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TL;DR
Key findings include that recent illness/injury and food insecurity were significantly associated with worse SPH, while higher income and drug use were associated with less deterioration.
International Journal of Environmental Research and Public Health · 6 authors, 5 centres
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Key findings include that recent illness/injury and food insecurity were significantly associated with worse SPH, while higher income and drug use were associated with less deterioration.
Self-perceived health (SPH) is a key indicator of overall health, and informal settlement dwellers in South Africa face significant health risks due to poor living conditions. This study aimed to identify determinants of deteriorated SPH in this population. Methods: The study used data from the 2015 national Informal Settlements Survey (HSRC), employing stratified random sampling. The final analytic sample was 2,242 respondents. The outcome was SPH compared to one year prior, dichotomized into 'deteriorated' vs. 'better/about the same'. Multivariate logistic and multinomial logistic regression models were used to assess associations with demographic, socioeconomic, and health-related factors. Key Results: Significant associations were found. Those aged 30-39 (OR=0.332, 95%CI [0.131–0.840], p<0.05), with household income ≥ZAR 5501 (OR=0.365, 95%CI [0.144–0.922], p<0.05), and who reported drug use (OR=0.069, 95%CI [0.020–0.240], p<0.001) were less likely to report deteriorated SPH. Conversely, those who always ran out of food (OR=3.120, 95%CI [1.258–7.737], p<0.05) and those with recent illness/injury (OR=3.645, 95%CI [2.147–6.186], p<0.001) were more likely to report deterioration. Employment was also associated with higher odds of deterioration (OR=1.830, 95%CI [1.001–3.347], p=0.05) in one model. SPH is subject to recall and social desirability bias. The sample is skewed towards unemployed and lower-income groups, potentially overestimating poor SPH. Implications: The findings highlight the importance of age, income, food security, illness, and employment as determinants of SPH in informal settlements. The authors recommend incorporating these factors into policy and planning to improve health and living standards for these vulnerable residents.