The Magnitude of Health Inequalities Among Older Adults in Brazil and Mexico

This chapter assesses the magnitude of wealth-related inequalities on five health outcomes (obesity, abdominal obesity, diabetes, hypertension, and heart disease) among older adults in Brazil and Mexico. Analyses were based on crosssectional data from the 2013 Brazilian National Health Survey and the 2012 Mexican National Health and Nutrition Survey. Socioeconomic status was based on a wealth index. We calculated wealth-related inequalities in the prevalence of five health outcomes by calculating the concentration index (CI) and horizontal index (HI). Data analyses were performed in STATA SE 14 and ADePT (6.0). Results indicated that prevalence of obesity, abdominal obesity, diabetes, hypertension, and heart disease were higher in the central wealth-quintiles. The concentration indices were all positive, indicating a higher concentration of these health conditions among older adults who are more affluent. Wealth inequalities in health conditions were mainly explained by socioeconomic factors, such as place of residency and educational attainment, rather than demographic factors, such as age and sex. Nonetheless, in both countries, strong inequities in health prevail. Brazil and Mexico have expanded public health actions aimed at improving health behaviours, diagnosis, and access to treatment of chronic conditions. However, prevalence of obesity, abdominal obesity, diabetes, hypertension and heart disease is high in both countries, and among older adults, even more concentrated among those with higher wealth. Prevention and early detection strategies, including improving lifestyle behaviours, such as physical activity and dietary habits, could benefit both countries.