Socioeconomic inequalities in the prevalence of chronic non-communicable disease risk factors in the DIMAMO Health Demographic Surveillance Site
1
1 Department of Public Health, University of Limpopo, Polokwane, South Africa
2
2 Academic Affairs and Research, National Health Laboratory Services, Johannesburg, South Africa
3
3 Department of Public Health, Walter Sisulu University, Umtata, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Socioeconomic inequalities influence the burden of non-communicable diseases (NCDs) and their risk factors. This study assessed socioeconomic disparities in chronic NCD risk factors among adults in the DIMAMO Health and Demographic Surveillance Site (HDSS), Limpopo Province, South Africa.
METHODS:
A cross-sectional survey was conducted among adults aged 18 years and above. Data on socioeconomic status (SES) and NCD risk factors, including smoking, alcohol use, high salt intake, low fruit and vegetable intake, and physical inactivity, were collected using an adapted WHO STEPS questionnaire. SES was measured using household assets, and a wealth index was constructed using principal component analysis to classify participants into SES quintiles. Concentration indices (CIs) and curves assessed the magnitude and direction of SES-related inequalities, while decomposition analysis quantified SES contributions to each risk factor’s inequality.
RESULTS:
The sample was predominantly female (63%) and under 50 years (58%), with most participants unemployed (60.3%) and holding secondary education (63.1%). Low fruit and vegetable intake (88.7%) was the most prevalent risk factor, followed by alcohol consumption (35.2%) and hypertension (22.6%). Diabetes prevalence was higher among individuals in higher SES groups (p = 0.0071). Smoking, physical inactivity, and low fruit and vegetable intake were more concentrated among the poor, whereas diabetes and alcohol use were more prevalent among the wealthy. Decomposition analysis indicated SES accounted for nearly all observed inequalities, highlighting wealth disparities as the dominant driver of NCD risk distribution.
CONCLUSIONS:
The study reveals a dual burden of NCD risk factors: behavioural risks are concentrated among the poor, while metabolic conditions such as diabetes are more common among the affluent. Addressing these disparities requires context-specific interventions targeting both behavioural and metabolic risk factors across all socioeconomic strata.
Socioeconomic inequalities influence the burden of non-communicable diseases (NCDs) and their risk factors. This study assessed socioeconomic disparities in chronic NCD risk factors among adults in the DIMAMO Health and Demographic Surveillance Site (HDSS), Limpopo Province, South Africa.
METHODS:
A cross-sectional survey was conducted among adults aged 18 years and above. Data on socioeconomic status (SES) and NCD risk factors, including smoking, alcohol use, high salt intake, low fruit and vegetable intake, and physical inactivity, were collected using an adapted WHO STEPS questionnaire. SES was measured using household assets, and a wealth index was constructed using principal component analysis to classify participants into SES quintiles. Concentration indices (CIs) and curves assessed the magnitude and direction of SES-related inequalities, while decomposition analysis quantified SES contributions to each risk factor’s inequality.
RESULTS:
The sample was predominantly female (63%) and under 50 years (58%), with most participants unemployed (60.3%) and holding secondary education (63.1%). Low fruit and vegetable intake (88.7%) was the most prevalent risk factor, followed by alcohol consumption (35.2%) and hypertension (22.6%). Diabetes prevalence was higher among individuals in higher SES groups (p = 0.0071). Smoking, physical inactivity, and low fruit and vegetable intake were more concentrated among the poor, whereas diabetes and alcohol use were more prevalent among the wealthy. Decomposition analysis indicated SES accounted for nearly all observed inequalities, highlighting wealth disparities as the dominant driver of NCD risk distribution.
CONCLUSIONS:
The study reveals a dual burden of NCD risk factors: behavioural risks are concentrated among the poor, while metabolic conditions such as diabetes are more common among the affluent. Addressing these disparities requires context-specific interventions targeting both behavioural and metabolic risk factors across all socioeconomic strata.
| eISSN: | 2654-1459 |
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