Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys

 

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dc.contributor.author Umuhoza, Stella M
dc.contributor.author Ataguba, John E
dc.date.accessioned 2018-05-03T13:06:14Z
dc.date.available 2018-05-03T13:06:14Z
dc.date.issued 2018-04-27
dc.identifier.citation International Journal for Equity in Health. 2018 Apr 27;17(1):52
dc.identifier.uri https://doi.org/10.1186/s12939-018-0762-8
dc.identifier.uri http://hdl.handle.net/11427/27915
dc.description.abstract Abstract Background Socioeconomic inequalities in health have been documented in many countries including those in the Southern African Development Community (SADC). However, a comprehensive assessment of health inequalities and inequalities in the distribution of health risk factors is scarce. This study specifically investigates inequalities both in poor self-assessed health (SAH) and in the distribution of selected risk factors of ill-health among the adult populations in six SADC countries. Methods Data come from the 2002/04 World Health Survey (WHS) using six SADC countries (Malawi, Mauritius, South Africa, Swaziland, Zambia and Zimbabwe) where the WHS was conducted. Poor SAH is reporting bad or very bad health status. Risk factors such as smoking, heavy drinking, low fruit and vegetable consumption and physical inactivity were considered. Other environmental factors were also considered. Socioeconomic status was assessed using household expenditures. Standardised and normalised concentration indices (CIs) were used to assess socioeconomic inequalities. A positive (negative) concentration index means a pro-rich (pro-poor) distribution where the variable is reported more among the rich (poor). Results Generally, a pro-poor socioeconomic inequality exists in poor SAH in the six countries. However, this is only significant for South Africa (CI = − 0.0573; p < 0.05), and marginally significant for Zambia (CI = − 0.0341; P < 0.1) and Zimbabwe (CI = − 0.0357; p < 0.1). Smoking and inadequate fruit and vegetable consumption were significantly concentrated among the poor. Similarly, the use of biomass energy, unimproved water and sanitation were significantly concentrated among the poor. However, inequalities in heavy drinking and physical inactivity are mixed. Overall, a positive relationship exists between inequalities in ill-health and inequalities in risk factors of ill-health. Conclusion There is a need for concerted efforts to tackle the significant socioeconomic inequalities in ill-health and health risk factors in the region. Because some of the determinants of ill-health lie outside the health sector, inter-sectoral action is required.
dc.language.iso en
dc.publisher BioMed Central
dc.source a International Journal for Equity in Health
dc.source.uri https://equityhealthj.biomedcentral.com/
dc.subject.other Health inequality
dc.subject.other Self-assessed health
dc.subject.other World Health Survey
dc.subject.other Southern African development community
dc.title Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys
dc.type Journal Article
dc.date.updated 2018-04-29T03:28:14Z
dc.rights.holder The Author(s).
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Health Economics Unit en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Umuhoza, S. M., & Ataguba, J. E. (2018). Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys. <i>a International Journal for Equity in Health</i>, http://hdl.handle.net/11427/27915 en_ZA
dc.identifier.chicagocitation Umuhoza, Stella M, and John E Ataguba "Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys." <i>a International Journal for Equity in Health</i> (2018) http://hdl.handle.net/11427/27915 en_ZA
dc.identifier.vancouvercitation Umuhoza SM, Ataguba JE. Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys. a International Journal for Equity in Health. 2018; http://hdl.handle.net/11427/27915. en_ZA
dc.identifier.ris TY - Journal Article AU - Umuhoza, Stella M AU - Ataguba, John E AB - Abstract Background Socioeconomic inequalities in health have been documented in many countries including those in the Southern African Development Community (SADC). However, a comprehensive assessment of health inequalities and inequalities in the distribution of health risk factors is scarce. This study specifically investigates inequalities both in poor self-assessed health (SAH) and in the distribution of selected risk factors of ill-health among the adult populations in six SADC countries. Methods Data come from the 2002/04 World Health Survey (WHS) using six SADC countries (Malawi, Mauritius, South Africa, Swaziland, Zambia and Zimbabwe) where the WHS was conducted. Poor SAH is reporting bad or very bad health status. Risk factors such as smoking, heavy drinking, low fruit and vegetable consumption and physical inactivity were considered. Other environmental factors were also considered. Socioeconomic status was assessed using household expenditures. Standardised and normalised concentration indices (CIs) were used to assess socioeconomic inequalities. A positive (negative) concentration index means a pro-rich (pro-poor) distribution where the variable is reported more among the rich (poor). Results Generally, a pro-poor socioeconomic inequality exists in poor SAH in the six countries. However, this is only significant for South Africa (CI = − 0.0573; p < 0.05), and marginally significant for Zambia (CI = − 0.0341; P < 0.1) and Zimbabwe (CI = − 0.0357; p < 0.1). Smoking and inadequate fruit and vegetable consumption were significantly concentrated among the poor. Similarly, the use of biomass energy, unimproved water and sanitation were significantly concentrated among the poor. However, inequalities in heavy drinking and physical inactivity are mixed. Overall, a positive relationship exists between inequalities in ill-health and inequalities in risk factors of ill-health. Conclusion There is a need for concerted efforts to tackle the significant socioeconomic inequalities in ill-health and health risk factors in the region. Because some of the determinants of ill-health lie outside the health sector, inter-sectoral action is required. DA - 2018-04-27 DB - OpenUCT DP - University of Cape Town J1 - a International Journal for Equity in Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys TI - Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys UR - http://hdl.handle.net/11427/27915 ER - en_ZA


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