SciELO - Scientific Electronic Library Online

 
vol.16 issue1Retaining professional nurses in South Africa: Nurse managers' perspectivesFactors affecting mothers' choice of breastfeeding vs. formula feeding in the lower Umfolozi district war memorial hospital, KwaZulu-Natal author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Article

Indicators

Related links

  • On index processCited by Google
  • On index processSimilars in Google

Share


Health SA Gesondheid (Online)

On-line version ISSN 2071-9736
Print version ISSN 1025-9848

Health SA Gesondheid (Online) vol.16 n.1 Cape Town  2011

 

ORIGINAL RESEARCH

 

A closer look at racial differences in the reporting of self-assessed health status and related concepts in South Africa

 

 

Gerard Boyce; Geoff Harris

School of Economics and Finance, University of KwaZulu-Natal, South Africa

Correspondence

 

 


ABSTRACT

South Africa's populace is characterised by large differences in health, with vast inequalities between members of different groups that can be identified by using a number of tested health indicators, with self-assessed health (SAH) status amongst them. Generally, the average White person's health, however measured, is considerably better than that of Black African persons with the health of Indian and Coloured persons somewhere between the two. Typically, this pattern is attributed to the continued association between race and socio-economic status. Recent empirical work conducted, however, seems to cast doubt on the validity of the assumption that SAH can be compared directly across members of different groups. In light of this concern, and the challenge which it poses to the interpretation of the results of much current South African empirical work, this article explores possible systematic differences with respect to the perception and reporting of SAH between members of different race groups in South Africa. Using data drawn from a nationally representative survey of approximately 3000 respondents, this study analysed racial differences in SAH alongside domain-specific SAH and attitudes to a number of health-related areas (e.g. reference groups, perceptions of main influences on health, etc.). The analysis revealed a number of differences when compared to the usual racialised pattern observed. It is held that these differences suggest that there might be a role for race to play in the assessment and reporting of SAH independently of its continued association with socio-economic status.


OPSOMMING

Suid-Afrikaners word gekenmerk deur groot verskille in die gesondheidsvlakke van die bevolking, met beduidende ongelykhede tussen die verskillende bevolkingsgroepe wat geïdentifiseer kan word met behulp van vele beproefde gesondheidsaanwysers, onder meer self-geassesseerde gesondheid (SAH)-status. Die gemiddelde Wit persoon se gesondheid is, nieteenstaande die maatstaf, aansienlik beter as dié van 'n Swart-Afrikaanse person, met die gesondheid van die Indiër persoon en Kleurling persoon wat êrens tussen die twee groepe lê. Hierdie tendens word tipies toegeskryf aan die voortgesette assosiasie tussen ras en sosiaal-ekonomiese status Onlangse empiriese werk werp egter twyfel op die geldigheid van die veronderstelling dat SAH van lede van verskillende groepe direk met mekaar vergelyk kan word. In die lig hiervan en die uitdaging wat dit inhou vir die interpretasie van die resultate van 'n baie onlangse Suid-Afrikaanse empiriese studie, ondersoek hierdie artikel moontlike sistematiese verskille met betrekking tot die persepsie en rapportering van SAH tussen mense van verskillende rassegroepe in Suid-Afrika. Data vanuit 'n nasionale verteenwoordigende opname van ongeveer 3000 respondente is in hierdie studie gebruik. Die studie ontleed hierdie rasseverskille in SAH tesame met die domein-spesifieke SAH asook die gesindhede ten opsigte van 'n aantal van die gesondheidsverwante gebiede (bv. verwysingsgroepe, die persepsies van die belangrikste invloede op gesondheid ens.) Die analise het 'n aantal verskille getoon in vergelyking met die gewone patroon wat op ras gebaseer is. Daar is van mening dat hierdie verskille daarop dui dat ras dalk tog 'n rol speel in die evaluering en rapportering van SAH, ongeag die voortgesette assosiasie met sosiaal-ekonomiese status.


 

 

“Full text available only in PDF format”

 

 

References

Adler, N. & Newman, K., 2002, 'Socio-economic Disparities In Health: Pathways and Policies', Health Affairs 21(2), 60-76. doi:10.1377/hlthaff.21.2.60, PMid:11900187        [ Links ]

Ahn, N., 2003, 'Assessing Self-Assessed Health Data', working paper no. 200224R, Fundación de Estudios de Economía Aplicada (FEDEA).         [ Links ]

Charasse-Pouèlè, C. & Fournier, M., 2006, 'Health disparities between racial groups in South Africa: A decomposition analysis', Social Science and Medicine 62, 2897-2914.         [ Links ]

Deaton, A., 2002, 'Policy Implications of the Gradient of Health and Wealth', Health Affairs 21(2), 13-30. doi:10.1377/hlthaff.21.2.13, PMid:11900153        [ Links ]

Desmond, C. & Boyce, G., 2006, 'A healthy attitude?', in U. Pillay, B. Roberts & S. Rule (eds.), South African Social Attitudes Changing Times Diverse Voices, pp. 200-221, HSRC Press, Cape Town.         [ Links ]

Feinstein, J.S., 1993, 'The Relationship between Socio-economic Status and Health: A Review of the Literature', The Milbank Quarterly 71(2), 279-322. doi:10.2307/3350401, PMid:8510603        [ Links ]

Goldman, N., 2001, 'Social Inequalities in Health: Disentangling the Underlying Mechanisms', paper presented at Demography and Epidemiology: Frontiers in Population Health and Aging Conference, Georgetown University.         [ Links ]

Health Systems Trust, 2004, 'The Second Equity Gauge Monitoring Fairness in Access to Basic Services Essential for Health', Report, Health Systems Trust, Durban.         [ Links ]

Hillen, T., Schaub, R., Hiestermann, A., Kirschner, W. & Robra, R.P., 2000, 'Self rating of health is associated with stressful life events, social support and residency in East and West Berlin shortly after the fall of the wall', Journal of Epidemiology and Community Health 54, 575-580. doi:10.1136/jech.54.8.575        [ Links ]

Hoogeveen, J. & Özler, B., 2005, 'Not Separate, Not Equal: Poverty and Inequality in Post-Apartheid South Africa', working Paper, William Davidson Institute, University of Michigan.         [ Links ]

Idler, E. & Benyamini, Y., 1997, 'Self-rated health and mortality: A review of twenty-seven community studies', Journal of Health and Social Behaviour 38(1), 21-37. doi:10.2307/2955359, PMid:9097506        [ Links ]

Idler, E. & Kasl, S., 1991, 'Health perceptions and survival: Do global evaluations of health status really predict mortality?', Journal of Gerontology 46(2), S55-S65.         [ Links ]

Ijumba, P. & Barron, P., 2005, 'South African Health Review 2005', Health Systems Trust, Durban.         [ Links ]

Jelsma, J. & Ferguson, G., 2004, 'The determinants of self-reported health-related quality of life in a culturally diverse South African community', Bulletin of the World Health Organization 82(3), 206-212. PMid:15112009, PMCid:2585936        [ Links ]

Judge, K. & Paterson, I., 2001, 'Poverty, Income Inequality, and Health', working paper no. 01/29, New Zealand Treasury, Commonwealth Government, Wellington.         [ Links ]

Jürges, H., 2004, 'Self-assessed health, reference levels, and mortality', discussion paper no. 0457, Mannheim Research Institute for the Economics of Aging (MEA), University of Mannheim.         [ Links ]

Jürges, H., 2007, 'True health vs Response Styles: Exploring cross-country differences in self-reported health', Health Economics 16, 163-178. doi:10.1002/hec.1134, PMid:16941555        [ Links ]

Kuhn, R., Rahman, O. & Menken, J., 2004, 'Survey Measures of Health: How Well do Self-reported and Observed Indicators Measure Health and Predict Mortality?, paper presented at the Workshop on Aging in Africa, University of the Witwatersrand, Johannesburg, South Africa.         [ Links ]

Okun, M.A., Stock, W.A., Haring, M.J. & Witter, R.A. 1984, 'Health and subjective well-being: A meta-analysis', The International Journal of Aging and Human Development 19(2), 111-132. doi:10.2190/QGJN-0N81-5957-HAD        [ Links ]

Pillay, U., Roberts, B. & Rule, S. 2006, 'Appendix 1: Technical details of the survey', in U. Pillay, B. Roberts & S. Rule (eds.), South African Social Attitudes Changing Times Diverse Voices, pp. 296-300, HSRC Press, Cape Town.         [ Links ]

Quesnel-Vallée, A., 2007, 'Self-rated Health: Caught in the crossfire of the quest for "true" health', International Journal of Epidemiology 36(6), 1161-1164.         [ Links ]

Ramkissoon, A., Kleinschmidt, I., Beksinska, M., Smit, J., Hlazo, J. & Mabude, Z., 2004, 'National Baseline Assessment of Sexually Transmitted Infection and HIV services in South African public sector health facilities 2002/2003', Summary Report, Reproductive Health Research Unit, University of the Witwatersrand.         [ Links ]

Salomon, J.A., Nordhagen, S, Oza, S. & Murray, C.J.L., 2009, 'Are Americans Feeling Less Healthy? The Puzzle of Trends in Self-rated Health', American Journal of Epidemiology 170(3), 343-351. doi:10.1093/aje/kwp144, PMid:19564169, PMCid:2714952        [ Links ]

Sen, A., 2002, 'Health: Perception versus observation', British Medical Journal 324, 860-861.         [ Links ]

Statistics South Africa, 2004, 'Perceived health and other health indicators in South Africa', Report, Pretoria: Statistics South Africa. doi:10.1136/bmj.324.7342.860, PMid:11950717, PMCid:1122815        [ Links ]

Statistics South Africa, 2007, 'Income and expenditure of households 2005/2006: Analysis of results', Statistical Release P0100, Statistics South Africa, Pretoria.         [ Links ]

Wilkinson, R. & Marmot, M., 2003, Social determinants of health: The solid facts, 2nd edn., World Health Organization (Europe), Geneva.         [ Links ]

Williams, D.R., Gonzalez, H.M., Williams, S., Mohammed, S.A., Moomal, H. & Stein, D.J., 2008, 'Perceived Discrimination, Race and Health in South Africa', Social Science & Medicine 67(3), 441-452. doi:10.1016/j.socscimed.2008.03.021        [ Links ]

 

 

Correspondence:
Gerard Boyce
PO Box 54001
Durban 4000
South Africa
gdboyce@yahoo.com

Received: 22 Apr. 2010
Accepted: 18 Apr. 2011
Published: 05 Oct. 2011

 

 

Note: Following common practice, 'Black' refers to Black African persons whilst 'black' refers to Black, Coloured and Indian respondents, that is, the groups collectively referred to as 'non-whites' under apartheid.

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License