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AJPH First Look, published online ahead of print Nov 13, 2008
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January 2009, Vol 99, No. 1 | American Journal of Public Health 81-86
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2007.130708

RESEARCH AND PRACTICE

Reductions in Disability Prevalence Among the Highest Income Groups of Older Brazilians

Maria Isabel Parahyba, PhD, Kara Stevens, MSc, William Henley, PhD, Iain A. Lang, PhD and David Melzer, PhD, MB

Maria Isabel Parahyba is with the Brazilian Institute of Geography and Statistics, Rio de Janeiro. Kara Stevens, William Henley, Iain A. Lang, and David Melzer are with the Epidemiology and Public Health Group, Peninsula Medical School, Exeter, England.

Correspondence: Requests for reprints should be sent to Maria Isabel Parahyba, Instituto Brasileiro de Geografia e Estatística, Coordenação de População e Indicadores Sociais, Av. República do Chile, 500/8° andar, Centro, Rio de Janeiro, 20031-170, Brazil (e-mail: isabel.parahyba{at}ibge.gov.br).

Objectives. We sought to identify the income–disability prevalence relationship among older Brazilians.

Methods. Data were from 63 985 individuals 60 years and older from the 1998 and 2003 Brazilian National Household Surveys. Generalized additive logistic models with cubic regression splines were used to estimate the disability–income relationships.

Results. There was a strong linear relationship between increased income and reduced disability prevalence for most of the income distribution. Benefits were still present above the 90th percentile of income but were more modest. Because incomes among the wealthiest few are disproportionately large, odds ratios of disability nevertheless showed marked improvements, even across the very highest income groups.

Conclusions. Among older Brazilians, reduced disability is associated with higher income, and these associations are present even above the 90th percentile of income. In addition to understanding mechanisms of disability reduction among impoverished individuals, work is needed to understand these mechanisms in middle- and high-income groups.






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