Abstract
Background:This paper examines the relationship between hypertension and wealth in a national sample of Kenyan adults.Methods:Data from 27,552 individuals from the Demographic and Health Survey Program (DHS) for Kenya were analyzed. Wealth index, a cumulative measure of household standard of living, was the outcome. The final analysis was stratified by gender with covariates added in blocks (demographics, economic, and cultural) to investigate the independent association of hypertension with wealth index.Results:Approximately 7.6% of those with hypertension had a wealth index above the median. For women and men, hypertension was significantly associated with higher wealth index (women ß=0.26; CI=0.19; 0.34; men ß=0.36; CI=0.19; 0.53). After adjusting for age, rural location, children, employment, education, ethnicity, and religion, hypertension maintained statistical significance with wealth index for both women and men (women ß=0.06; CI=0.01; 0.11; men ß=0.20; CI=0.08; 0.31).Conclusions:As Kenya as a nation undergoes health care reform while also experiencing a high burden of hypertension, the results presented here provide preliminary evidence that may be used in support for decision makers for the wealth effects of health interventions. Additional work is needed to understand the longitudinal relationship between hypertension and wealth at the national level.
Highlights
Wealth, characterized as the “value of the assets of worth owned by a person or community, or country”, (Silver, Chen, Kagan, & Woolsey, 2018; Pfeffer & Schoeni, 2016) has been shown to have a strong impact on health outcomes across the world (Wagstaff, 2002)
As Kenya as a nation undergoes health care reform while experiencing a high burden of hypertension, the results presented here provide preliminary evidence that may be used in support for decision makers for the wealth effects of health interventions
Additional work is needed to understand the longitudinal relationship between hypertension and wealth at the national level
Summary
Wealth, characterized as the “value of the assets of worth owned by a person or community, or country”, (Silver, Chen, Kagan, & Woolsey, 2018; Pfeffer & Schoeni, 2016) has been shown to have a strong impact on health outcomes across the world (Wagstaff, 2002). Often referred to as the wealth-health gradient, higher country level and individual level wealth, are shown to be associated with better health at the population and individual level (Semyonov, Lewin-Epstein, & Maskileyson, 2013) While this wealth-health gradient has been demonstrated across countries and population sectors, evidence suggests a bidirectional relationship (Evans, Wolfe, & Adler, 2012). This suggests that approximately 80% of the population pay for health expenditures out of pocket, resulting in an estimated 400,000 Kenyan adults transitioning to poverty each year as a result of high out of pocket health care expenditures (Kazungu & Barasa, 2017) Evidence shows that these high out of pocket expenditures are often gjhs.ccsenet.org. This paper examines the relationship between hypertension and wealth in a national sample of Kenyan adults
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