The influence of socioeconomic deprivation, access to healthcare and physical environment on old-age survival in Portugal

• Type: Article in International Scientific Journal
• Date: 2017

Authors

Ribeiro, AI (Author) FMUP; Krainski, ET (Author) Other; Carvalho, MS (Author) Other; de Pina, MD (Author) Other

Journal

Title: Geospatial health

Vol. 12

Pages: 252-263

ISSN: 1827-1987

Publisher: University of Naples Federico II

Indexing

ISI Web of Knowledge - 15 Citations

Scopus - 20 Citations

Other information

Authenticus ID: P-00N-7KY

DOI: 10.4081/gh.2017.581

Abstract (EN): Spatial inequalities in old-age survival exist in Portugal and might be associated with factors pertaining to three distinct domains: socioeconomic, physical environmental and healthcare. We evaluated the contribution of these factors on the old-age survival across Portuguese municipalities deriving a surrogate measure of life expectancy, a 10-year survival rate that expresses the proportion of the population aged 75-84 years old who reached 85-94. As covariates we used two internationally comparable multivariate indexes: the European deprivation index and the multiple physical environmental deprivation index. A national index was developed to evaluate the access to healthcare. Smoothed rates and oddS ratios (OR) were estimated using Bayesian spatial models. Socioeconomic deprivation was found to be the most relevant factor influencing old-age survival in Portugal [women: least deprived areas 012=1.132(1.064-1.207); men OR=1.044(1.001-1.094)] and explained a sizable amount of the spatial variance in survival, especially among women. Access to healthcare was associated with old-age survival in the univariable model only; results lost significance after adjustment for socioeconomic circumstances [women: higher access to healthcare OR=1.020(0.973-1.072); men OR=1.021(0.989-1.060)]. Physical enviromnental deprivation was unrelated with old-age survival. In conclusion, socioeconomic deprivation was the most important determinant in explaining spatial disparities in old-age survival in Portugal, which indicates that policy makers should direct their efforts to tackle socioeconomic differentials between regions.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 12