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Socio-economic inequalities as a predictor of health in South Africa - the Yenza cross-sectional study

Mfenyana, K; Griffin, M; Yogeswaran, P; Modell, B; Modell, M; Chandia, J; Nazareth, I; (2006) Socio-economic inequalities as a predictor of health in South Africa - the Yenza cross-sectional study. SAMJ S AFR MED J , 96 (4) 323 - 330. Gold open access

Abstract

Objectives. To describe the demographic, environmental and health characteristics of the rural Eastern Cape and to explore demographic and environmental predictors of health.Design. Cross-sectional study.Setting. Engcobo and Umtata in the Eastern Cape, South Africa.Subjects. 12 049 people from 4 608 households.Outcome measures. (i) Children: immunisation history and being breastfed; (ii) women aged 15 - 45 years: use of contraception; (iii) women aged 20 - 25 years: total numbers of dead children; and (iv) all adults: smoking status, body mass index and blood pressure.Results. 2 741 houses (59.5%) were structurally adequate, 1795 (39.0%) had access to clean water, and 1 174 (25.6%) had access to gas or electric energy. Of children up to 5 years of age 1436 (44.2%) were fully immunised and 2 472 (76.1%) were breastfed in their first year of life. Among women aged 15 - 45 years, 903 (37.8%) used contraceptives, and among women aged 20 - 25 years, 56 (11.8%) had lost at least 1 child. Self-report of chronic illness and disability was low. Current smokers include 264 men (12.7%) and 325 women (6.0%), and 315 men (15.2%) and 1439 women (26.7%) had a body mass index > 30. Adequate housing (odds ratio (OR) 1.31, 95% confidence interval (CI): 1.12 - 1.53) and access to refuse disposal (OR 1.65, 95% CI: 1.36 - 2.00) were predictive of complete immunisation in children. Children living in houses with access to clean water (OR 0.8, 95% CI: 0. 64 - 0.99) and a fitted toilet (OR 0.56, 95% CI: 0.38 - 0.83) were less likely to be breastfed in the first year of their life. Women aged 15 - 45 years were likely to use contraception if they were well educated (OR 2.75,95% CI: 1.76 - 4.28) and lived in houses with access to refuse disposal (OR 1.46, 95% CI: 1.20 - 1.78). Better education was associated with a reduced likelihood of loss of a child (OR 0.11, 95% CI: 0.02 - 0.51) and being a smoker (OR 0.52, 95% Cl: 0.38 - 0.73). Obesity was associated with being female (OR 1.88, 95% CI: 1.62 - 2.18) and living in a house with electricity (OR 1.46, 95% CI: 1.26 - 1.68). High blood pressure was associated with living in a house with electricity (OR 1.36,95% CI: 1.10 - 1.70) and with monthly household income exceeding R2 000 (OR 1.38, 95% CI: 1.07 - 1.78). Conclusions. High socio-economic deprivation in the Eastern Cape is associated with health status comparable to that of poorer regions in sub-Saharan Africa. The educational level of the population, access to electricity, clean water and refuse disposal facilities are important predictors of child, maternal and adult health.

Type: Article
Title: Socio-economic inequalities as a predictor of health in South Africa - the Yenza cross-sectional study
Open access status: An open access publication
Publisher version: http://www.samj.org.za/index.php/samj/index
Keywords: UNDERPRIVILEGED AREAS, IDENTIFICATION, DEPRIVATION
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: http://discovery.ucl.ac.uk/id/eprint/119351
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