Gómez-Olivé, F. Xavier, Thorogood, Margaret, Clark, B. (Benjamin), Kahn, Kathleen and Tollman, Stephen (2013) Self-reported health and health care use in an ageing population in the Agincourt sub-district of rural South Africa. Global Health Action, Vol.6 . Article no. 19305. doi:10.3402/gha.v6i0.19305

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Abstract

Background: South Africa is experiencing a demographic and epidemiological transition with an increase in population aged 50 years and older and rising prevalence of non-communicable diseases. This, coupled with high HIV and tuberculosis prevalence, puts an already weak health service under greater strain.

Objective: To measure self-reported chronic health conditions and chronic disease risk factors, including smoking and alcohol use, and to establish their association with health care use in a rural South African population aged 50 years or older.

Methods: The Study on Global Ageing and Adult Health (SAGE), in collaboration with the INDEPTH Network and the World Health Organization, was implemented in the Agincourt sub-district in rural northeast South Africa where there is a long-standing health and socio-demographic surveillance system. Household-based interviews were conducted in a random sample of people aged 50 years and older. The interview included questions on self-reported health and health care use, and some physical measurements, including blood pressure and anthropometry.

Results: Four hundred and twenty-five individuals aged 50 years or older participated in the study. Musculoskeletal pain was the most prevalent self-reported condition (41.7%; 95% Confidence Interval [CI] 37.0-46.6) followed by hypertension (31.2%; 95% CI 26.8-35.9) and diabetes (6.1%; 95% CI 4.1-8.9). All selfreported conditions were significantly associated with low self-reported functionality and quality of life, 57% of participants had hypertension, including 44% of those who reported normal blood pressure. A large waist circumference and current alcohol consumption were associated with high risk of hypertension in men, whereas in women, old age, high waisthip ratio, and less than 6 years of formal education were associated with high risk of hypertension. Only 45% of all participants reported accessing health care in the last 12 months. Those who reported higher use of the health facilities also reported lower levels of functioning and quality of life.

Conclusions: Self-reported chronic health conditions, especially hypertension, had a high prevalence in this population and were strongly associated with higher levels of health care use. The primary health care system in South Africa will need to provide care for people with non-communicable diseases.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Medical care -- Utilization -- South Africa -- Agincourt, Older people -- Health and hygiene -- South Africa -- Agincourt
Journal or Publication Title:	Global Health Action
Publisher:	Co-Action Publishing
ISSN:	1654-9880
Official Date:	2013
Dates:	Date Event 2013 Published
Volume:	Vol.6
Page Range:	Article no. 19305
DOI:	10.3402/gha.v6i0.19305
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	National Institute on Aging (NIA), Wellcome Trust (London, England)
Grant number:	058893/Z/99/A (WT), 069683/Z/02/Z (WT)

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