Social Security Coverage and Related Factors in Mexican Older Adults: Analysis of Three National Surveys From the Mexican Health and Aging Study

Abstract

Aim: This study aims to analyze social security coverage and identify the associated factors that may promote access to healthcare services in three nationally representative surveys of older Mexican adults. Methods: The present study used data obtained from nationally representative surveys conducted by the Mexican Health and Aging Study (MHAS) and comprising three waves undertaken, in 2015, 2018, and 2021, on a sample of 24,081 older adults (19.6% resident in rural areas and 55.2% women). The variables included age, gender, residence, years of education, multimorbidity, marital status, use of glasses, self-reported health (SRH), and social security coverage (insured vs. uninsured). A nominal logistic regression model was used to evaluate the associations between the independent variables and social security coverage. Results: In the sample, 60.8% (n = 14,644) of the older adults were insured, presenting an increase of 6.7% from 2015 to 2021. By 2021, the variables years of education (odds ratio [OR] = 3.37 [95% confidence interval [CI] 2.74–4.15]), living in an urban area (OR = 4.80 [95% CI 4.24–5.43]), using glasses (OR = 1.47 [95% CI 1.33–1.63]), multimorbidity (OR = 1.36 [95% CI 1.22–1.53]), and with spouse/partner (OR = 1.26 [95% CI 1.13–1.40]) increased the probability of social security coverage in older adults. Conclusions: In the sample, 60.8% of older adults have access to social security coverage, representing a 6.7% increase on the percentage obtained for the 2015 sample. Identifying the barriers to social security coverage is necessary in order to improve access to the healthcare system and reduce health in equalities for all older Mexican adults.