Aging Clinical and Experimental Research

, Volume 20, Issue 1, pp 53–61

Life course, gender and ethnic inequalities in functional disability in a Brazilian urban elderly population

  • Ricardo O. Guerra
  • Beatriz Eugenia Alvarado
  • Maria Victoria Zunzunegui
Original Article


Background and aims: To examine life course social, gender and ethnic inequalities in ADL disability in a Brazilian urban elderly population. Methods: We used the São Paulo-SABE study (health, well-being and aging in Latin America and the Caribbean) to assess the associations between ADL disability and gender, ethnicity and life course social conditions (childhood socio-economic and health status, education, lifetime occupation, current perception of income), controlling for current physical and mental health (cognitive impairment and co-morbidity). ADL disability was defined as the presence of one or more difficulties with six tasks: bathing, toileting, dressing, walking across the room, eating, and getting out of bed. Results: Results suggest that social inequalities during the life course (hunger and poverty in early life; illiteracy, a low skilled occupation, having been a housewife; insufficient income) tend to result in disability in later life. The prevalence of ADL disability was higher among women (22.4%) than among men (14.8%). Mestizo/Native elders reported higher prevalence of disability compared with Whites and Blacks/Mulattos. Ethnic inequalities concerning ADL disability were explained by social and health conditions, but the gender gap persisted (OR women vs men= 2.16; 95% CI 1.32–3.55). Despite their higher rate of ADL disability in old age, women appear to be more resilient than men toward poor socio-economic conditions throughout the life course. Chronic conditions were more likely to result in ADL disability among men than women (OR= 1.83; 95% CI 1.41–2.38 in women; OR= 3.42; 95% CI 2.41–4.86 in men). Conclusions: Decreasing social inequalities during childhood and adulthood will reduce socio-economic inequalities in disability in old age, especially among men.


Activities of daily living aging gender inequalities 


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Copyright information

© Springer Internal Publishing Switzerland 2008

Authors and Affiliations

  • Ricardo O. Guerra
    • 1
  • Beatriz Eugenia Alvarado
    • 2
  • Maria Victoria Zunzunegui
    • 2
    • 3
  1. 1.Department of Physical Therapy, Centro de Ciências da SaúdeFederal University of Rio Grande do NortePetrópolis, Natal-RNBrasil
  2. 2.Groupe de Recherche Interdisciplinaire en SantéCanada
  3. 3.Département de Médecine Sociale et PreventiveUniversité de MontrealMontrealCanada

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