A gender and life course perspective on health and function in the urban elderly populations of Latin America and the Caribbean

Objective:  This work describes differences in health and functional status among older men and women and attempts to anchor the explanations of these differences from within  a gender and lifecourse perspective.

 Methods: Seven health outcomes between men and women 60 years and older from seven Latin American and Caribbean cities are examined, using data from the 2000 SABE survey (— n=10,587).  Age-adjusted as well as city- and sex-specific prevalence were estimated for poor self-rated health, co-morbidity, mobility limitations, cognitive impairment, depressive symptoms and disability in basic and instrumental activities of daily living. Logistic regressions were fitted to assess if the differences in each outcome between men and women could be explained by differential exposures to social and economic adversity in childhood, adolescence and old age and/or by differential vulnerability of men and women to these exposures.  

 Results: Sao Paulo, Santiago and Mexico, cities in countries with high level of income inequalities, presented the highest prevalence of disability, functional limitations and poor physical health for both women and men. Women showed poorer health outcomes for all health indicators and in all cities. Controlling for childhood, adulthood and old age life course exposures did not attenuate these differences.  Unadjusted and adjusted women’s odds of reporting poor self-rated health, cognitive impairment and basic activities of daily living disability were approximately 50% higher than for men, twice higher for number of comorbidity, depressive symptoms and instrumental activities of daily living disability, and almost three times higher for mobility limitations.

Conclusions: Higher vulnerability in women as compared with men was not found, meaning that life course exposures have similar odds of poor health outcomes for men and women.  A more integrated understanding of how sex and gender act together to influence health and function in old age needs consideration of  biological and additional social factors