The Puzzling SES Gradients in Adult Health and Mortality of a Latin American Population

Luis Rosero-Bixby, Universidad de Costa Rica
William H. Dow, University of California, Berkeley

Vast evidence has shown that poorer health and higher mortality in children are clearly associated with lower socioeconomic status of parents everywhere. In contrast, the evidence of a SES gradient in developing country adult health is scarce and conflicting. Particularly puzzling is the fact that subjective general health status measures have been found in some studies to have much larger SES gradients than more objectively measured health indicators. This paper further investigates this paradox using data from an ongoing longitudinal study of health and survival among elderly Costa Ricans (the CRELES study). We document varying SES gradients across a rich array of health indicators including subjective health, functional status, disease conditions, objective risk factors from blood and urine samples, and mortality data. In addition, we estimate SES gradients in key mediating environmental and behavior variables in order to elucidate what hypotheses may be most promising for further research.