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.

摘要：本研究以哥伦比亚SABE调查（Health, Well-Being, and Aging Study，健康、福祉与老龄化研究）为数据基础，该调查覆盖该国城乡地区共23694名60岁及以上的居民。本分析以老年人的健康自评状况作为因变量，采用经标准化验证的色卡判定技术，探究其与族群/种族自我认同、以及访员基于表型特征判定的肤色之间的关联。社会不平等程度通过社会经济地位、城乡居住属性、识字水平与平均受教育年限进行表征与测算。本研究将社会经济因素、族群-种族自我认同与肤色纳入歧视相关影响因素的分析范畴。研究开展了描述性统计检验，并构建了四个调整后的逻辑回归模型，以受访者的性别与年龄作为控制变量。结果显示，家庭社会经济状况更优的老年人，其健康自评水平更高。就族群-种族自我认同而言，非裔后裔、黑人与穆拉托群体的健康自评水平显著低于白人-梅斯蒂索群体，且这类群体的社会经济状况最为窘迫。综上，肤色、族群与种族自我认同类别，结合经典社会经济变量，对于理解老年人的健康自评状况具有重要价值——这一关联属于对健康不平等产生影响的排斥与歧视过程的组成部分。