Skin color, social inequalities and health in older adults: an analysis based on the SABE survey in Colombia

Abstract

Our study is based on the Colombia SABE survey (Health, Well-Being, and Aging Study), which included 23,694 individuals aged 60+ in urban and rural areas of the country. The analysis addresses adult self-perception of health status as a dependent variable and its relationships to ethnic/racial self-recognition and to interviewer-ascribed skin color as a phenotypic trait using a validated technique with a color palette. Social inequalities were determined based on the characterization of socioeconomic status, urban or rural residence, literacy, and the average years of education attained. Our study brought together socioeconomic factors, ethnic-racial self-recognition and skin color as factors of discrimination. Descriptive statistical tests and four adjusted logistic models were developed, controlling by the sex and the age of the individuals. The findings show that adults in households with better socioeconomic conditions have a better self-perception of health. Regarding ethnic-racial self-recognition, Afro-descendant, black, and mulatto adults have less good health perception than white-mestizo adults and face the worst socioeconomic conditions. In summary, skin color and ethnic and racial self-recognition categories, together with classic socioeconomic variables, are relevant to understand the health status self-perception of older adults as part of the processes of exclusion and discrimination that have consequences for health inequalities.

Healthy aging determinants and disability among older adults: SABE Colombia

“…Our results corroborated the important role of ethnicity, Indigenous and Black, in developing mobility and ADL/IADL disability ( 34 ). Recently, a study from SABE Colombia showed the social and economic gradients that occur among older adults according to ethnicity; Black or Afro-descendant adults faced the worst social and economic vulnerability, as assessed by their SES and educational level ( 10 ). Our results also indicate disability differences between rich and poor populations.…”

“…Recent studies have also shown that inequalities and inequities have grown among Colombian older adults ( 8 – 17 ). Significant associations have been found between indicators of health and SDH, including age and gender ( 8 , 9 ), skin color ( 10 ), chronic conditions ( 11 ), frailty ( 12 , 13 ), functional limitations ( 14 ), health care utilization ( 15 ), use of psychotropic drugs ( 16 ), and social capital ( 17 ). All of these factors, together with other SDH, are relevant to understanding the health status of older adults as part of the processes of exclusion and discrimination that have consequences for health inequities in the region.…”