Examining social determinants of undiagnosed diabetes in Namibia and South Africa using a behavioral model of health services use Academic Article uri icon

abstract

  • AIMS: To examine factors associated with undiagnosed diabetes in Namibia and South Africa. METHODS: This study used the most recent Demographic and Health Surveys (DHS) from Namibia (2013) and South Africa (2016). This study focused on adults at 35-64 years old. Using Andersen's Behavioral Model, potential contributing factors were categorized into predisposing factors (sex and education), enabling factors (wealth, health insurance, and residence), and a need factor (age, BMI, and high blood pressure). Separate multivariable logistic regression models were used to examine factors associated with undiagnosed diabetes in Namibia (N = 242) and South Africa (N = 525). RESULTS: In Namibia, higher odds of having undiagnosed diabetes were associated with rural residence (adjusted odds ratio (aOR) = 2.21) and age younger than 45 years old (aOR = 3.20). In South Africa, odds of having undiagnosed diabetes were higher among the poorest-to-poorer group than it was in the richer-to-richest group (aOR = 2.33). In both countries, having high blood pressure was associated with lower odds of having undiagnosed diabetes (aOR = 0.31 in Namibia; aOR = 0.21 in South Africa). DISCUSSION: Different enabling and need factors were associated with undiagnosed diabetes in these two countries, which implies potentially-different mechanisms driving the high prevalence of undiagnosed diabetes, as well as the needs for different solutions.

author list (cited authors)

  • Lee, S., Washburn, D. J., Colwell, B., Gwarzo, I. H., Kellstedt, D., Ahenda, P., & Maddock, J. E.

publication date

  • January 1, 2021 11:11 AM