Social determinants of health and diabetes self-care management in South Africa
Objective: Diabetes is an incapacitating condition affecting millions of people in South Africa. Maintaining optimal glycaemic control is crucial in preventing diabetes complications, highlighting the importance of diabetes self-care. This study examined how Social Determinants of Health (SDoH) are...
| Main Authors: | , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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2024
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| Subjects: | |
| Online Access: | http://hdl.handle.net/20.500.11937/96586 |
| _version_ | 1848766174011064320 |
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| author | Hellebo, A. Kengne, A.P. Obse, A. Levitt, N. Myers, Bronwyn Cleary, S. Alaba, O. |
| author_facet | Hellebo, A. Kengne, A.P. Obse, A. Levitt, N. Myers, Bronwyn Cleary, S. Alaba, O. |
| author_sort | Hellebo, A. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective: Diabetes is an incapacitating condition affecting millions of people in South Africa. Maintaining optimal glycaemic control is crucial in preventing diabetes complications, highlighting the importance of diabetes self-care. This study examined how Social Determinants of Health (SDoH) are associated with self-care management practices in individuals with diabetes in South Africa using the framework developed by the Healthy People 2020 initiative. Methods: This study utilised cross-sectional Project Mind baseline data collected in 2017. Self-care management was coded on a scale from ‘0’ (never) to ‘7’ (daily adherence). For analysis, this scale was dichotomised into two categories: low self-care (scores 0–5) and high self-care (scores 6–7). Furthermore, adherence with these daily self-care activities was categorised into three levels: no adherence, partial adherence (inconsistent or partial adherence to activities), and full adherence (consistent adherence to all self-care activities). Results: The analytical sample (n = 539) was predominantly female (76%), with a mean age of 54 years, urban residents (60%), unemployed (70%), and attained secondary education (11.3%). In determining the attainment of a higher scale of self-care, age (AOR = 1.02, CI=[0.99,1.05]) and secondary education (AOR = 1.13, CI=[1.02, 2.03]) were associated with an increase in the scale of self-care. Conversely, urban residency (AOR = 0.50, CI=[0.29,0.88]) and being obese (AOR = 0.43, CI=[0.19,1.00]) were associated with a lower scale of self-care. Although not statistically robust, food insecurity decreased while being a woman and having a stable house showed an increased association. Travelling longer distances to access healthcare was positively associated with no adherence, and urban residency has a negative association with full adherence relative to partial adherence. Conclusions: The associations between SDoH and diabetes self-care management within a South African context highlight the need for a more holistic understanding and approach to interventions. Future endeavours should examine these determinants more broadly and formulate integrative strategies to ameliorate diabetes self-care. |
| first_indexed | 2025-11-14T11:46:57Z |
| format | Journal Article |
| id | curtin-20.500.11937-96586 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | eng |
| last_indexed | 2025-11-14T11:46:57Z |
| publishDate | 2024 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-965862025-01-23T05:51:30Z Social determinants of health and diabetes self-care management in South Africa Hellebo, A. Kengne, A.P. Obse, A. Levitt, N. Myers, Bronwyn Cleary, S. Alaba, O. Humans South Africa Female Male Social Determinants of Health Middle Aged Cross-Sectional Studies Self Care Adult Diabetes Mellitus Aged Humans Diabetes Mellitus Self Care Cross-Sectional Studies Adult Aged Middle Aged South Africa Female Male Social Determinants of Health Objective: Diabetes is an incapacitating condition affecting millions of people in South Africa. Maintaining optimal glycaemic control is crucial in preventing diabetes complications, highlighting the importance of diabetes self-care. This study examined how Social Determinants of Health (SDoH) are associated with self-care management practices in individuals with diabetes in South Africa using the framework developed by the Healthy People 2020 initiative. Methods: This study utilised cross-sectional Project Mind baseline data collected in 2017. Self-care management was coded on a scale from ‘0’ (never) to ‘7’ (daily adherence). For analysis, this scale was dichotomised into two categories: low self-care (scores 0–5) and high self-care (scores 6–7). Furthermore, adherence with these daily self-care activities was categorised into three levels: no adherence, partial adherence (inconsistent or partial adherence to activities), and full adherence (consistent adherence to all self-care activities). Results: The analytical sample (n = 539) was predominantly female (76%), with a mean age of 54 years, urban residents (60%), unemployed (70%), and attained secondary education (11.3%). In determining the attainment of a higher scale of self-care, age (AOR = 1.02, CI=[0.99,1.05]) and secondary education (AOR = 1.13, CI=[1.02, 2.03]) were associated with an increase in the scale of self-care. Conversely, urban residency (AOR = 0.50, CI=[0.29,0.88]) and being obese (AOR = 0.43, CI=[0.19,1.00]) were associated with a lower scale of self-care. Although not statistically robust, food insecurity decreased while being a woman and having a stable house showed an increased association. Travelling longer distances to access healthcare was positively associated with no adherence, and urban residency has a negative association with full adherence relative to partial adherence. Conclusions: The associations between SDoH and diabetes self-care management within a South African context highlight the need for a more holistic understanding and approach to interventions. Future endeavours should examine these determinants more broadly and formulate integrative strategies to ameliorate diabetes self-care. 2024 Journal Article http://hdl.handle.net/20.500.11937/96586 10.1186/s12889-024-20200-w eng http://creativecommons.org/licenses/by-nc-nd/4.0/ fulltext |
| spellingShingle | Humans South Africa Female Male Social Determinants of Health Middle Aged Cross-Sectional Studies Self Care Adult Diabetes Mellitus Aged Humans Diabetes Mellitus Self Care Cross-Sectional Studies Adult Aged Middle Aged South Africa Female Male Social Determinants of Health Hellebo, A. Kengne, A.P. Obse, A. Levitt, N. Myers, Bronwyn Cleary, S. Alaba, O. Social determinants of health and diabetes self-care management in South Africa |
| title | Social determinants of health and diabetes self-care management in South Africa |
| title_full | Social determinants of health and diabetes self-care management in South Africa |
| title_fullStr | Social determinants of health and diabetes self-care management in South Africa |
| title_full_unstemmed | Social determinants of health and diabetes self-care management in South Africa |
| title_short | Social determinants of health and diabetes self-care management in South Africa |
| title_sort | social determinants of health and diabetes self-care management in south africa |
| topic | Humans South Africa Female Male Social Determinants of Health Middle Aged Cross-Sectional Studies Self Care Adult Diabetes Mellitus Aged Humans Diabetes Mellitus Self Care Cross-Sectional Studies Adult Aged Middle Aged South Africa Female Male Social Determinants of Health |
| url | http://hdl.handle.net/20.500.11937/96586 |