This Article Full Text (OnlineFirst PDF) All Versions of this Article: 1403494808100272v1 37/2/176    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Schneider, M. Articles by Laubscher, R. Search for Related Content PubMed PubMed Citation Articles by Schneider, M. Articles by Laubscher, R. Pubmed/NCBI databases Medline Plus Health Information Coping with Chronic Illness Social Bookmarking                         What's this?

Poverty and non-communicable diseases in South Africa

¹ Burden of Disease Research Unit, South African Medical Research Council
² Chronic Disease of Lifestyle Research Unit, South African Medical Research Council
³ Biostatistics Unit, South African Medical Research Council

^* To whom correspondence should be addressed.

	Abstract

Background: High levels of wealth inequality with improved health statistics in South Africa (SA) provide an important opportunity to investigate non-communicable diseases (NCDs) among the poor. Aims: This paper uses two distinct national data sets to contrast patterns of mortality in rich and poor areas and explore the associations between poverty, risk factors, health care and selected NCDs diseases in South African adults. Methods: Causes of premature mortality in 1996 experienced in the poorest magisterial districts are compared with those in the richest, using average household wealth to classify districts. Logistic and multinomial regression are used to investigate the association of a household asset index and selected chronic conditions, related risk factors and healthcare indicators using data from the 1998 South African Demographic and Health Survey. Results: NCDs accounted for 39% and 33% of premature mortality in rich and poor districts respectively. The household survey data showed that the risk factors hypertension and obesity increased with increasing wealth, while most of the lifestyle factors, such as light smoking, domestic exposure to "smoky" fuels and alcohol dependence were associated with poverty. Treatment status for hypertension and asthma was worse for poor people than for rich people. Conclusions: The study suggests that NCDs and lifestyle-related risk factors are prevalent among the poor in SA and treatment for chronic diseases is lacking for poor people. The observed increase in hypertension and obesity with wealth suggests that unless comprehensive health promotion strategies are implemented, there will be an unmanageable chronic disease epidemic with future socioeconomic development in SA.

Key Words: Chronic conditions, lifestyle factors, poverty, non-communicable disease (NCD), risk factors, South African Demographic and Health Survey (SADHS)

First published on January 22, 2009, doi:10.1177/1403494808100272

Scandinavian Journal of Public Health 2009;37:176.

A more recent version of this article appeared on March 1, 2009


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?