A closer look at racial differences in the reporting of self-assessed health status and related concepts in South Africa

Abstract

South Africa’s populace is characterised by large differences in health, with vast inequalities between members of different groups that can be identified by using a number of tested health indicators, with self-assessed health (SAH) status amongst them. Generally, the average White person’s health, however measured, is considerably better than that of Black African persons with the health of Indian and Coloured persons somewhere between the two. Typically, this pattern is attributed to the continued association between race and socio-economic status. Recent empirical work conducted, however, seems to cast doubt on the validity of the assumption that SAH can be compared directly across members of different groups. In light of this concern, and the challenge which it poses to the interpretation of the results of much current South African empirical work, this article explores possible systematic differences with respect to the perception and reporting of SAH between members of different race groups in South Africa. Using data drawn from a nationally representative survey of approximately 3000 respondents, this study analysed racial differences in SAH alongside domain-specific SAH and attitudes to a number of health-related areas (e.g. reference groups, perceptions of main influences on health, etc.). The analysis revealed a number of differences when compared to the usual racialised pattern observed. It is held that these differences suggest that there might be a role for race to play in the assessment and reporting of SAH independently of its continued association with socio-economic status.

Suid-Afrikaners word gekenmerk deur groot verskille in die gesondheidsvlakke van die bevolking, met beduidende ongelykhede tussen die verskillende bevolkingsgroepe wat geïdentifiseer kan word met behulp van vele beproefde gesondheidsaanwysers, onder meer self-geassesseerde gesondheid (SAH)-status. Die gemiddelde Wit persoon se gesondheid is, nieteenstaande die maatstaf, aansienlik beter as dié van ‘n Swart-Afrikaanse person, met die gesondheid van die Indiër persoon en Kleurling persoon wat êrens tussen die twee groepe lê. Hierdie tendens word tipies toegeskryf aan die voortgesette assosiasie tussen ras en sosiaalekonomiese status. Onlangse empiriese werk werp egter twyfel op die geldigheid van die veronderstelling dat SAH van lede van verskillende groepe direk met mekaar vergelyk kan word. In die lig hiervan en die uitdaging wat dit inhou vir die interpretasie van die resultate van ‘n baie onlangse Suid-Afrikaanse empiriese studie, ondersoek hierdie artikel moontlike sistematiese verskille met betrekking tot die persepsie en rapportering van SAH tussen mense van verskillende rassegroepe in Suid-Afrika. Data vanuit ‘n nasionale verteenwoordigende opname van ongeveer 3000 respondente is in hierdie studie gebruik. Die studie ontleed hierdie rasseverskille in SAH tesame met die domeinspesifieke SAH asook die gesindhede ten opsigte van ’n aantal van die gesondheidsverwante gebiede (bv. verwysingsgroepe, die persepsies van die belangrikste invloede op gesondheid ens.) Die analise het ‘n aantal verskille getoon in vergelyking met die gewone patroon wat op ras gebaseer is. Daar is van mening dat hierdie verskille daarop dui dat ras dalk tog ‘n rol speel in die evaluering en r