Self-perceived health among urban and rural older adults in Maranhão: sociodemographic, lifestyle, and health condition differences

INTRODUCTION: population aging poses different challenges depending on the area of residence, while the Brazilian literature on urban–rural inequalities in older adults' health remains scarce in the Northeast region. OBJECTIVE: to determine whether there are differences in self-perceived health between urban and rural older adults in Maranhão when sociodemographic, lifestyle, and health condition factors are considered. METHODS: a cross-sectional, descriptive-comparative study with a convenience sample of 60 older adults (38 urban residents affiliated with a community center for older adults and 22 rural residents approached through a pastoral group in a municipality in the interior of the state), interviewed face to face using a structured questionnaire. Comparisons between groups were performed using the chi-square test or Fisher's exact test (significance level of 5%). RESULTS: rural older adults had lower educational attainment and income, higher proportions of physical inactivity and smoking, worse self-perceived general and physical health, and greater difficulty with instrumental activities of daily living (AIVD), especially using transportation and managing finances, compared with urban older adults (p<0.05 for most variables). CONCLUSIONS: the findings show substantial territorial inequality in the health and living conditions of older adults in Maranhão, reinforcing the need for differentiated public policies on aging adapted to the specific characteristics of rural areas.