- The poor bore suffered ill health before and still do during the Covid-19 pandemic, research has found.
- Racial disparities, hunger, income inequality and unemployment need to be addressed to mitigate income-related health inequalities in SA.
- The research looks at how poor people are disproportionately affected by the pandemic.
Research has found that poor people bore a higher burden of ill health before the Covid-19 pandemic in South Africa, with the problem only exacerbating during the pandemic.
In addition, race, income, and hunger were the significant contributors to such inequality, with unemployment also playing an important role.
"Understanding the nature and key determinants of income-related health inequalities during the period of the Covid-19 pandemic is important for designing and implementing appropriate policies aimed at tackling health disparities," researchers Chijoke Nwosu and Adeola Oyenubi said in their report.
Oyenubi, a senior lecturer in the Wits School of Economics and Finance, and Nwosu - a senior research specialist within the Impact Centre (IC) at the HSRC - stated their findings in their research article titled "Income-related health inequalities associated with the coronavirus pandemic in South Africa: A decomposition analysis", published in the International Journal for Equity in Health.
The research looks at how the economic dislocation of income loss or job loss caused by the pandemic will disproportionately affect the health of the poor in South Africa.
The researchers said:
"Apartheid resulted in spatial segregation mostly along racial lines, with many of the poorer non-white population confined to poorly developed and overcrowded neighbourhoods popularly known as townships. Twenty-six years after the official end of apartheid, such race-based spatial segregation largely remains in place," they argue.
In addition, the researchers argue that income-related health inequality has been higher among women than among men in the Covid-19 period.
"We suspect that this may not be unconnected with the fact that women have been more adversely affected by Covid-19-related lockdowns and economic disruption," they added.
This estimate was determined by 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.
"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," Oyenubu and Nwosu said.
The authors submit that to mitigate the income-related health inequalities in South Africa, certain contributors to inequality - such as race, income and hunger - have to be addressed, given their magnitude.
"Therefore, addressing disparities associated with these factors – which constitute social determinants of health – will likely go a long way in protecting the health of the poor, thus mitigating the health disparities associated with income in South Africa," Oyenubu and Nwosu concluded.
Read the full paper here.