Income-related health inequalities associated with the coronavirus pandemic in South Africa: a decomposition analysis

SOURCE: International Journal for Equity in Health
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2021
TITLE AUTHOR(S): C.O.Nwosu, A.Oyenubi
KEYWORDS: COVID-19, HEALTH, INEQUALITIES
DEPARTMENT: Impact Centre (IC), Impact Centre (PRESS), Impact Centre (CC)
Print: HSRC Library: shelf number 11867
HANDLE: 20.500.11910/15907
URI: http://hdl.handle.net/20.500.11910/15907

If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.

Abstract

The coronavirus disease 2019 (COVID-19) has resulted in an enormous dislocation of society especially in South Africa. The South African government has imposed a number of measures aimed at controlling the pandemic, chief being a nationwide lockdown. This has resulted in income loss for individuals and firms, with vulnerable populations (low earners, those in informal and precarious employment, etc.) more likely to be adversely affected through job losses and the resulting income loss. Income loss will likely result in reduced ability to access healthcare and a nutritious diet, thus adversely affecting health outcomes. Given the foregoing, we hypothesize that the economic dislocation caused by the coronavirus will disproportionately affect the health of the poor. Using the fifth wave of the National Income Dynamics Study (NIDS) dataset conducted in 2017 and the first wave of the NIDS-Coronavirus Rapid Mobile Survey (NIDS-CRAM) dataset conducted in May/June 2020, this paper estimated income-related health inequalities in South Africa before and during the COVID-19 pandemic. Health was a dichotomized self-assessed health measure, with fair and poor health categorized as 'poor' health, while excellent, very good and good health were categorized as 'better' health. Household per capita income was used as the ranking variable. Concentration curves and indices were used to depict the income-related health inequalities. Furthermore, we decomposed the COVID-19 era income-related health inequality in order to ascertain the significant predictors of such inequality. The results indicate that poor health was pro-poor in the pre-COVID-19 and COVID-19 periods, with the latter six times the value of the former. Being African (relative to white), per capita household income and household experience of hunger significantly predicted income-related health inequalities in the COVID-19 era (contributing 130%, 46% and 9% respectively to the inequalities), while being in paid employment had a nontrivial but statistically insignificant contribution (13%) to health inequality. Given the significance and magnitude of race, hunger, income and employment in determining socioeconomic inequalities in poor health, addressing racial disparities and hunger, income inequality and unemployment will likely mitigate income-related health inequalities in South Africa during the COVID-19 pandemic.

The Human Sciences Research Council

Contact Us

134 Pretorius Street
Pretoria
South Africa 
0002

Tel: +27 (0)12 302 2000
Fax: +27 (0)12 302 2001

© 2024 The Human Sciences Research Council (HSRC). All rights reserved.