Obesidad e hipertensión en los adultos mayores uruguayos

The present work studies the incidence of obesity and socioeconomic status on the prevalence of hypertension on the elderly of Montevideo, Uruguay. Based on data from the Survey on Health, Well-being and Aging (SABE project, PAHO-WHO), a bivariate probit model is estimated controlling by the potential endogeneity of obesity. The results obtained confirm the appropriateness of the joint estimation of both outcomes, and led us to state that being obese raises the probability of suffering from hypertension in 50 percentage points. This effect should have been understated in the probit estimation. At the same time, the instruments chosen that pick up religiosity, smoking and eating habits were relevant and valid with the expected coefficient signs. Tobacco consumption reduces the probability of being obese, showing that either smokers have different metabolism that make them burn more calories than non-smokers, or that smokers tend to ingest less amounts of food given the well-known appetite-suppressant effect of tobacco. On the other hand, the results show a positive association between obesity and religiosity, probably meaning that religion acts as a support once the problem is present, more than a mechanism of self-control or censorship. Finally, the thermic effect of food is confirmed, in the sense that as more meals one eats per day less the probability of being obese. The results do not show a significative association between poor health, measured through morbidity (presence of chronic disease hypertension), and low socioeconomic status. Given the fact that the variable that captures socioeconomic status is positive and statistically significative in the obese equation, the negative effects on health status of a worst socioeconomic status might operate through nutritional outcomes. On the other hand, there might be a problem of selection bias, in the sense that individuals of lower status have higher probability of early death (survival effect), and that public provision of health services with an emphasis on the elderly, reduce the gap between purchasing power and access to health care services.