Abstract

BackgroundThere are limited studies assessing rural–urban disparities among older adults in Africa including South Africa.AimThis study explores rural–urban health disparities among older adults in a population-based survey in South Africa.SettingData for this study emanated from the 2008 study on ‘Global Ageing and Adult Health (SAGE) wave 1’ (N = 3280) aged 50 years or older in South Africa.MethodsAssociations between exposure variables and outcome variables (health status variables and chronic conditions) were examined through bivariate analyses and multivariable logistic regression.ResultsRural dwellers were more likely to be older, black African and had lower education and wealth than urban dwellers. Rural and urban dwellers reported a similar prevalence of self-rated health status, quality of life, severe functional disability, arthritis, asthma, lung disease, hypertension, obesity, underweight, stroke and/or angina, low vision, depression, anxiety and nocturnal sleep problems. Adjusting for socio-demographic and health risk behaviour variables, urban dwellers had a higher prevalence of diabetes (OR: 2.36, 95% CI: 1.37, 4.04), edentulism (OR: 2.79, 95% CI: 1.27, 6.09) and cognitive functioning (OR: 1.91, 95% CI: 1.27, 2.85) than rural dwellers.ConclusionThere are some rural–urban health disparities in South Africa, that is, urban dwellers had a higher prevalence of diabetes, edentulism and cognitive functioning than rural ones. Understanding these rural–urban health variations may help in developing better strategies to improve health across geolocality in South Africa.

Highlights

  • Noncommunicable diseases (NCDs) have become one of the world’s biggest public health problems, contributing to premature death, disability, productivity losses and high health care costs that may eventually affect the achievement of the sustainable development goals.[1]

  • Compared to single individuals, widowed middle and older aged South Africans living in urban communities were more likely to have hypertension and diabetes.[7]

  • This study examines rural–urban differences among older South Africans who participated in the Study of Global Ageing and Adults Health (SAGE)

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Summary

Introduction

Noncommunicable diseases (NCDs) have become one of the world’s biggest public health problems, contributing to premature death, disability, productivity losses and high health care costs that may eventually affect the achievement of the sustainable development goals.[1] Ageing is often associated with decline in health status characterised by limited physical functioning, increase in chronic diseases as well as decrease in cognitive functioning.[2,3] Social determinants of NCDs include socio-economic factors (e.g. poverty, inequality, rural–urban differences)[4] and risky health behavioural repertoire that may have developed in earlier years (e.g. such as smoking, alcohol abuse, limited physical activity and unhealthy diet with high cholesterol, salt and saturated fats lacking fresh fruits and vegetables).[2,3,4]. There are limited studies assessing rural–urban disparities among older adults in Africa including South Africa

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