Sample Of South African Adults Research Articles

Self-regulatory employability attributes and competency: the strengthening role of grit

IntroductionThis study examines grit as psychological mindsets that explain the link between self-regulatory employability attributes and perceived employability competency expectations in a sample of South African adults (N = 308).MethodsA quantitative, cross-sectional research design approach was used to collect primary data.ResultsResults of a mediation analysis through structural equation modelling revealed grit as an important mechanism to strengthen the association between employability attributes (career agility, cultural ingenuity, proactive career resilience) and employability competency expectations (autonomy/leadership skills and personal employability qualities).DiscussionThis study makes an important contribution to the role of learning and training through understanding the role of grit in enhancing prospects of employability. This study further adds to the grit literature, highlighting the role that grit plays in the contemporary employment context. Practical implications include supportive practices that strengthen individual workers’ grit when confronted with the turbulent changes of today’s work world.

Socioeconomic status and social capital as predictors of happiness: evidence and gender differences

Understanding socioeconomic status (SES) and social capital as predictors of life outcomes has remained central to humanitarian, health and social research. This current study explores how socioeconomic status and social capital (community solidarity, locus of control and generalised trust) predict happiness among a sample of South African adults. Possible gender differences were also considered. Cross-sectional data from (n = 1049) South Africans on SES, social capital, happiness and sociodemographic characteristics were collected using an online questionnaire between January 2021 and September 2021. A correlation matrix was calculated to explore bivariate associations between the variables. Hierarchical regression analysis was conducted to examine the predictive influence of SES and social capital indices on happiness and the gender differential in these relationships. SES and all social capital variables were significantly correlated with happiness. The model, including SES and social capital, accounted for 25% of the variance in happiness. Gender differences were found regarding the relationship between SES and all social capital variables (except locus of control) and happiness. The results confirm that efforts to facilitate individual social capital correspond to greater happiness among South Africans. Furthermore, it highlights the need for further empirical exploration of social predictors of life outcomes. The current analysis provides a framework for developing and implementing policies that promote happiness and other life outcomes.

Prevalence of cardio-metabolic multi-morbidity and associated risk factors in a population-based sample of South Africans

Abstract Objectives Cardio-metabolic multi-morbidity (CM), the co-existence of two or more cardio-metabolic disorders in the same person, is rapidly increasing. We examined the prevalence and risk factors associated with CM in a population-based sample of South African adults. Study design Data were analyzed on individuals aged ≥15 years from the South African National Health and Nutrition Examination Survey (SANHANES), a cross sectional population-based survey conducted in 2011-2012. Methods CM was defined as having ≥2 of hypertension, diabetes, stroke and angina. Multivariable logistic regression was used to investigate the sociodemographic and modifiable risk factors associated with CM. Results Of the 3832 individuals analyzed, the mean age was 40.8 years (S.D. 18.3), 64.5% were female and 18% were ≥60 years. The prevalence of CM was 10.5%. The most prevalent CM cluster was hypertension and diabetes (7.3%), followed by hypertension and angina (2.6%) and hypertension and stroke (1.9%). Of the individuals with diabetes, nearly three quarters had multi-morbidity from co-occurring hypertension, angina and/or stroke and of those with hypertension, 30% had co-occurring diabetes, angina and/or stroke. Age (30-44 years Adjusted Odds Ratio (AOR) = 2.68, 95% CI: 1.15-6.26), 45-59 years AOR = 16.32 (7.38-36.06), 60-74 years AOR = 40.14 (17.86-90.19), and ≥75 years AOR = 49.54 (19.25-127.50) compared with 15-29 years); Indian ethnicity (AOR = 2.58 (1.1-6.04) compared with black African ethnicity), overweight (AOR = 2.73 (1.84-4.07)) and obesity (AOR = 4.20 (2.75-6.40)) compared with normal or underweight) were associated with increased odds of CM. Conclusions A tenth of South Africans have two or more cardio-metabolic conditions. The findings call for immediate prioritization of prevention, screening and management of cardio-metabolic conditions and their risk factors to avert large scale health care costs and adverse health outcomes associated with multi-morbidity.

Hazardous or harmful alcohol use and reward processing in people with HIV.

The intersecting epidemics of HIV and hazardous or harmful alcohol use (HAU) can have significant detrimental consequences. Both HIV and HAU have independent negative influences on executive function. Dysfunction in reward processing may play a role in these co-occurring epidemics. In this cross-sectional case-control study, we investigated the association of HAU with reward processing amongst people with HIV (PWH). We investigated the function of the ventral-striatal reward system using a functional MRI (fMRI) monetary incentive delay (MID) task in a sample of 60 South African adults (mean age 32.7years): 42 living with HIV and on ART (21 with harmful alcohol use [HIV + HAU], 21 without [HIV-HAU]) and 18 healthy controls, matched for age, gender, and resident community. Education significantly influenced task performance, with those with a secondary level of education demonstrating a greater increase in reaction time (p = 0.048) and accuracy (p = 0.002) than those without. There were no significant differences in reward anticipation in the ventral striatum (VS) between HIV + HAU, HIV-HAU, and healthy controls when controlling for level of education. There were also no significant differences in reward outcome in the orbitofrontal cortex (OFC) between HIV + HAU, HIV-HAU, and healthy controls when controlling for level of education. In a sample of South African adults, we did not demonstrate significant differences in reward anticipation in the VS and reward outcome in the OFC in PWH, with and without HAU, and controls. Factors, such as task performance, education, and depression may have influenced our results. Further studies are needed to better delineate the potential links between HIV, HAU, and depression and reward system function.

A cross-cultural adaptation and validation of a scale to assess illness identity in adults living with a chronic illness in South Africa: a case of HIV

The chronic illness trajectory and its outcomes are well explained by the concept of illness identity; the extent to which ill individuals have integrated their diagnosed chronic illness into their identity or sense of self. The capacity to measure illness identity in people living with HIV (PLHIV) is still relatively unexplored. However, this is potentially useful to help us understand how outcomes for PLHIV could be improved and sustained. This paper aims to explore the cross-cultural adaptation of a Belgian developed Illness Identity Questionnaire (IIQ) and validate the instrument using a sample of South African adults living with HIV. We followed a phased scale adaptation and validation process which included an investigation of conceptual, item, semantic and operational equivalence and also examined the psychometric properties of the IIQ. The concept of illness identity with its four factors; engulfment, rejection, acceptance and enrichment in PLHIV, was found to be relevant within this context. Five items from the original IIQ were excluded from the adapted IIQ due to either semantic insufficiency and/or inadequate measurement equivalence. The mode of administration of the IIQ was changed to accommodate current study participants. The original four factor 25-item model did not fit current data, however, a better contextualized, four-factor, 20-item model was identified and found valid in the current setting. The results showed adequate statistical fit; χ2/d.f. = 1.516, RMSEA = 0.076, SRMR = 0.0893, and CFI = 0.909. Convergent and discriminant validity were also tenable. The cross-cultural adaptation and validation of the IIQ was successful, resulting in the availability of an instrument capable of measuring illness identity in PLHIV in a high HIV prevalence and resource-constrained setting. This therefore addresses the paucity of information and expands on knowledge about illness identity.

Expression of whole blood miR-126-3p, -30a-5p, -1299, -182-5p and -30e-3p in chronic kidney disease in a South African community-based sample

The burden of chronic kidney disease (CKD) in Africa remains poorly characterized, due partly to the lack of appropriate diagnostic strategies. Although in recent years the diagnostic and prognostic utility of microRNAs (miRNAs) have gained prominence in the context of CKD, its value has not been evaluated in African populations. We investigated the expression of whole blood miRNAs (miR-126-3p, -30a-5p, -1299, -182-5p and -30e-3p) in a total sample of 1449 comprising of 13.3% individuals with CKD (stage 1–5) and 26.4% male participants, as well as the association of these miRNAs with prevalent CKD, in a community-based sample of South African adults. We used Reverse Transcription Quantitative Real-Time PCR (RT-qPCR) to analyze miRNA expression. There was an increased expression in whole blood miR-126-3p, -30a-5p, -1299 and -182-5p in individuals with CKD, compared to those without (all p ≤ 0.036), whereas miR-30e-3p showed no significant difference between the groups (p = 0.482). Only miR-126-3p, -182-5p and -30e-3p were independently associated with increased risk of CKD (all p ≤ 0.022). This study showed for the first time that there is a dysregulation of whole blood miR-126-3p, -30a-5p, -1299 and -182-5p in South Africans of mixed-ancestry with CKD. More research is needed to ascertain their role in CKD risk screening in African populations.

Prevalence of multimorbidity of cardiometabolic conditions and associated risk factors in a population-based sample of South Africans: A cross-sectional study

ObjectivesAgeing populations have led to a growing prevalence of multimorbidity. Cardiometabolic multimorbidity (CM), the co-existence of two or more cardiometabolic disorders in the same person, is rapidly increasing. We examined the prevalence and risk factors associated with CM in a population-based sample of South African adults. Study designData were analysed on individuals aged ≥15 years from the South African National Health and Nutrition Examination Survey (SANHANES), a cross sectional population-based survey conducted in 2011–2012. MethodsCM was defined as having ≥2 of hypertension, diabetes, stroke and angina. Hypertension was defined as blood pressure ≥140/90 mmHg or self-reported antihypertensive medication use. Diabetes was defined by HbA1c ≥ 6.5% or self-reported medication use. Stroke and angina were assessed by self-report. Multivariable logistic regression was used to investigate the sociodemographic and modifiable risk factors associated with CM. The association of CM with the functional status of individuals was examined using logistic regression, where functional status was measured by the WHO DAS 2.0 12-item instrument. ResultsOf the 3832 individuals analysed, the mean age was 40.8 years (S.D. 18.3), 64.5% were female and 18% were ≥60 years. The prevalence of CM was 10.5%. The most prevalent CM cluster was hypertension and diabetes (7.3%), followed by hypertension and angina (2.6%) and hypertension and stroke (1.9%). Of the individuals with diabetes, nearly three quarters had multimorbidity from co-occurring hypertension, angina and/or stroke and of those with hypertension, 30% had co-occurring diabetes, angina and/or stroke. Age (30–44 years Adjusted Odds Ratio (AOR) = 2.68, 95% CI: 1.15–6.26), 45–59 years AOR = 16.32 (7.38–36.06), 60–74 years AOR = 40.14 (17.86–90.19), and ≥75 years AOR = 49.54 (19.25–127.50) compared with 15–29 years); Indian ethnicity (AOR = 2.58 (1.1–6.04) compared with black African ethnicity), overweight (AOR = 2.73 (1.84–4.07)) and obesity (AOR = 4.20 (2.75–6.40)) compared with normal or underweight) were associated with increased odds of CM. When controlling for age, sex and ethnicity, having ≥2 conditions was associated with significantly higher WHO DAS percentage scores (β = 5.4, S.E. = 1.1, p < 0.001). ConclusionsA tenth of South Africans have two or more cardiometabolic conditions. The findings call for immediate prioritisation of prevention, screening and management of cardiometabolic conditions and their risk factors to avert large scale health care costs and adverse health outcomes associated with multimorbidity.

How will South Africa’s mandatory salt reduction policy affect its salt iodisation programme? A cross-sectional analysis from the WHO-SAGE Wave 2 Salt & Tobacco study

ObjectiveThe WHO’s global targets for non-communicable disease reduction recommend consumption of<5 g salt/day. In 2016, South Africa was the first country to legislate maximum salt levels in processed foods. South...

Prevalence and unmet need for diabetes care across the care continuum in a national sample of South African adults: Evidence from the SANHANES-1, 2011-2012.

South Africa faces an epidemic of chronic non-communicable diseases (NCDs), yet national surveillance is limited due to the lack of recent data. We used data from the first comprehensive national survey on NCDs—the South African National Health and Nutrition Examination Survey (SANHANES-1 (2011–2012))—to evaluate the prevalence of and health system response to diabetes through a diabetes care cascade. We defined diabetes as a Hemoglobin A1c equal to or above 6.5% or currently on treatment for diabetes. We constructed a diabetes care cascade by categorizing the population with diabetes into those who were unscreened, screened but undiagnosed, diagnosed but untreated, treated but uncontrolled, and treated and controlled. We then used multivariable logistic regression models to explore factors associated with diagnosed and undiagnosed diabetes. The age-standardized prevalence of diabetes in South Africans aged 15+ was 10.1%. Prevalence rates were higher among the non-white population and among women. Among individuals with diabetes, a total of 45.4% were unscreened, 14.7% were screened but undiagnosed, 2.3% were diagnosed but untreated, 18.1% were treated but uncontrolled, and 19.4% were treated and controlled, suggesting that 80.6% of the diabetic population had unmet need for care. The diabetes care cascade revealed significant losses from lack of screening, between screening and diagnosis, and between treatment and control. These results point to significant unmet need for diabetes care in South Africa. Additionally, this analysis provides a benchmark for evaluating efforts to manage the rising burden of diabetes in South Africa.

The relationship between negative household events and depressive symptoms: Evidence from South African longitudinal data

BackgroundThe relationship between negative life events and vulnerability to depression is not well-documented in developing countries, particularly using large-scale, longitudinal data. This study seeks to add to this literature by examining the relationship between negative household events and vulnerability to depression amongst a representative sample of South African adults for the period 2008–2012. MethodsData from three waves of the longitudinal South African National Income Dynamics Study (NIDS) were analysed to estimate the association between negative household events and adult depressive symptoms using ordinary least squares (OLS) and fixed-effects regression models. ResultsOne in four South Africans reported that they lived in a household where at least one household member had been seriously ill or injured, or where a household member, relative or friend had died within the previous two years. There was a significant association between the serious illness of a household member, or the death of a family member who provided financial assistance, and adult depression scores. LimitationsThe study used data collected in a large-scale household survey by field work teams. It is reliant on self-reported depressive symptoms that have not been validated by formal clinical diagnosis. ConclusionsThere are high rates of morbidity and mortality in South Africa, and adults living in households where family members are ill or have died are significantly more vulnerable to depression. These findings highlight the importance of providing counselling and psychiatric support not only to those directly affected by negative health events, but also to their family or household members.

Passive Suicidal Ideation and Community Mental Health Resources in South Africa.

South African communities continue to experience elevated incidence and prevalence of HIV infection. Passive suicidal ideation (PSI) may be one expression of distress in high prevalence communities. We report the prevalence of PSI and examine the relationship between PSI and participation in community organizations in a semi-rural sample of South African adults (N=594). The prevalence of PSI in the 2weeks prior to the interview was 9.1%. Members of burial societies (Χ (2)=7.34; p=0.01) and stokvels (Χ (2)=4.1; p=0.04) (community-based savings groups) reported significantly less PSI compared to other respondents. Using a multivariate model adjusted for demographic characteristics, psychological distress, and socioeconomic status, we found lower odds of reporting PSI for members of burial societies (OR 0.48, CI 0.25 -0.91). Participation in community organizations that provide contextually salient resources in settings with high levels of distress may be a resource for mental health.

Mental illness and lost income among adult South Africans

PurposeLittle is known regarding the links between mental disorder and lost income in low- and middle-income countries. The purpose of this study was to investigate the association between mental disorder and lost income in the first nationally representative psychiatric epidemiology survey in South Africa.MethodsA probability sample of South African adults was administered the World Health Organization Composite International Diagnostic Interview schedule to assess the presence of mental disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders, version IV.ResultsThe presence of severe depression or anxiety disorders was associated with a significant reduction in earnings in the previous 12 months among both employed and unemployed South African adults (p = 0.0043). In simulations of costs to individuals, the mean estimated lost income associated with severe depression and anxiety disorders was $4,798 per adult per year, after adjustment for age, gender, substance abuse, education, marital status, and household size. Projections of total annual cost to South Africans living with these disorders in lost earnings, extrapolated from the sample, were $3.6 billion. These data indicate either that mental illness has a major economic impact, through the effect of disability and stigma on earnings, or that people in lower income groups are at increased risk of mental illness. The indirect costs of severe depression and anxiety disorders stand in stark contrast with the direct costs of treatment in South Africa, as illustrated by annual government spending on mental health services, amounting to an estimated $59 million for adults.ConclusionsThe findings of this study support the economic argument for investing in mental health care as a means of mitigating indirect costs of mental illness.

Household food insufficiency and mental health in South Africa

BackgroundBoth mental illness and food insufficiency are common in low and middle income countries. However, there are limited data on the relation between food insufficiency and mental disorders, despite the...

The role of leisure activities and social attitudes in the mass media consumption of a sample of South African adults: A psychographic approach

This study, the second in a two-article series, explores the interplay between attitudes, behaviour and media consumption in a sample of South African adults. Participants aged 16 years and older were drawn from a subsample of data collected during the 2007A South African Advertising Research Foundation (SAARF) All Media and Products Survey (AMPS®). Utilising statistical comparison of psychographic typologies, this study confirmed the existence of significant, albeit weak, relationships between mass media consumption, social attitudes and leisure interests/activities in this sample. Analyses of demographic variables revealed further significant relationships between mass media consumption and home language, work status, the SAARF Lifestages and the SAARF Universal Living Standards Measure (SU-LSM®). The findings are discussed in relation to available empirical literature and the need for advancement of the media psychology sub-discipline in South Africa.

The association between hypertension and depression and anxiety disorders: results from a nationally-representative sample of South African adults.

ObjectiveGrowing evidence suggests high levels of comorbidity between hypertension and mental illness but there are few data from low- and middle-income countries. We examined the association between hypertension and depression and anxiety in South Africa.MethodsData come from a nationally-representative survey of adults (n = 4351). The Composite International Diagnostic Interview was used to measure DSM-IV mental disorders during the previous 12-months. The relationships between self-reported hypertension and anxiety disorders, depressive disorders and comorbid anxiety-depression were assessed after adjustment for participant characteristics including experience of trauma and other chronic physical conditions.ResultsOverall 16.7% reported a previous medical diagnosis of hypertension, and 8.1% and 4.9% were found to have a 12-month anxiety or depressive disorder, respectively. In adjusted analyses, hypertension diagnosis was associated with 12-month anxiety disorders [Odds ratio (OR) = 1.55, 95% Confidence interval (CI) = 1.10–2.18] but not 12-month depressive disorders or 12-month comorbid anxiety-depression. Hypertension in the absence of other chronic physical conditions was not associated with any of the 12-month mental health outcomes (p-values all <0.05), while being diagnosed with both hypertension and another chronic physical condition were associated with 12-month anxiety disorders (OR = 2.25, 95% CI = 1.46–3.45), but not 12-month depressive disorders or comorbid anxiety-depression.ConclusionsThese are the first population-based estimates to demonstrate an association between hypertension and mental disorders in sub-Saharan Africa. Further investigation is needed into role of traumatic life events in the aetiology of hypertension as well as the temporality of the association between hypertension and mental disorders.

Social determinants of psychological distress in a nationally-representative sample of South African adults

There is substantial evidence from developed countries that lower socioeconomic status (SES) is associated with increased occurrence of mental illness, and growing interest in the role of social support and social capital in mental health. However, there are few data on social determinants of mental health from low- and middle-income nations. We examined the association between psychological distress and SES, social support and bonding social capital in a nationally-representative sample of South African adults. As part of a national survey of mental health, a probability sample of 4351 individuals was interviewed between 2002 and 2004. Non-specific psychological distress was measured using the Kessler K-10 scale. SES was assessed from an aggregate of household income, individual educational and employment status, and household material and financial resources. Social support, bonding social capital and traumatic life events were measured using multi-item scales. The mean age in the sample was 37 years and 76% of participants were black African. Measures of SES and social capital were inversely associated ( p < 0.001). Both recent and traumatic life events were more common among individuals with low levels of SES and social support. After adjusting for participant demographic characteristics and life events, high levels of psychological distress were most common among individuals with lower levels of SES and social capital. There was no independent association between levels of social support and psychological distress. The occurrence of recent life events appeared to partially mediate the association between SES and psychological distress ( p = 0.035) but not the association involving social capital ( p = 0.40). These data demonstrate persistent associations between levels of SES, social capital and psychological distress in South Africa. The increased frequency of recent life events appears to only partially explain higher levels of psychological distress among individuals of lower SES. Additional research is required to understand the temporality of this association as well as mechanisms through which SES and social capital influence mental health in low- and middle-income settings where high levels of poverty and trauma may contribute to excess burden of mental illness.