Dimensions of health and well-being in South Africa

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Recent welfare research has widened its focus, incorporating dimensions of satisfaction and health, while relative status, inequality, and perception-based indicators have come to the fore in the array of material well-being measures. This thesis focuses on the relationship between health and material well-being. It has two aims: first, to investigate the reliability of self-rated health (SRH) as an overall health measure in the South African context; and second, to examine the relationships between SRH and socioeconomic status and inequality, taking into account the role of perceptions. Further, the innate gender disparities in these relationships are explicitly recognised throughout. Chapters 2 and 3 approach the first aim from opposing angles. Chapter 2 addresses the reporting heterogeneity in SRH, which is its main disadvantage. The heterogeneous reporting patterns found are similar for men and women, with notable differences in the role of household material resources and location type. Nevertheless, the analysis corroborates international evidence that SRH is an internally consistent measure when employed in panel data analysis. Chapter 3 tests the validity of SRH in the South African context, based on its main advantage as a predictor of the most reliable health indicator: death. Chapter 4 examines the relationships of health with absolute income, rank, and inequality, using both measured and perceived indicators of rank and inequality. The findings show that perceived measures of rank and inequality have a greater impact on SRH than measured indicators, and these effects are stronger for women.
A thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy to the Faculty of Commerce, Law and Management, University of the Witwatersrand, 2022
Health, Well-being, South Africa