Local presence of low income has been constantly associated with worst health in a variety of settings. On the other hand, the effect of income inequality on health has been so far inconclusive. The present study aims to test the association between income inequality (measured by the Gini coefficient) and health in the Municipality of São Paulo, by analyzing a sample of elderly residents. The current project will use the results of the Saúde, Bem-Estar e Envelhecimento Study (SABE) from the years 2000, 2006 and 2010, when 2143 older individuals from 49 distritos of the Municipality of São Paulo were analyzed by answering questionnaires and taking part in physical, cognitive and anthropometric tests. Multilevel models will be fitted with the presence of diseases (hypertension, diabetes, pulmonary diseases, cancer and heart diseases), cognitive evaluation, physical condition and functional capability as the outcome variables, in order to test the effects of local inequality in health, after controlling for individual characteristics (sex, age, income, education, Body Mass Index (BMI) and smoking). Afterwards, longitudinal multilevel models will be fitted where the year of the analysis (2000, 2006 and 2010) will be entered as a third level. By the calculation of growth curve models for each outcome variable, it will be tested if the health conditions change differently depending on the level of inequality of the distrito of residence. The residuals of the multilevel models will help to determine for which distritos the health factors (and its changes between the interview periods) are more influenced by income inequality. The study will be supervised by Prof. Ruy Laurenti and will have the collaboration and evaluation of Prof. Maria Lúcia Lebrão, Prof. Ichiro Kawachi and Prof. S.V. Subramanian.
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