Original Article

International Journal of Public Health

, Volume 58, Issue 1, pp 133-141

First online:

Socioeconomic position and later life prevalence of hypertension, diabetes and visual impairment in Nakuru, Kenya

  • George B. PloubidisAffiliated withDepartment of Population Studies, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine Email author 
  • , Wanjiku MathengeAffiliated withInternational Centre for Eye Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine
  • , Bianca De StavolaAffiliated withDepartment of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine
  • , Emily GrundyAffiliated withDepartment of Population Studies, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine
  • , Allen FosterAffiliated withDepartment of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine
  • , Hannah KuperAffiliated withDepartment of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine

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Abstract

Objectives

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.

Keywords

Socioeconomic position Education Material resources Hypertension Diabetes Kenya Health inequalities Visual impairment Alcohol Smoking