IDEAS home Printed from https://ideas.repec.org/p/pre/wpaper/201716.html
   My bibliography  Save this paper

Social Determinants of Health Inequalities in South Africa: A Decomposition Analysis

Author

Listed:
  • Kehinde O. Omotoso

    (Department of Economics, University of Pretoria, Pretoria, South Africa)

  • Steven F. Koch

    (Department of Economics, University of Pretoria, Pretoria, South Africa)

Abstract

This study uses information collected on social determinants of health (SDH) and on a variety of health indicators in the 2004 and 2014 questionnaires of the South African General Household Surveys (GHSs) to explain how changes in the SDH have impacted health inequalities over the last decade, the second since the end of Apartheid. Specifically, the Oaxaca-type decomposition of change in a concentration index is used to illustrate how changes in health inequalities over time are attributable to changes in inequality in the determinants of health, and changes in their elasticities. This study finds that rising inequalities in ill-health are largely explained by widening inequalities among those residing in the urban areas and in the relatively richer provinces. Meanwhile, rising inequality in medical aid coverage and utilisation of private health care are mainly attributable to inequalities in educational attainment and racial composition. However, changing elasticities in SDH, rather than rising inequalities, are found to be important factors in explaining inequality in the utilisation of public health care.

Suggested Citation

  • Kehinde O. Omotoso & Steven F. Koch, 2017. "Social Determinants of Health Inequalities in South Africa: A Decomposition Analysis," Working Papers 201716, University of Pretoria, Department of Economics.
    • Handle: RePEc:pre:wpaper:201716
    as

    Download full text from publisher

    To our knowledge, this item is not available for download. To find whether it is available, there are three options:
    1. Check below whether another version of this item is available online.
    2. Check on the provider's web page whether it is in fact available.
    3. Perform a search for a similarly titled item that would be available.

    References listed on IDEAS

    as
    1. Martin Wittenberg & Murray Leibbrandt, 2017. "Measuring Inequality by Asset Indices: A General Approach with Application to South Africa," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 63(4), pages 706-730, December.
    2. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896, December.
    3. Solmi, Francesca & Von Wagner, Christian & Kobayashi, Lindsay C. & Raine, Rosalind & Wardle, Jane & Morris, Stephen, 2015. "Decomposing socio-economic inequality in colorectal cancer screening uptake in England," Social Science & Medicine, Elsevier, vol. 134(C), pages 76-86.
    4. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    5. Mackenbach, Johan P. & Kunst, Anton E., 1997. "Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe," Social Science & Medicine, Elsevier, vol. 44(6), pages 757-771, March.
    6. Adam Wagstaff, 2005. "The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 429-432, April.
    7. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    8. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Olufunke Alaba & Lumbwe Chola, 2014. "Socioeconomic Inequalities in Adult Obesity Prevalence in South Africa: A Decomposition Analysis," IJERPH, MDPI, vol. 11(3), pages 1-20, March.
    2. Eibhlin Hudson & David Madden & Irene Mosca, 2015. "A Formal Investigation of Inequalities in Health Behaviours After Age 50 on the Island of Ireland," The Economic and Social Review, Economic and Social Studies, vol. 46(2), pages 233-265.
    3. Philip Clarke & Tom Van Ourti, 2009. "Correcting the Bias in the Concentration Index when Income is Grouped," CEPR Discussion Papers 599, Centre for Economic Policy Research, Research School of Economics, Australian National University.
    4. John E. Ataguba, 2022. "A short note revisiting the concentration index: Does the normalization of the concentration index matter?," Health Economics, John Wiley & Sons, Ltd., vol. 31(7), pages 1506-1512, July.
    5. Clifton Makate & Marshall Makate & Nelson Mango, 2019. "Wealth-related inequalities in adoption of drought-tolerant maize and conservation agriculture in Zimbabwe," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 11(4), pages 881-896, August.
    6. Martha Tangeni Nghipandulwa & Alfred Kechia Mukong, 2023. "Estimating Income-Related Health Inequalities Associated with Tobacco and Alcohol Consumption in Namibia," IJERPH, MDPI, vol. 20(2), pages 1-17, January.
    7. Kjellsson, Gustav, 2014. "Extending Decomposition Analysis to Account for Socioeconomic Background: Income-Related Smoking Inequality among Swedish Women," Working Papers 2014:29, Lund University, Department of Economics.
    8. Hai Zhong, 2010. "On decomposing the inequality and inequity change in health care utilization: change in means, or change in the distributions?," International Journal of Health Economics and Management, Springer, vol. 10(4), pages 369-386, December.
    9. Hajizadeh, Mohammad & Hu, Min & Bombay, Amy & Asada, Yukiko, 2018. "Socioeconomic inequalities in health among Indigenous peoples living off-reserve in Canada: Trends and determinants," Health Policy, Elsevier, vol. 122(8), pages 854-865.
    10. Mohammad Habibullah Pulok & Kees Gool & Mohammad Hajizadeh & Sara Allin & Jane Hall, 2020. "Measuring horizontal inequity in healthcare utilisation: a review of methodological developments and debates," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 171-180, March.
    11. Peng Nie & Andrew E. Clarck & Conchita D'Ambrosio & Lanlin Ding, 2020. "Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions," Working Papers 524, ECINEQ, Society for the Study of Economic Inequality.
    12. Mohammad Monirul Hasan & Jalal Uddin & Mohammad Habibullah Pulok & Nabila Zaman & Mohammad Hajizadeh, 2020. "Socioeconomic Inequalities in Child Malnutrition in Bangladesh: Do They Differ by Region?," IJERPH, MDPI, vol. 17(3), pages 1-14, February.
    13. Ziebarth, Nicolas, 2010. "Measurement of health, health inequality, and reporting heterogeneity," Social Science & Medicine, Elsevier, vol. 71(1), pages 116-124, July.
    14. Laura Rossouw & Hana Ross, 2021. "Understanding Period Poverty: Socio-Economic Inequalities in Menstrual Hygiene Management in Eight Low- and Middle-Income Countries," IJERPH, MDPI, vol. 18(5), pages 1-14, March.
    15. Erreygers, Guido & Van Ourti, Tom, 2011. "Measuring socioeconomic inequality in health, health care and health financing by means of rank-dependent indices: A recipe for good practice," Journal of Health Economics, Elsevier, vol. 30(4), pages 685-694, July.
    16. Aristides dos Santos, Anderson Moreira & Perelman, Julian & Jacinto, Paulo de Andrade & Tejada, Cesar Augusto Oviedo & Barros, Aluísio J.D. & Bertoldi, Andréa D. & Matijasevich, Alicia & Santos, Iná S, 2019. "Income-related inequality and inequity in children’s health care: A longitudinal analysis using data from Brazil," Social Science & Medicine, Elsevier, vol. 224(C), pages 127-137.
    17. Marion Devaux, 2015. "Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 21-33, January.
    18. Mohammad Hajizadeh & M. Karen Campbell & Sisira Sarma, 2014. "Socioeconomic inequalities in adult obesity risk in Canada: trends and decomposition analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(2), pages 203-221, March.
    19. Pulok, Mohammad Habibullah & van Gool, Kees & Hall, Jane, 2020. "Inequity in physician visits: the case of the unregulated fee market in Australia," Social Science & Medicine, Elsevier, vol. 255(C).
    20. Mohammad Hajizadeh & Luke B. Connelly & James R.G. Butler & Aredshir Khosravi, 2012. "Unmet need and met unneed in health care utilisation in Iran," International Journal of Social Economics, Emerald Group Publishing Limited, vol. 39(6), pages 400-422, May.

    More about this item

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:pre:wpaper:201716. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Rangan Gupta (email available below). General contact details of provider: https://edirc.repec.org/data/decupza.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.