Socioeconomic-Related Inequalities in COVID-19 Vulnerability in South Africa

Muna Shifa; David Gordon; Murray Leibbrandt; Mary Zhang

doi:10.3390/ijerph191710480

Socioeconomic-Related Inequalities in COVID-19 Vulnerability in South Africa

Int J Environ Res Public Health. 2022 Aug 23;19(17):10480. doi: 10.3390/ijerph191710480.

Authors

Muna Shifa¹, David Gordon², Murray Leibbrandt¹, Mary Zhang³

Affiliations

¹ Southern Africa Labour and Development Research Unit, University of Cape Town, Cape Town 7700, South Africa.
² School for Policy Studies, University of Bristol, Bristol BS8 1TH, UK.
³ Oxford School of Global and Area Studies, University of Oxford, Oxford OX2 6LH, UK.

Abstract

Individuals' vulnerability to the risk of COVID-19 infection varies due to their health, socioeconomic, and living circumstances, which also affect the effectiveness of implementing non-pharmacological interventions (NPIs). In this study, we analysed socioeconomic-related inequalities in COVID-19 vulnerability using data from the nationally representative South African General Household Survey 2019. We developed a COVID-19 vulnerability index, which includes health and social risk factors for COVID-19 exposure and susceptibility. The concentration curve and concentration index were used to measure socioeconomic-related inequalities in COVID-19 vulnerability. Recentred influence function regression was then utilised to decompose factors that explain the socioeconomic-related inequalities in COVID-19 vulnerability. The concentration index estimates were all negative and highly significant (p < 0.01), indicating that vulnerability to COVID-19 was more concentrated among the poor. According to the decomposition analysis, higher income and education significantly (p < 0.01) positively impacted lowering socioeconomic-related COVID-19 vulnerability. Living in an urban region, being Black, and old all had significant (p < 0.01) positive impacts on increasing socioeconomic-related COVID-19 vulnerability. Our findings contribute to a better understanding of socially defined COVID-19-vulnerable populations in South Africa and the implications for future pandemic preparedness plans.

Keywords: COVID-19; South Africa; concentration index; inequality; infection prevention; vulnerability index.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Humans
Income
Prevalence
Socioeconomic Factors
South Africa / epidemiology

Grants and funding

This research was funded by the Agence Française de Développement through the EU-AFD Research Facility in Inequalities and African Research Universities Alliance (Grant number: ES/T004215/1) and the United Kingdom Economic and Social Research Council (Grant number: ES/T015446/1), the United Kingdom Research and Innovation Global Challenge Research Fund (Grant number: ES/T010487/1), and the Elizabeth Blackwell Institute for Health Research at the University of Bristol, United Kingdom.