Prevalence and Psychosocial Correlates of Diabetes Mellitus in South Africa: Results from the South African National Health and Nutrition Examination Survey (SANHANES-1)

Sibusiso Sifunda; Anthony David Mbewu; Musawenkosi Mabaso; Thabang Manyaapelo; Ronel Sewpaul; Justin Winston Morgan; Nigel Walsh Harriman; David R Williams; Sasiragha Priscilla Reddy

doi:10.3390/ijerph20105798

Prevalence and Psychosocial Correlates of Diabetes Mellitus in South Africa: Results from the South African National Health and Nutrition Examination Survey (SANHANES-1)

Int J Environ Res Public Health. 2023 May 12;20(10):5798. doi: 10.3390/ijerph20105798.

Authors

Affiliations

¹ Public Health, Societies and Belonging, Human Sciences Research Council, Pretoria 0001, South Africa.
² School of Medicine, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa.
³ Social Science Core, Africa Health Research Institute, Somkhele 3925, South Africa.
⁴ Public Health, Societies and Belonging, Human Sciences Research Council, Cape Town 8000, South Africa.
⁵ Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
⁶ Department of African and African American Studies, Harvard University, Cambridge, MA 02138, USA.
⁷ Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth 6031, South Africa.
⁸ The Centre for Critical Research on Race and Identity, University of KwaZulu-Natal, Durban 4041, South Africa.

Abstract

In South Africa, there are a limited number of population estimates of the prevalence of diabetes and its association with psychosocial factors. This study investigates the prevalence of diabetes and its psychosocial correlates in both the general South African population and the Black South African subpopulation using data from the SANHANES-1. Diabetes was defined as a hemoglobin A1c (HbA1c) ≥6.5% or currently on diabetes treatment. Multivariate ordinary least squares and logistic regression models were used to determine factors associated with HbA1c and diabetes, respectively. The prevalence of diabetes was significantly higher among participants who identified as Indian, followed by White and Coloured people, and lowest among Black South Africans. General population models indicated that being Indian, older aged, having a family history of diabetes, and being overweight and obese were associated with HbA1c and diabetes, and crowding was inversely associated with HbA1c and diabetes. HbA1c was inversely associated with being White, having higher education, and residing in areas with higher levels of neighborhood crime and alcohol use. Diabetes was positively associated with psychological distress. The study highlights the importance of addressing the risk factors of psychological distress, as well as traditional risk factors and social determinants of diabetes, in the prevention and control of diabetes at individual and population levels.

Keywords: Black South African; South Africa; diabetes; epidemiological transition; non-communicable diseases (NCDs); psychological distress; psychosocial determinants; rural; urban.

Publication types

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

MeSH terms

Diabetes Mellitus* / epidemiology
Glycated Hemoglobin
Humans
Nutrition Surveys
Prevalence
Risk Factors
South Africa / epidemiology

Substances

Glycated Hemoglobin

Grants and funding

The SANHANES-1 data production was funded by the South African Department of Health, the U.K. Department for International Development (DFID), the Human Sciences Research Council (HSRC), and compiled by the HSRC and the South African Medical Research Council.