Socioeconomic position and later life prevalence of hypertension, diabetes and visual impairment in Nakuru, Kenya.
OBJECTIVE
We examined the extent to which the association between socioeconomic position (SEP) and later life prevalence of hypertension, diabetes and visual impairment in Nakuru, Kenya is mediated by health-related behaviour.


METHODS
We used data from a community survey of 4,314 participants sampled from urban and rural areas in Nakuru, Kenya. Structural equation modelling was employed to estimate the direct and indirect--via health-related behaviour--effects of SEP on the three health outcomes.


RESULTS
The accumulation of material resources was positively associated with hypertension and diabetes, whereas both education and material resources had a negative association with the prevalence of visual impairment. However, the observed health inequalities were not due to variation between SEP groups in health-related behaviour.


CONCLUSIONS
The pattern of associations between education, material resources and the three health outcomes varied, suggesting that in Kenya, unlike the observed pattern of inequalities in high income countries, different dimensions of SEP provide different aspects of protection as well as risk. Smoking and alcohol use did not appear to mediate the observed associations, in contrast with countries past the epidemiologic transition.
Department of Population Studies, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Room 150, Keppel Street, London WC1E 7HT, UK. George.Ploubidis@lshtm.ac.uk
George B
GB
Ploubidis
Wanjiku
W
Mathenge
Bianca
B
De Stavola
Emily
E
Grundy
Allen
A
Foster
Hannah
H
Kuper
D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015995:Prevalence; D012424:Rural Population; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D014505:Urban Population; D014786:Vision Disorders / Q000453:epidemiology*