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Socioeconomic differences in mortality in the antiretroviral therapy era in Agincourt, rural South Africa, 2001-13: a population surveillance analysis

Kabudula, Chodziwadziwa; Houle, Brian; Collinson, Mark; Kahn, Kathleen; Gomez-Olive, Francesc Xavier; Tollman, Stephen M.; Clark, Samuel J.

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Background Understanding the effects of socioeconomic disparities in health outcomes is important to implement specific preventive actions. We assessed socioeconomic disparities in mortality indicators in a rural South African population over the period 2001–13. Methods We used data from 21 villages of the Agincourt Health and socio-Demographic Surveillance System (HDSS). We calculated the probabilities of death from birth to age 5 years and from age 15 to 60 years, life expectancy at...[Show more]

dc.contributor.authorKabudula, Chodziwadziwa
dc.contributor.authorHoule, Brian
dc.contributor.authorCollinson, Mark
dc.contributor.authorKahn, Kathleen
dc.contributor.authorGomez-Olive, Francesc Xavier
dc.contributor.authorTollman, Stephen M.
dc.contributor.authorClark, Samuel J.
dc.date.accessioned2021-09-20T00:08:14Z
dc.date.available2021-09-20T00:08:14Z
dc.identifier.issn2214-109X
dc.identifier.urihttp://hdl.handle.net/1885/248210
dc.description.abstractBackground Understanding the effects of socioeconomic disparities in health outcomes is important to implement specific preventive actions. We assessed socioeconomic disparities in mortality indicators in a rural South African population over the period 2001–13. Methods We used data from 21 villages of the Agincourt Health and socio-Demographic Surveillance System (HDSS). We calculated the probabilities of death from birth to age 5 years and from age 15 to 60 years, life expectancy at birth, and cause-specific and age-specific mortality by sex (not in children <5 years), time period, and socioeconomic status (household wealth) quintile for HIV/AIDS and tuberculosis, other communicable diseases (excluding HIV/AIDS and tuberculosis) and maternal, perinatal, and nutritional causes, non-communicable diseases, and injury. We also quantified differences with relative risk ratios and relative and slope indices of inequality. Findings Between 2001 and 2013, 10 414 deaths were registered over 1 058 538 person-years of follow-up, meaning the overall crude mortality was 9·8 deaths per 1000 person-years. We found significant socioecomonic status gradients for mortality and life expectancy at birth, with outcomes improving with increasing socioeconomic status. An inverse relation was seen for HIV/AIDS and tuberculosis mortality and socioeconomic status that persisted from 2001 to 2013. Deaths from non-communicable diseases increased over time in both sexes, and injury was an important cause of death in men and boys. Neither of these causes of death, however, showed consistent significant associations with household socioeconomic status.
dc.description.sponsorshipThe MRC/Wits Rural Public Health and Health Transitions Research Unit, which runs the Agincourt Health and socio-Demographic Surveillance System, was supported by the Wellcome Trust (grants 058893/Z/99/A, 069683/Z/02/Z, 085477/Z/08/Z, and 085477/B/08/Z), the South African Medical Research Council, and University of the Witwatersrand, Johannesburg South Africa.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherElsevier
dc.rights© The Author(s).
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceThe Lancet Global Health
dc.titleSocioeconomic differences in mortality in the antiretroviral therapy era in Agincourt, rural South Africa, 2001-13: a population surveillance analysis
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume5
dc.date.issued2017
local.identifier.absfor160304 - Mortality
local.identifier.ariespublicationu8403255xPUB21
local.publisher.urlhttp://www.elsevier.com/
local.type.statusPublished Version
local.contributor.affiliationKabudula, Chodziwadziwa, University of the Witwatersrand
local.contributor.affiliationHoule, Brian, College of Arts and Social Sciences, ANU
local.contributor.affiliationCollinson, Mark, University of the Witwatersrand
local.contributor.affiliationKahn, Kathleen, University of Colorado at Boulder
local.contributor.affiliationGomez-Olive, Francesc Xavier, University of the Witwatersrand
local.contributor.affiliationTollman, Stephen M., University of Colorado at Boulder
local.contributor.affiliationClark, Samuel J., Ohio State University
local.bibliographicCitation.issue9
local.identifier.doi10.1016/S2214-109X(17)30297-8
local.identifier.absseo920506 - Rural Health
dc.date.updated2020-11-23T11:08:48Z
local.identifier.scopusID2-s2.0-85027238542
local.identifier.thomsonID000407504700030
dcterms.accessRightsOpen Access
dc.provenanceThis is an Open Access article under the CC BY 4.0 license.
dc.rights.licenseCreative Commons License (Attribution 4.0 International)
CollectionsANU Research Publications

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