Lifestyle and social conditions associated with self-rated health in South Africa

Context: Social conditions known to compromise quality of life may also affect health status. Consistent with good public health practice of involving people in the assessment of their own health, this study sought to determine the influence of lifestyle factors and socio-economic conditions on self-rated health (SRH) in South Africa. 

Methods: This study involved a nationally representative sample of South Africans ≥15 years (n = 8,060) who participated in the 2003/2004 South African Demographic and Health Survey (SADHS). Information obtained using a self-administered questionnaire included socio-demographics, tobacco use and self-report of drinking problem (Cage score>=2), participation in vigorous physical activity at leisure and exposure to violence (ETV). ETV was measured using a six-item scale (Cronbach alpha=0.82). Main outcome: Self-rated good health, defined as rating own health as good/excellent. Taking into account the cluster-sampling procedure used in the SADHS, data analysis included chi-square statistics, t-test and multiple logistic regression analysis.

 Results: Of the respondents, 40.2% (n=3236) rated their health as good/excellent. Self –rated good health was positively associated with engaging in physical activity (OR=1.40; 95%CI=1.13-1.71), having a paid job in the past year (1.44; 1.24-1.67),and self-identifying as white(3.27; 2.12-5.03)  as compared to black African. Factors negatively associated included being female (0.72; 0.62-0.85), increasing exposure to violence (0.81; 0.71-0.91), having drinking problem (0.78; 0.63-0.97), reporting lifetime exposure to secondhand smoke (0.68; 0.56-0.82) and concurrently smoking and snuffing (0.16; 0.04-0.60).

 Conclusions: This study’s findings suggest that in addition to promoting healthy lifestyle, there is a need for focused attention on interventions directed towards improving the level of employment and reducing exposure to violence, particularly among the most vulnerable population – black Africans and women. 
 Author Keywords:  Lifestyle, Social conditions, Self-rated health, adult, South Africa