Self-perceived health status in older adults: regional and sociodemographic inequalities in Spain

Beatriz Fernandez-Martinez,Maria-Eugenia Prieto-Flores,Gloria Fernández-Mayoralas,Fermina Rojo-Pérez,Maria João Forjaz,Pablo Martínez-Martín

doi:10.1590/s0034-89102012000200013

Abstract

OBJECTIVE: To assess regional and sociodemographic differences in self-perceived health status among older adults. METHODS: A face-to-face quality of life survey was conducted in a representative sample of the Spanish population comprising 1,106 non-institutionalized elderly aged 60 or more in 2008. Logistic regression models were used to explain self-perceived health status according to the EuroQol Group Visual Analogue Scale (EQ-VAS). Independent variables included sociodemographic and health characteristics as well as the nomenclature of territorial units for statistics level 1 (NUTS1: group of autonomous regions) and level 2 (NUTS 2: autonomous regions). RESULTS: Younger and better off respondents were more likely to have a positive self-perceived health status. Having no chronic conditions, independence in performing daily living activities and lower level of depression were also associated with positive self-perceived health status. People living in the south of Spain showed a more negative self-perceived health status than those living in other regions. CONCLUSION: The study results point to health inequality among Spanish older adults of lower socioeconomic condition and living in the south of Spain. The analysis by geographic units allows for international cross-regional comparisons.

Highlights

Aging of the population is a worldwide trend in recent decades
People living in the south of Spain showed a more negative self-perceived health status than those living in other regions
The study results point to health inequality among Spanish older adults of lower socioeconomic condition and living in the south of Spain

Summary

Introduction

Aging of the population is a worldwide trend in recent decades. According to the United Nations, among populations of developed countries, the proportion of people aged 60 or more is projected to increase from 21% in 2009 to 33% in 2050, with greater increase among the older-elderly (80 years or more).a In Spain, people aged 60 years or more accounted for 21.8% of total population in 2009 (45,828,172 people), and this segment is estimated to increase to 37.7% in 2049.bThe aging process implies higher probability of suffering from disease and disability, in the very old population. Self-perceived health status is a measure widely used in many studies as it is closely associated with objective health status and health care demand It is a useful indicator of health care needs when designing programs and is highly sensitive to social factors that cause health inequalities.[12]. The impact of sociodemographic, socioeconomic and health-related factors on health status perception among older adults is well known,13,c but there are few studies that have analyzed geographic differences in self-perceived health in Spain. Geographic differences between diseases and health indicators at different territorial scales have become evident nationwide Many of these studies have shown a disadvantage of the south and northwest[1,4,8,11,26] in regard to mortality, health status and disability, among others. Little is known about such inequalities among older adults, a population segment that is susceptible to socioeconomic inequalities and their impact on health

Methods

Results

Conclusion