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Social Determinants of Health Inequalities in South Africa: A Decomposition Analysis

Kehinde Omotoso and Steven Koch

No 201716, Working Papers from University of Pretoria, Department of Economics

Abstract: This study uses information collected on social determinants of health (SDH) and on a variety of health indicators in the 2004 and 2014 questionnaires of the South African General Household Surveys (GHSs) to explain how changes in the SDH have impacted health inequalities over the last decade, the second since the end of Apartheid. Specifically, the Oaxaca-type decomposition of change in a concentration index is used to illustrate how changes in health inequalities over time are attributable to changes in inequality in the determinants of health, and changes in their elasticities. This study finds that rising inequalities in ill-health are largely explained by widening inequalities among those residing in the urban areas and in the relatively richer provinces. Meanwhile, rising inequality in medical aid coverage and utilisation of private health care are mainly attributable to inequalities in educational attainment and racial composition. However, changing elasticities in SDH, rather than rising inequalities, are found to be important factors in explaining inequality in the utilisation of public health care.

Pages: 22 pages
Date: 2017-03
New Economics Papers: this item is included in nep-dev and nep-hea
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