Gender differences in predictors of self-rated health among older adults in Brazil and Chile

Abstract

Background: The determinants of self-rated health (SRH) have been widely investigated to explain social differences and gender differences in health. This study aimed to investigate the gender differences in predictors of SRH among Brazilian and Chilean older adults. Methods: We used two samples of older people: 2052 Brazilian community-dwelling participants (1226 women and 862 men) and 1301 Chilean community-dwelling participants (855 women and 446 men). Sequential logistic regression analysis was used to examine the relationships between SRH and potential predictors in a hierarchical model. Results: Overall, 35.5% and 52.1% of individuals in Chile and Brazil, respectively, reported good SRH. There was a gradient association between good SRH and chronic diseases in both countries. Chilean men without chronic disease or with one had a higher chance of good SRH, compared to two or more diseases. For Brazilian men, no or one chronic disease was associated with good SRH. For women, the set of independent predictors for good SRH included no chronic diseases or one chronic disease, and no activities of daily living limitation. For men, the set also included instrumental activities limitation. For Brazilian adults of both genders, depression demonstrated the strongest independent association with good SRH. Conclusions: We conclude that when examining gender differences in predictors of SRH, the similarities are greater than the differences between Brazilian and Chilean older adults. In both countries, physical health was the most important predictor of SRH. In addition, absence of depression was the strongest predictor of good health in older Brazilian adults.