Diversity and disease : the demographic and socio-economic determinants of chronic disease in South Africa.
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Chronic diseases are the leading cause of global mortality and morbidity. The already high rates of these diseases are predicted to increase even further, particularly in developing regions. Diabetes, hypertension and cardiovascular disease prove most common around the world, as well as in South Africa. The burden of such diseases may be far reaching, long lasting and multi-dimensional. Adverse outcomes include death and disability, decreases in labour force participation and in turn economic output, as well as increased pressure on health care facilities and services. In post-apartheid South Africa, only a few epidemiological studies have focused on uncovering the determinants of chronic diseases. As a result, this study aimed to identify the demographic and socio-economic determinants of diabetes, hypertension and cardiovascular disease in South Africa. The study used nationally representative data sourced from the National Income Dynamic Study (NIDS). Descriptive and inferential statistical analysis including multivariate logistic regression was used to assess prevalence and risk. Age was identified as a strong predictor of disease as the elderly exhibited the highest prevalence as well as risk. Similarly, sex was identified as an important predictor as females displayed higher prevalence and risk for all chronic diseases. Racial disparities were consistent over all chronic diseases as Whites, Asian/Indians, and Coloureds displayed higher prevalence and risk compared to African adults. In terms of marital status, widows/widowers and divorcees were identified to have high prevalence and risk of chronic diseases. Low levels of education were shown to increase disease prevalence and risk. Additionally, economically inactive adults presented the highest prevalence and risk for all chronic diseases. Both skilled and unskilled occupations as well as low and high income earners were found to be at increased risk. Furthermore, both formal and informal residency were identified as strong socio-economic predictors of disease. Health care programmes which specifically target high risk groups should be put in place to potentially decrease levels of chronic disease. More importantly however, broader initiatives promoting sociom-economic equality may be a long term solution not only to high levels of chronic diseases, but a host of health problems commonly identified in the country.