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Richer, wiser and in better health? The socioeconomic gradient in hypertension prevalence, unawareness and control in South Africa

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Title: Richer, wiser and in better health? The socioeconomic gradient in hypertension prevalence, unawareness and control in South Africa
Authors: Thomas, R
Burger, R
Hauck, K
Item 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.
Issue Date: 1-Nov-2018
Date of Acceptance: 20-Sep-2018
URI: http://hdl.handle.net/10044/1/64982
DOI: https://dx.doi.org/10.1016/j.socscimed.2018.09.038
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/Funder: Medical Research Council (MRC)
National Institute for Health Research
Pepfar, NIAID, NIMH, NIDA, BMGF
Department for International Development (UK) (DFI
Funder's Grant Number: MR/K010174/1B
HPRU-2012-10080
N/A
Keywords: 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
Online Publication Date: 2018-09-27
Appears in Collections:School of Public Health