Poverty and non-communicable diseases in South Africa

Schneider, Michelle, Bradshaw, Debbie, Steyn, Krisela, Norman, Rosana and Laubscher, Ria (2009) Poverty and non-communicable diseases in South Africa. Scandinavian Journal of Public Health, 37 2: 176-186. doi:10.1177/1403494808100272

Author Schneider, Michelle
Bradshaw, Debbie
Steyn, Krisela
Norman, Rosana
Laubscher, Ria
Title Poverty and non-communicable diseases in South Africa
Journal name Scandinavian Journal of Public Health   Check publisher's open access policy
ISSN 1403-4948
Publication date 2009-01-22
Year available 2009
Sub-type Article (original research)
DOI 10.1177/1403494808100272
Open Access Status DOI
Volume 37
Issue 2
Start page 176
End page 186
Total pages 11
Editor Kamper-Jorgensen, Finn
Place of publication Stockholm
Publisher Sage Publications Ltd
Language eng
Subject 1117 Public Health and Health Services
929999 Health not elsewhere classified
Abstract Cambodia developed its public health system along the principles of the district model and geared its services towards managing communicable diseases and maternal and child health issues. In line with other countries in the region, non-communicable diseases have emerged as a leading cause of adult mortality. We assessed the current capacity of the Cambodian district health system to manage hypertension and diabetes, with a focus on access to medicine for these chronic conditions.
Formatted 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.
Keyword Chronic conditions
lifestyle factors
non-communicable disease (NCD)
risk factors
South African Demographic and Health Survey (SADHS)
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 001
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Faculty of Health and Behavioural Sciences -- Publications
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Citation counts: TR Web of Science Citation Count  Cited 25 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 26 times in Scopus Article | Citations
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Created: Thu, 28 Jan 2010, 19:04:19 EST by Thelma Whitbourne on behalf of Faculty Of Health Sciences