Socioeconomic inequalities in activities of daily living limitations and in the provision of informal and formal care for noninstitutionalized older Brazilians: National Health Survey, 2013Reportar como inadecuado




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International Journal for Equity in Health

, 15:137

A panorama of health inequities in Brazil

Abstract

BackgroundThis study assesses the association between socioeconomic factors and living arrangements with activity of daily living limitations ADL and the receipt of informal and formal care among non-institutionalized Brazilians aged ≥ 60 years.

MethodsData come from a nationally representative survey the Brazilian National Health Survey, conducted in 2013. Outcomes examined include the number of ADL tasks performed with limitations and number of tasks for which the individual received informal care provided by unpaid relatives or friends, formal care, or no care. Key exposure variables were years of education and household assets.

ResultsFunctioning limitations were reported by 7,233 30.1 % of 23,815 survey participants. Of these, 5,978 reported needing help to perform at least one ADL task. There was a strong inverse gradient between physical functioning and both education and household assets that was independent of confounders. The provision of care showed an opposite trend, with the wealthiest being more likely to receive help for performing ADL tasks. The receipt of formal care was strongly correlated with highest education Fully adjusted prevalence ratio PR = 1.64; 95 % CI 1.05, 2.58 and with the highest assets level PR = 2.24; 95 % CI 1.38, 3.64. Living with someone else was associated with provision of care formal or informal for those at the lowest and intermediate educational and assets levels, but not for the wealthiest.

ConclusionDespite worse physical functioning, older Brazilians in worse socioeconomic conditions are much less likely to receive needed help in performing ADL tasks.

KeywordsActivities of daily living Instrumental activities of daily living Informal care Formal care National health survey Functional limitation Social inequalities Socioeconomic position AbbreviationsADLBasic activities of daily living

IADLInstrumental activities of daily living

OROdds ratio

PNSNational Health Survey in Portuguese, Pesquisa Nacional de Saúde

SEPsocioeconomic position

SUSNational Health System in Portuguese, Sistema Único de Saúde

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Autor: Ma.Fernanda Lima-Costa - Juliana V. M. Mambrini - Sérgio V. Peixoto - Deborah C. Malta - James Macinko

Fuente: https://link.springer.com/







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