Small-area variation  of cardiovascular diseases and select risk factors and their association to household and area poverty in South Africa: Capturing emerging trends in South Africa to better target local level interventions

Abstract

Background Of the total 56 million deaths worldwide during 2012, 38 million (68%) were due to noncommunicable diseases (NCDs), particularly cardiovascular diseases (17.5 million deaths) cancers (8.2 million) which represents46.2% and 21.7% of NCD deaths, respectively). Nearly 80 percent of the global CVD deaths occur in low-and middle-income countries. Some of the major CVDs such as ischemic heart disease (IHD) and stroke and CVD risk conditions, namely, hypertension and dyslipidaemia share common modifiable risk factors including smoking, unhealthy diets, harmful use of alcohol and physical inactivity. The CVDs are now putting a heavy strain of the health systems at both national and local levels, which have previously largely focused on infectious diseases and appalling maternal and child health. We set out to estimate district-level co-occurrence of two cardiovascular diseases (CVDs), namely, ischemic heart disease (IHD) and stroke; and two major risk conditions for CVD, namely, hypertension and dyslipidaemia in South Africa. Method The analyses were based on adults health collected as part of the 2012 South African National Health and Nutrition Examination Survey (SANHANES). We used joint disease mapping models to estimate and map the spatial distributions of risks of hypertension, selfreport of ischaemic heart disease (IHD), stroke and dyslipidaemia at the district level in South Africa. The analyses were adjusted for known individual social demographic and lifestyle factors, household and district level poverty measurements using binary spatial models.

Individual and area-level socioeconomic correlates of hypertension prevalence, awareness, treatment, and control in uMgungundlovu, KwaZulu-Natal, South Africa

“…To our knowledge, only one other study has assessed the relationship between this measure of area-level deprivation with cardiovascular health outcomes. In that analysis, which used data from SANHANES-1, area-level deprivation was positively associated with the prevalence of ischemic heart disease, but not hypertension [ 43 ].…”

“…The SAMPI has been linked in prior research to various dimensions of health, including self-rated health and cardiovascular disease [ 42 , 43 ]. It has typically been modeled as a categorical variable with cut points based on the quintiles of the distribution of scores.…”

A Retrospective Medical Record Review to Describe Health Status and Cardiovascular Disease Risk Factors of Bus Drivers in South Africa

“…Amadi et al (2018) reported a nearly three times increased odds of hypertension in those who were overweight/obese. Data from SANHANES also found that hypertension was highest for those who were overweight (48.3%; N = 16,293) [ 36 ]. A recent study on CVD risk factors in long-distance bus drivers in Lagos, Nigeria (N = 293), reported that BMI and an extended length of time as a professional driver correlated with the risk of hypertension [ 28 ].…”

Racial disparities in psychological distress in post-apartheid South Africa: results from the SANHANES-1 survey

“…Marked racial stratification developed during the Apartheid era in South Africa placed Whites at the top, Indians and Coloureds in the middle, and Africans at the bottom [38]. Geographic location was categorized as formal urban, informal urban, formal rural, or informal rural [39][40][41][42]. Age was categorized into 10-year groups.…”