Neighbourhood deprivation, smoking, and race in South Africa: A cross-sectional analysis
Research on the role of neighbourhood-level deprivation in low- and middle-income countries with respect to tobacco use is relatively nascent. In South Africa, where race and deprivation are closely linked due to the history of apartheid, smoking disparities exist by individual risk factors such as...
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doaj-639854c00c8a48d0bd898af62d8bcc6b2020-11-25T00:08:40ZengElsevierPreventive Medicine Reports2211-33552018-09-0111202208Neighbourhood deprivation, smoking, and race in South Africa: A cross-sectional analysisYan Kwan Lau0Jamie Tam1Nancy L. Fleischer2Rafael Meza3Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, 1415 Washington Heights, United States of AmericaDepartment of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, 1415 Washington Heights, United States of AmericaDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, 1415 Washington Heights, United States of America; Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, United States of AmericaDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, 1415 Washington Heights, United States of America; Corresponding author.Research on the role of neighbourhood-level deprivation in low- and middle-income countries with respect to tobacco use is relatively nascent. In South Africa, where race and deprivation are closely linked due to the history of apartheid, smoking disparities exist by individual risk factors such as gender, race, and socioeconomic status. However, less is known about how community-level factors affect smoking disparities in the country, or how the relationship between deprivation and smoking differs by race. We used data from the 2008 South African National Income Dynamics Study (NIDS) and Poisson generalised estimating equations to assess the relationship between neighbourhood deprivation and current smoking for individuals nested within neighbourhoods, while controlling for individual-level and household-level covariates. Subgroup analyses for racial categories Black and Coloured were performed. We found that the relationship between neighbourhood deprivation and smoking prevalence was non-linear: the smoking prevalence ratio was highest among those in the middle range for our deprivation index, and lower at extremely high and low levels of deprivation. Both Black and Coloured subsamples exhibited this inverted U-shape, although the relationship was weaker in the latter group. That the relationship between neighbourhood deprivation and smoking is non-linear contrasts with what has been found in high-income countries, where the relationship between neighbourhood deprivation and smoking is linear. Moreover, these findings are relevant to assess the potential differential impact of smoking interventions as a function of socioeconomic and environmental context. Keywords: Smoking, South Africa, Residential characteristics, Epidemiologyhttp://www.sciencedirect.com/science/article/pii/S2211335518301141 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yan Kwan Lau Jamie Tam Nancy L. Fleischer Rafael Meza |
spellingShingle |
Yan Kwan Lau Jamie Tam Nancy L. Fleischer Rafael Meza Neighbourhood deprivation, smoking, and race in South Africa: A cross-sectional analysis Preventive Medicine Reports |
author_facet |
Yan Kwan Lau Jamie Tam Nancy L. Fleischer Rafael Meza |
author_sort |
Yan Kwan Lau |
title |
Neighbourhood deprivation, smoking, and race in South Africa: A cross-sectional analysis |
title_short |
Neighbourhood deprivation, smoking, and race in South Africa: A cross-sectional analysis |
title_full |
Neighbourhood deprivation, smoking, and race in South Africa: A cross-sectional analysis |
title_fullStr |
Neighbourhood deprivation, smoking, and race in South Africa: A cross-sectional analysis |
title_full_unstemmed |
Neighbourhood deprivation, smoking, and race in South Africa: A cross-sectional analysis |
title_sort |
neighbourhood deprivation, smoking, and race in south africa: a cross-sectional analysis |
publisher |
Elsevier |
series |
Preventive Medicine Reports |
issn |
2211-3355 |
publishDate |
2018-09-01 |
description |
Research on the role of neighbourhood-level deprivation in low- and middle-income countries with respect to tobacco use is relatively nascent. In South Africa, where race and deprivation are closely linked due to the history of apartheid, smoking disparities exist by individual risk factors such as gender, race, and socioeconomic status. However, less is known about how community-level factors affect smoking disparities in the country, or how the relationship between deprivation and smoking differs by race. We used data from the 2008 South African National Income Dynamics Study (NIDS) and Poisson generalised estimating equations to assess the relationship between neighbourhood deprivation and current smoking for individuals nested within neighbourhoods, while controlling for individual-level and household-level covariates. Subgroup analyses for racial categories Black and Coloured were performed. We found that the relationship between neighbourhood deprivation and smoking prevalence was non-linear: the smoking prevalence ratio was highest among those in the middle range for our deprivation index, and lower at extremely high and low levels of deprivation. Both Black and Coloured subsamples exhibited this inverted U-shape, although the relationship was weaker in the latter group. That the relationship between neighbourhood deprivation and smoking is non-linear contrasts with what has been found in high-income countries, where the relationship between neighbourhood deprivation and smoking is linear. Moreover, these findings are relevant to assess the potential differential impact of smoking interventions as a function of socioeconomic and environmental context. Keywords: Smoking, South Africa, Residential characteristics, Epidemiology |
url |
http://www.sciencedirect.com/science/article/pii/S2211335518301141 |
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