Gender Differences in Life Expectancy and Disability-Free Life Expectancy Among Older Adults in São Paulo, Brazil

Abstract

Background Research on life expectancy has demonstrated the negative impact of disability on the health of older adults and its differential effects on women as evidenced by their higher disabled life expectancy (DLE). The goal of the present study was to investigate gender differences in total life expectancy (TLE), disability-free life expectancy (DFLE), and DLE; examine gender differences on personal care assistance among older adults in São Paulo, Brazil; and discuss the implications for public policies. Methods The sample was drawn from two waves (2000, 2006) of the dataset of Salud, Bienestar, y Envejecimiento, a large longitudinal study conducted in São Paulo ( n = 2,143). The study assessed disability using the activities of daily living (ADL). The interpolation of Markov Chain method was used to estimate gender differences in TLE, DLE, and DFLE. Findings TLE at age 60 years was approximately 5 years longer for women than men. Women aged 60 years were expected to live 28% of their remaining lives—twice the percentage for men—with at least one ADL disability. These women also lived more years ( M = 0.71, SE = 0.42) with three or more ADL disabilities than men ( M = 0.82, SE = 0.16). In terms of personal care assistance, women received more years of assistance than men. Conclusion Among older adults in São Paulo, women lived longer lives but experienced a higher and more severe disability burden than men. In addition, although women received more years of personal assistance than men, women experienced more unmet care assistance needs.