Desigualdades nos determinantes do envelhecimento ativo (Belo Horizonte, 2003-2010) e nos determinantes sociais da saúde (Belo Horizonte e New York, 2010), entre adultos mais velhos

Abstract

Objective: To evaluate trends of social inequalities in seven years (2003-2010) among older adults living in Belo Horizonte (BH), considering indicators of active aging and health status. It also investigates social inequalities in intermediary determinants of health and health status indicators, comparing older adults living in Belo Horizonte and New York City (NYC), United States, in 2010. Methods: Data came from the Belo Horizonte Metropolitan Region Health Survey, conducted in 2003 and 2010 and the NYC Community Health Survey, conducted in 2010. Social inequality was measured using the slope and the relative index of inequality. Educational attainment was used to define socioeconomic status. Results: From 2003 to 2010, Belo Horizonte presented significant improvements in the prevalence rates of 7 out of 12 indicators. However, the social inequalities persisted through 10 out of 12 selected active aging and health status indicators, except for fear of falling on the sidewalks/crossing the streets and fear of assault. In comparison with NYC, BH presented better performance for preventive care and health status indicators. In turn, New York presented better performance in total prevalence for material circumstances and behavioral factors. The cities also presented distinctive patterns of absolute and relative inequalities. In general, the city with the best prevalence rates also showed higher absolute and/or relative inequalities. Discussion: With few exceptions, absolute and relative inequalities in both cities were concentrated among the less educated. Although many public policies likely have improved the global performance of the indicators over time, it seems that the unequal distribution of resources is still persistent.