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In urban South Africa, 16 year old adolescents experience greater health equality than children


  • Griffiths, Paula L.
  • Johnson, William
  • Cameron, Noël
  • Pettifor, John M.
  • Norris, Shane A.


Despite the strongly established link between socio-economic status (SES) and health across most stages of the life-course, the evidence for a socio-economic gradient in adolescent health outcomes is less consistent. This paper examines associations between household, school, and neighbourhood SES measures with body composition outcomes in 16 year old South African Black urban adolescents from the 1990 born Birth to Twenty (Bt20) cohort. Multivariable regression analyses were applied to data from a sub-sample of the Bt20 cohort (n=346, 53% male) with measures taken at birth and 16 years of age to establish socio-economic, biological, and demographic predictors of fat mass, lean mass, and body mass index (BMI). Results were compared with earlier published evidence of health inequality at ages 9–10 years in Bt20. Consistent predictors of higher fat mass and BMI in fully adjusted models were being female, born post term, having a mother with post secondary school education, and having an obese mother. Most measures of SES were only weakly associated with body composition, with an inconsistent direction of association. This is in contrast to earlier findings with Bt20 9–10 year olds where SES inequalities in body composition were observed. Findings suggest targeting obesity interventions at females in households where a mother has a high BMI.

Suggested Citation

  • Griffiths, Paula L. & Johnson, William & Cameron, Noël & Pettifor, John M. & Norris, Shane A., 2013. "In urban South Africa, 16 year old adolescents experience greater health equality than children," Economics & Human Biology, Elsevier, vol. 11(4), pages 502-514.
  • Handle: RePEc:eee:ehbiol:v:11:y:2013:i:4:p:502-514
    DOI: 10.1016/j.ehb.2013.05.004

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    References listed on IDEAS

    1. Case, Anne & Menendez, Alicia, 2009. "Sex differences in obesity rates in poor countries: Evidence from South Africa," Economics & Human Biology, Elsevier, vol. 7(3), pages 271-282, December.
    2. repec:pri:cheawb:case_and_menendez_ehb_dec_2009 is not listed on IDEAS
    3. Shane A. Norris & Linda M. Richter & Stella A. Fleetwood, 2007. "Panel studies in developing countries: case analysis of sample attrition over the past 16 years within the birth to twenty cohort in Johannesburg, South Africa," Journal of International Development, John Wiley & Sons, Ltd., vol. 19(8), pages 1143-1150.
    4. Cleland, John G. & van Ginneken, Jerome K., 1988. "Maternal education and child survival in developing countries: The search for pathways of influence," Social Science & Medicine, Elsevier, vol. 27(12), pages 1357-1368, January.
    5. Cameron, Noel, 2003. "Physical growth in a transitional economy: the aftermath of South African apartheid," Economics & Human Biology, Elsevier, vol. 1(1), pages 29-42, January.
    6. West, Patrick, 1997. "Health inequalities in the early years: Is there equalisation in youth?," Social Science & Medicine, Elsevier, vol. 44(6), pages 833-858, March.
    7. Boyle, Michael H. & Racine, Yvonne & Georgiades, Katholiki & Snelling, Dana & Hong, Sungjin & Omariba, Walter & Hurley, Patricia & Rao-Melacini, Purnima, 2006. "The influence of economic development level, household wealth and maternal education on child health in the developing world," Social Science & Medicine, Elsevier, vol. 63(8), pages 2242-2254, October.
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