The Sex and SES Paradox in Health Status and Mortality among Elderly Populations

Luis Rosero-Bixby, Universidad de Costa Rica
Xinia Fernandez, Universidad de Costa Rica
Ericka Mendez, Universidad de Costa Rica
Guido Pinto, University of Wisconsin at Madison

Adult males have higher mortality than females, while, paradoxically, health status indicators often show the contrary: males are better off than females. Mortality indicators are hard, indisputable data. Health indicators, however, are often based on “soft” data, dependent on definitions, interpretations, and subjective self-reports. Based on panel data for elderly Mexicans (the MHAS study) and biomarkers for elderly Costa Ricans (CRELES), we conclude that self-reported indicators of health may be misleading. The sex gap showing elderly women with poorer health than men is to some extent a spurious result of differential age structure, survival selection, and sex-bias in self-reports. The paper also explores whether the huge socioeconomic gap in self-reported health suffers problems analogous to the sex gap. Elderly Costa Ricans do not show the inverse gradient in health by socioeconomic status (SES) in important biomarkers. This finding contradicts results obtained when using self reported indicators.