The prevalence and determinants of non-communicable diseases among older person in South Africa

Lekulo, Abiel Mothibakhoro
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Background: The prevalence of non-communicable disease is deemed to increase significantly in future in South Africa. At the same time, population ageing is inevitable. Arguably, it has been emphasised around the globe, that mortality rate and life expectancy cannot monitor state of health in a population. Thus, illnesses and psychosocial support should be mainstreamed across age groups, in addressing population health. Older persons are no exception, as their health and social needs form part of their improved health status and welfare. Objective: To determine the levels and determinants of non-communicable disease among older persons in South Africa Data and Methods: The study used General Household Survey (GHS) 2017 and South Africa Population and Housing Census 2011 datasets GHS 2017 dataset was used to address study objective while census 2011 was used solely in the calculation of projection estimates. Data was based on older persons aged 60 years and older. Descriptive statistics using percentages, tables and bar graphs were used to show the disease status among older persons aged 60+ years in South Africa. Age specific disease rates were computed to indicate disease burden among older persons in South Africa. The cohort component population projection was used to estimate the proportion of older persons aged 60 years and older, in South Africa in 2031. The change in population structure between 2011 and 2031 were depicted by population pyramids. Eventually, multivariate binary logistic regression was used to test the association of each disease by demographic and socio-economic factors. Stata v15 was used in the regression analysis. Results: A high proportion of older persons aged 60 years and older, had diabetes (45.4%) while 54.6% did not have diabetes. On the same note,15.1% of older persons in 2017 were diagnosed with the hypertensive disease while 84.9% did not have the disease. The married had a high prevalence of heart disease (44.8%) compared to the widowed, never married and divorced. The prevalence of hypertension was 454 cases per 1000 population, among older persons aged 60 years and older in South Africa. This was followed by diabetes with 151 cases per 1000 population in 2017. The total prevalence rate would increase from 638.5 cases per 1000 older persons in 2017 to 660.8 cases per 1000 older persons in 2031. The chances of diabetes disease among the Indian/Asian population group were 55% higher compared to the African/Black population group. Older persons aged between 70-74 years were 1.28 times more likely to hypertensive disease compared to those aged 60-64 years. Again, older persons who lived in Free State Province were 1.66times more likely to get heart disease than those who lived in Western Cape Province. Conclusion: Increase in the prevalence of non-communicable diseases in South Africa implies an increase in household costs in line with health care needs among older persons. Indian/Asian population group is the major concern concerning non-communicable disease hence it is vital to establish leading factors, which make population groups more susceptible to non-communicable disease. Ageing population in South Africa is increasing at a faster pace. It is a country call to prevent and manage non-communicable disease holistically, while at the same time bearing in mind population changing lifestyles across age groups. Population health check initiatives should be established and where they exist, they have to be strengthened so that population health status may be improved. This will help support and encourage older persons in the management of non-communicable diseases at the grass roots level
A research report submitted to the Faculty of Humanities, School of Social Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Arts in the field of Health Demography, 2021