Richer, wiser and in better health? The socioeconomic gradient in
hypertension prevalence, unawareness and control in South Africa
hypertension prevalence, unawareness and control in South Africa
File(s)
Accepted version
Author(s)
Thomas, R
Burger, R
Hauck, Katharina
Type
Journal Article
Abstract
The socioeconomic gradient in chronic conditions is clear in the poorest and wealthiest of countries, but extant evidence on this relationship in low- and middle-income countries is inconclusive. We use data gathered between 2008-2012 from a nationally representative sample of over 10,000 South African adults, and objective health measures to analyse the differential effects of education, income and other factors on the prevalence of hypertension, individuals' awareness and control of hypertensive status. Prevalence of hypertension is high at 38% among
women and 34% among men. 59% of hypertensive individuals are unaware of their status. We and prevalence and unawareness of hypertension are a public health concern across all income
groups in South Africa. Higher income is however associated with effective control amongst men. Completing secondary education is associated with 7 mmHg lower blood pressure only in a small sub-group of women but is associated with 22 percentage point higher likelihood
of effective hypertension control amongst women. We conclude that poorer and less educated individuals are particularly at high risk of cardiovascular disease in South Africa.
women and 34% among men. 59% of hypertensive individuals are unaware of their status. We and prevalence and unawareness of hypertension are a public health concern across all income
groups in South Africa. Higher income is however associated with effective control amongst men. Completing secondary education is associated with 7 mmHg lower blood pressure only in a small sub-group of women but is associated with 22 percentage point higher likelihood
of effective hypertension control amongst women. We conclude that poorer and less educated individuals are particularly at high risk of cardiovascular disease in South Africa.
Date Issued
2018-11-01
Date Acceptance
2018-09-20
Citation
Social Science and Medicine, 2018, 217, pp.18-30
ISSN
0277-9536
Publisher
Elsevier
Start Page
18
End Page
30
Journal / Book Title
Social Science and Medicine
Volume
217
Copyright Statement
© 2018 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor
Medical Research Council (MRC)
National Institute for Health Research
Pepfar, NIAID, NIMH, NIDA, BMGF
Department for International Development (UK) (DFI
Grant Number
MR/K010174/1B
HPRU-2012-10080
N/A
Subjects
Science & Technology
Social Sciences
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Social Sciences, Biomedical
Biomedical Social Sciences
South Africa
Hypertension
Socioeconomic gradient
Unawareness
Control
MIDDLE-INCOME COUNTRIES
HEART-RATE
WAIST CIRCUMFERENCE
RISK-FACTORS
DISEASE
TUBERCULOSIS
AWARENESS
DEMAND
CARE
1117 Public Health And Health Services
1601 Anthropology
1608 Sociology
Public Health
Publication Status
Published
Date Publish Online
2018-09-27