Inequalities in multimorbidity in South Africa.
Inequalities in multimorbidity in South Africa.
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DOI：
10.1186/1475-9276-12-64
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发表时间：
2013-08-20
影响因子：
4.8
通讯作者：
Ataguba JE
中科院分区：
文献类型：
--
作者：
Ataguba JE
人们对多发病中与社会经济相关的不平等现象知之甚少，特别是在发展中国家。传统上，关于健康不平等的研究主要集中于单一疾病状况或孤立的不同状况。本文考察了2005年至2008年间南非疾病和残疾多发病的社会经济不平等。数据来自2005年、2006年、2007年和2008年具有全国代表性的年度南非综合住户调查（GHS）。使用间接标准化的浓度指数来评估社会经济不平等。使用在所有GHS轮次中可用的一组选定变量，每年构建一个社会经济地位的代理指数。疾病和残疾的多重发病率是利用全球统一系统中关于九种疾病和六种残疾的数据构建的。多种疾病影响了相当数量的南非人。大多数情况下，根据所考虑的九种疾病和六种残疾情况，发现疾病和残疾的多重发病只涉及两种情况。2008年在南非，影响最多个人（0.6%的人口）的多重疾病是高血压（BP）与至少一种其他疾病相结合。性传播疾病（性病）和其他病症相结合的报告最少（即占人口的0.02%）。2005年至2008年期间，疾病和残疾的多重发病率在穷人中更为普遍；在残疾方面更是如此。2005年和2008年多病浓度指数分别为- 0.0009和- 0.0006。多个残疾对应的值分别为−0.0006和−0.0006。虽然缺乏关于多种疾病在许多发展中国家的社会经济分布的信息，但本文表明，其在南非的分布表明，穷人承担着更大的多种疾病负担。残疾比疾病更能说明问题。本文认为，鉴于多重疾病的高负担和倾斜的社会经济分布，有必要设计政策来解决这种情况。此外，有必要设计专门评估多重发病的调查。
Very little is known about socioeconomic related inequalities in multimorbidity, especially in developing countries. Traditionally, studies on health inequalities have mainly focused on a single disease condition or different conditions in isolation. This paper examines socioeconomic inequality in multimorbidity in illness and disability in South Africa between 2005 and 2008. Data were drawn from the 2005, 2006, 2007, and 2008 rounds of the nationally representative annual South African General Household Surveys (GHS). Indirectly standardised concentration indices were used to assess socioeconomic inequality. A proxy index of socioeconomic status was constructed, for each year, using a selected set of variables that are available in all the GHS rounds. Multimorbidity in illness and disability were constructed using data on nine illnesses and six disabilities contained in the GHS. Multimorbidity affects a substantial number of South Africans. Most often, based on the nine illness conditions and six disability conditions considered, multimorbidity in illness and multimorbidity in disability are each found to involve only two conditions. In 2008 in South Africa, the multimorbidity that affected the greatest number of individuals (0.6% of the population) combined high blood pressure (BP) with at least one other illness. The combination of sexually transmitted diseases (STDs) and other condition or conditions is the least reported (i.e. 0.02% of the population). Between 2005 and 2008, multimorbidity in illness and disability is more prevalent among the poor; in disabilities this is yet more consistent. The concentration index of multiple illnesses in 2005 and 2008 are −0.0009 and −0.0006 respectively. The corresponding values for multiple disabilities are −0.0006 and −0.0006 respectively. While there is a dearth of information on the socioeconomic distribution of multimorbidity in many developing countries, this paper has shown that its distribution in South Africa indicates that the poor bear a greater burden of multimorbidity. This is more so for disability than for illness. This paper argues that, given the high burden and skewed socioeconomic distribution of multimorbidity, there is a need to design policies to address this situation. Further, there is a need to design surveys that specifically assess multimorbidity.
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影响因子：
7.2
作者：
van den Akker, M;Buntinx, F;Knottnerus, JA
通讯作者：
Knottnerus, JA
影响因子：
5.4
作者：
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影响因子：
2.1
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影响因子：
3.5
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影响因子：
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