A cross-sectional and spatial analysis of the prevalence of multimorbidity and its association with socioeconomic disadvantage in South Africa: A comparison between 2008 and 2012

Abstract

This study utilised data from the National Income Dynamics Study, a longitudinal study with a sample of approximately 28 000 people, to investigate the cross-sectional and spatial distribution of multimorbidity and the association with socioeconomic disadvantage in South Africa for 2008 and 2012. Multimorbidity increased in prevalence from 2.73% to 2.84% in adults between 2008 and 2012 and was associated with age, socioeconomic deprivation, obesity and urban areas. Hypertension was found frequently coexisting with diabetes. Spatial analysis showed clusters (hot spots) of higher multimorbidity prevalence in parts of KwaZulu-Natal and the Eastern Cape, which compared with the socioeconomic disadvantage spatial pattern. Although these results were limited to a district level analysis, this study has provided a platform for future local level research and has provided insight into the socioeconomic determinants of disease multimorbidity within a developing country.

Prevalence and health effects of communicable and non‐communicable disease comorbidity in rural KwaZulu‐Natal, South Africa

“…This study described the high burden of NCD and communicable disease comorbidity in this rural South African population, with NCD prevalence comparable to that of data from other South African studies [5,9,10].…”

“…Recent studies show a high prevalence of dysglycaemia, dyslipidaemia and increased visceral adiposity in HIV-infected patients on ART, thereby predisposing to hypertension and diabetes [26,27]. While efforts to maintain progress with ART must continue, our findings point to a need to expand our focus to enable effective management of communicable disease and NCD comorbidity particularly among lower socioeconomic groups [6,10].…”

“…Prevalence of diabetes in Southern Africa is estimated at 14% among older African adults, and the prevalence of hypertension at over 50% of older adults [8]. Community-based epidemiological studies on the prevalence of comorbidities among the HIV population in South Africa, Uganda and Tanzania show considerable comorbidity of hypertension in people with HIV, with prevalences of up to 23% [9][10][11][12][13][14].…”

Assessing Urban Health Data: A Case Study of Maternal and Child Health Data in Cape Town, South Africa

“…For example, national data on child and maternal health do not include data from private sectors, making it impossible to accurately report on the status of the country with regard to this (Weimann et al 2016). According to a study by Oni and Mayosi (2016), gaps in data management on the subject exist, at province and even at country level, underreporting on both child and maternal mortality rates.…”

An Ordinal Measure of Population Health

“…Health comparisons are often made across populations that are not necessarily afflicted by the same types of diseases. This issue of comparability is perhaps most obvious in cross-country comparisons among countries in different stages of the epidemiological transition and in health comparisons over time (Burgard and Chen 2014), but it is also present in subnational health assessments (Rivera et al 2002;Weimann et al 2016). A further potential problem that can arise when using existing measures is that some of the most frequently collected measures of health rely on self-assessments of health, despite a growing body of evidence that suggests that there is systematic bias in how respondents rate their health.…”