International Journal of Public Health

, Volume 58, Issue 1, pp 133–141 | Cite as

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

  • George B. PloubidisEmail author
  • Wanjiku Mathenge
  • Bianca De Stavola
  • Emily Grundy
  • Allen Foster
  • Hannah Kuper
Original Article



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.


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.


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.


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.


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



George B. Ploubidis is supported by a Medical Research Council (MRC) Population Health Science fellowship—G0802442.


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Copyright information

© Swiss School of Public Health 2012

Authors and Affiliations

  • George B. Ploubidis
    • 1
    Email author
  • Wanjiku Mathenge
    • 2
  • Bianca De Stavola
    • 3
  • Emily Grundy
    • 1
  • Allen Foster
    • 4
  • Hannah Kuper
    • 5
  1. 1.Department of Population Studies, Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
  2. 2.International Centre for Eye Health, Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
  3. 3.Department of Medical Statistics, Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
  4. 4.Department of Clinical Research, Faculty of Infectious and Tropical DiseasesLondon School of Hygiene and Tropical MedicineLondonUK
  5. 5.Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK

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