Integrating rural–urban differentials in the appraisal of prevalence and risk factors of non-communicable diseases in South Africa

Abstract

Despite the increasing prevalence of non-communicable diseases in South Africa, there remains a dearth of nationally representative geographic analysis of the prevalence and risk factors of these diseases. The study, therefore, examines the spatially varying prevalence and risk factors of non-communicable diseases in South Africa. Data was from the 2014 National Income Dynamics (NIDS) survey, which was conducted in 9 provinces and 52 districts of South Africa. A composite index of non-communicable diseases was generated from occurrence of different diseases. Data analysis involved descriptive statistics, hotspot analysis, spatial autocorrelation, geographically weighted regression, and binary logistic regression. The results showed 57% and 43% prevalence level of non-communicable diseases in urban and rural areas respectively. In addition, there existed spatial variations in the prevalence of non-communicable diseases across the 9 provinces and 52 districts with regard to rural/urban place of residence. The socioeconomic factors, which significantly increased the odds of NCDs in both rural and urban areas, were older ages, being a female, being married, divorced, separated or divorced, higher incomes, and being non-black. Conversely, higher educational attainment and engagement in physical exercise decreased the odds of NCDs in both rural and urban areas. This study recommends among other things, awareness/sensitization activities targeted more at the females, those aged 25 + years and people with higher education on the risk factors of NCDs.