215 - USA

^[2] Univ Sao Paulo, Fac Saude Publ, Dept Epidemiol, BR-01255 Sao Paulo - Brazil

• Document type: Journal article
• Source: American Journal of Public Health; v. 103, n. 9, p. E43-E49, SEP 2013.
• Web of Science Citations: 5

Abstract

Objectives. We determined whether community-level income inequality was associated with mortality among a cohort of older adults in Sao Paulo, Brazil. Methods. We analyzed the Health, Well-Being, and Aging (SABE) survey, a sample of community-dwelling older adults in Sao Paulo (2000-2007). We used survival analysis to examine the relationship between income inequality and risk for mortality among older individuals living in 49 districts of Sao Paulo. Results. Compared with individuals living in the most equal districts (lowest Gini quintile), rates of mortality were higher for those living in the second (adjusted hazard ratio {[}AHR] = 1.44, 95% confidence interval {[}CI] = 0.87, 2.41), third (AHR = 1.96, 95% CI = 1.20, 3.20), fourth (AHR = 1.34, 95% CI = 0.81, 2.20), and fifth quintile (AHR = 1.74, 95% CI = 1.10, 2.74). When we imputed missing data and used poststratification weights, the adjusted hazard ratios for quintiles 2 through 5 were 1.72 (95% CI = 1.13, 2.63), 1.41 (95% CI = 0.99, 2.05), 1.13 (95% = 0.75, 1.70) and 1.30 (95% CI = 0.90, 1.89), respectively. Conclusions. We did not find a dose-response relationship between area-level income inequality and mortality. Our findings could be consistent with either a threshold association of income inequality and mortality or little overall association. (AU)

• FAPESP's process: 12/09717-2 - Income inequality and elderly health: a longitudinal multilevel analysis of a sample of the Municipality of São Paulo.
• Grantee: Alexandre Dias Porto Chiavegatto Filho
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 09/53778-3 - SABE Study 2010: Health, well-being and aging
• Grantee: Maria Lúcia Lebrão
• Support Opportunities: Research Projects - Thematic Grants