Elsevier

Women's Health Issues

Volume 21, Issue 1, January–February 2011, Pages 64-70
Women's Health Issues

Original article
Gender Differences in Life Expectancy and Disability-Free Life Expectancy Among Older Adults in São Paulo, Brazil

https://doi.org/10.1016/j.whi.2010.08.007Get rights and content

Abstract

Background

Research on life expectancy has demonstrated the negative impact of disability on the health of older adults and its differential effects on women as evidenced by their higher disabled life expectancy (DLE). The goal of the present study was to investigate gender differences in total life expectancy (TLE), disability-free life expectancy (DFLE), and DLE; examine gender differences on personal care assistance among older adults in São Paulo, Brazil; and discuss the implications for public policies.

Methods

The sample was drawn from two waves (2000, 2006) of the dataset of Salud, Bienestar, y Envejecimiento, a large longitudinal study conducted in São Paulo (n = 2,143). The study assessed disability using the activities of daily living (ADL). The interpolation of Markov Chain method was used to estimate gender differences in TLE, DLE, and DFLE.

Findings

TLE at age 60 years was approximately 5 years longer for women than men. Women aged 60 years were expected to live 28% of their remaining lives—twice the percentage for men—with at least one ADL disability. These women also lived more years (M = 0.71, SE = 0.42) with three or more ADL disabilities than men (M = 0.82, SE = 0.16). In terms of personal care assistance, women received more years of assistance than men.

Conclusion

Among older adults in São Paulo, women lived longer lives but experienced a higher and more severe disability burden than men. In addition, although women received more years of personal assistance than men, women experienced more unmet care assistance needs.

Section snippets

Methods

We analyzed data from the two waves (2000 and 2006) of SABE São Paulo, Brazil. The SABE is a multicenter survey with respondents in seven capital/major cities throughout the countries of Latin America and the Caribbean that has been investigating the health and well-being of older adults (age ≥60 years). The Pan American Health Organization, the Center for Demography and Ecology at the University of Wisconsin—Madison, and the National Institute on Aging provided funding and support for the

Results

Table 1 presents the prevalence estimates of ADL disability and assistance by age group and gender in São Paulo, Brazil for 2000. Weighted estimates indicate that 19.2% of individuals aged 60 years and over in São Paulo reported having difficulty in performing at least one ADL. The most prevalent types of ADL disabilities were difficulties in dressing and getting out of bed. The prevalence of ADL disability was higher among women (22.3%) than among men (14.9%; p < .01). In analyses controlling

Discussion

The current paper had three goals. The first was to examine the impact of gender on the TLE, the DFLE, and the DLE, while taking health transitions into account. Women in Brazil were more likely than men to have difficulty getting in and out of bed and walking across the room. Difficulties performing these activities could be lessened with the use of assistive devices such as a walkers or grab bars. There were no differences between men and women in other ADL disability measures more closely

Conclusion

Using longitudinal data from São Paulo, Brazil, this study confirmed previous studies that found that older women faced a greater disability burden than men. Given the greater prevalence of disability and longer periods of DLE compared with older men, older women face more social and economic marginalization tied to the stigma associated with disability (Filmer, 2008, Robb et al., 2008). The findings have important implications for policy makers in São Paulo, Brazil and other developing

Acknowledgments

The authors thank the editor and the anonymous reviewers for their insightful comments. The author thanks the following individuals for comments during the 2010 REVES meeting in Cuba: Sandra L. Reynolds, Yasuhiko Saito and Zachary Zimmer. The authors also acknowledge the help of Fernão Dias de Lima in the careful database management.

Flavia Cristina Drumond Andrade, PhD, is an Assistant Professor at the Kinesiology and Community Health Department at the University of Illinois, Urbana-Champaign. Her primary research interest focuses on the determinants of population health, particularly in Latin America and in the Caribbean.

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    Flavia Cristina Drumond Andrade, PhD, is an Assistant Professor at the Kinesiology and Community Health Department at the University of Illinois, Urbana-Champaign. Her primary research interest focuses on the determinants of population health, particularly in Latin America and in the Caribbean.

    Pilar Egüez Guevara is a PhD candidate in Anthropology at the University of Illinois, Urbana-Champaign. She has experience in the field of women's health, gender responsive budgeting and human rights in Ecuador. Her current research focuses on women's sexuality in Cuba.

    Maria Lúcia Lebrão, PhD, is Professor at the School of Public Health, Universidade de São Paulo, located in Pinheiros, São Paulo, Brazil. She is one of the principal investigators of the SABE study in São Paulo.

    Yeda Aparecida de Oliveira Duarte, PhD, is a Professor at the School of Nursing at Universidade de São Paulo.

    Jair Lício Ferreira Santos, PhD, is Professor of Demography at the School of Public Health, where he also served as Director, and at the School of Medicine of Ribeirão Preto at the University Universidade de São Paulo.

    Supported by FAPESP/Brazil, the Brazilian Ministry of Health and the Lemann Institute for Brazilian Studies at the University of Illinois at Urbana-Champaign.

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