Socioeconomic gradients in chronic disease risk behaviors in a population-based study of older adults in rural South Africa

Int J Public Health. 2019 Jan;64(1):135-145. doi: 10.1007/s00038-018-1173-8. Epub 2018 Nov 22.


Objectives: To investigate the associations between household wealth, household consumption, and chronic disease risk behaviors among older adults in rural South Africa.

Methods: Data were from baseline assessments of 5059 adults aged ≥ 40 in the population-based "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa" in 2015. Confounder-adjusted prevalence ratios were estimated for the associations between each of household wealth and household consumption quintiles with low moderate-to-vigorous physical activity (MVPA), current smoking, frequent alcohol intake, and overweight/obese body mass index (BMI).

Results: Low MVPA and overweight/obese BMI were common (57% and 58%, respectively), and linearly increased in prevalence across household wealth quintiles. Low MVPA decreased and overweight/obese BMI increased in prevalence across household consumption quintiles. Smoking and frequent alcohol intake were rare (9% and 6%, respectively); they decreased in prevalence across wealth quintiles, but did not vary by consumption quintile.

Conclusions: Chronic disease risk behaviors are socioeconomically graded among older, rural South African adults. The high prevalence of overweight and obesity in rural South Africa is a public health concern requiring urgent attention.

Keywords: Aging; Alcohol; Body mass index; Physical activity; Rural; Smoking; Socioeconomic inequalities; South Africa.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / epidemiology
  • Body Mass Index
  • Chronic Disease
  • Exercise
  • Female
  • Health Risk Behaviors*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Overweight / epidemiology
  • Prevalence
  • Risk Factors
  • Risk-Taking
  • Rural Population / statistics & numerical data*
  • Smoking / epidemiology
  • Socioeconomic Factors*
  • South Africa / epidemiology