Is there a link between socio-economic status and health in South Africa? Does deprivation vary between geographic areas? The University of Cape Town and the University of Witwatersrand, Johannesburg, studied the links between health and poverty. Do their results have implications for the strategies employed by policy-makers to allocate resources?
Small-area studies looking at links between health and poverty have been conducted in wealthy countries. The information is then used to help decide how the health budget should be spent. Few studies of this kind have been possible in developing countries.
Instead of simply using income levels to define poverty, the study considered a broader concept of deprivation by drawing on a range of demographic, socio-economic and area-wide variables. Factors considered included access to such amenities as piped water, a telephone, decent housing, education, electricity and rubbish collection.
The study found that:
- social deprivation is concentrated in specific areas of the country, in Eastern Cape, Northern Province and Kwazulu-Natal
- deprivation is closely linked to ill health. Deaths are often not reported in rural areas. In urban areas the most deprived members of the community have a shorter life expectancy
- the rural poor lack access to piped water, a telephone, decent housing, education, electricity and rubbish collection
- resources in South Africa are currently biased towards the less deprived areas of the country.
Issues and actions raised in this study have implications for resource allocation in other countries. The report recommends that:
- small-scale studies should be carried out to identify the poorest regions of a country
- Levels of deprivation must be taken into account when calculating how to allocate public resources
- Similar studies should be carried out at a more local level, if possible, to identify pockets of deprivation in the more affluent urban areas
- It appears to be just as effective to determine deprivation using one factor (such as access to piped water) rather than using a general index which includes a number of factors.
Source(s):
‘Geographic patterns of deprivation in South Africa: informing health
equity analyses and public resource allocation strategies’, Health Policy and
Planning 17(1): 30-39, by D. McIntyre, D. Muirhead and L. Gilson, 2002
Funded by:
The Regional Network for Equity in Health in Southern Africa (Equinet);
International Clearing House for Health Systems Reform Initiatives
id21 Research Highlight: 23 April 2003
Further Information:
Diane McIntyre
Health Economics Unit
Department of Public health and Primary Health Care
University of Cape Town
Health Sciences Faculty
Anzio Road
Observatory
7925
South Africa
Contact the contributor: dimac@cormack.uct.ac.za
Health Economics Unit, University of Cape Town
University of the Witwatersrand, South Africa
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'Health inequalities: the legacy of aprtheid in South Africa'
'Insurance policy: the concept of social health insurance in South Africa'
'Unequal measures: who benefits most from government spending on
healthcare?'
'The equity impacts of community financing initiatives in Africa'
'Health-wealth unhappiness: healthcare inequalities in South Africa'
'See id21's collection of links relevant to health systems and economics.'
