Sex and social class inequities in physical and mental health: an analysis using data from the Burden of Obstructive Lung Disease Trinidad and Tobago (BOLD-TT) study

ABSTRACT

Objectives: To examine sex and social class differences in physical and mental health in the Trinidad and Tobago population aged ≥40 years. Design and Methodology: Data from the BOLD-TT study, which included a stratified cluster sample of 1104 persons, were analysed. The Veteran Rand (VR)-12 instrument assessed physical (general health, physical functioning and role playing and bodily pain) and mental health (vitality, role-emotional, mental health and social functioning); using a physical health component (PCS) and mental health component (MCS) scores. Highest level of education attained, and employment status were used as measures of social class. General Linear Models were used to examine differences in PCS and MCS by sex, education and employment, controlling for age. Results: Mean age of the participants was 54.1 (SD10.8) years; 59.9% were females; 47% had no/primary education; 56% were employed. Mean PCS and MCS (SEM) scores were 47.8 (0.3) and 54.7 (0.3). Females had lower mean PCS and MCS than males (p<.001 in each case). There were significant mean differences in PCS (p<.001) and MCS (p=.04) by employment status. Persons who were not working had lower mean PCS (p<.001) and MCS (p=.002) than those employed. There were differences in PCS by education (p=.019); persons with no/primary education had lower PCS than those with post-secondary and university education. Multiple regression identified employment (p<.001) and education (p=.097) as independent predictors of PCS while sex (p=.002) and employment (p=.021) predicted MCS. Conclusion: The VR-12 provided initial results indicating health inequities i.e. poorer health status among females, the unemployed and uneducated.