Social inequalities in health among the elderly population: review of indicators used in Spain

Objective: To identify the indicators of social position used to evaluate inequalities in health among the population aged 65 and over in Spain. Method: A systematic search of the literature published in English and Spanish since 2000 in health and social databases was carried out. Primary and secondary studies analyzing these inequalities in Spain were included. The indicators used were identified, as well as the advantages and limitations pointed out by the authors. The main findings were synthesized in a review of the literature. Results: We included 87 studies, described in 89 articles. The socioeconomic indicators employed were both individual and ecological. Among the former, educational level was the most analyzed socioeconomic variable (n = 73). Other individual variables used were occupation (n = 17), objective economic level (n = 16), subjective economic level (n = 4), housing and household material wealth (n = 6), relationship with work activity (n = 5), and mixed measures (n = 5). Among the ecological indicators, simple (n = 3) and complex indices (n = 7) were identified. The latter had been constructed based on several indicators, such as educational level and unemployment. Inequalities in multiple health indicators were analyzed, self-perceived health being the only indicator assessed according to all the socioeconomic indicators described. Conclusions: A wide variety of indicators is identified for the evaluation of social inequalities in health among the elderly population. There have not been sufficiently assessed from a gender perspective; this is a line of interest for future research. (C) 2018 SESPAS. Published by Elsevier Espana, S.L.U.