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Title: Changes in income inequality and cardiovascular disease risk factors in South Africa
Citation Type: Conference Paper
Publication Year: 2016
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Abstract: Background: Societal income inequality has been associated with worse health outcomes, and it has been suggested that chronic stress linked to income disparity may increase risk factors for cardiovascular disease (CVD). South Africa consistently has one of the highest levels of income inequality in the world and has a large and growing burden of CVD risk factors and mortality. Given limited research on the relationship between income inequality and health in this setting, the present study uses longitudinal data to examine whether district-level income inequality and changes in inequality within South Africa are associated with risk and protective factors for CVD at the individual level. Methods: Data from 9,356 participants in Waves 1 (2008) and 3 (2012) of the National Income Dynamics Study (NIDS) were merged with data from South Africas Community Survey 2007 and Census 2011. Gini coefficients were calculated for each of 52 district councils. Pooled cross-sectional regression models and longitudinal, individual fixed-effects models were run for the outcomes body mass index (BMI), waist circumference, blood pressure, smoking, exercise, and alcohol consumption, controlling for individual, household, and district covariates. Results: Average district Gini coefficients were 0.73 (range: 0.65 to 0.80) in 2007 and 0.75 (range 0.69 to 0.78) in 2011. In fully-adjusted, pooled cross-sectional models, higher district Gini coefficients were associated with lower BMIs and waist circumferences. However, in fixed-effects models, changes in Gini coefficients were not significantly associated with the outcomes we examined. Discussion/Conclusion: While both income inequality and several CVD risk factors in this South African sample increased during this time period, the trends in these CVD risk factors were not explained by changes in district income inequality in fixed effects models. Thus, our findings do not support the income inequality hypothesis in relation to CVD risk factors in South Africa. Additional research over more extended periods of time, over broader ranges of income inequality, within specific subpopulations, and for other health outcomes in South Africa may shed greater light on these results.
Url: https://www.nhlbi.nih.gov/news/events/nhlbi-aha-trainee-session/agenda
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Authors: Adjaye-Gbewonyo, K; Kawachi, I; Subramanian, S V; Avendano, M
Conference Name: National Heart, Lung, and Blood Institute Cardiovascular Epidemiology, Biostatistics and Prevention Trainee Session
Publisher Location: Phoenix, AZ
Data Collections: IPUMS International
Topics: Health, Other, Poverty and Welfare
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