ArticleFrontiers in public health2026
Socioeconomic inequalities in the prevalence of chronic non-communicable disease risk factors in the DIMAMO health and demographic surveillance system.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Socioeconomic inequalities play a crucial role in shaping the burden of non-communicable diseases (NCDs) and associated risk factors. This study examined socioeconomic disparities in the prevalence of chronic NCD risk factors among adults in the DIMAMO Health and Demographic Surveillance Site (HDSS) in Limpopo Province, South Africa. Methods: A cross-sectional study was conducted among adults aged 18 years and above. Data on socioeconomic status (SES) and NCD risk factors such as smoking, alcohol consumption, high salt intake, low fruit and vegetable intake, and physical inactivity were collected using an adapted WHO STEPS questionnaire. Socioeconomic status (SES) was assessed through household assets. A wealth index was constructed using principal component analysis to classify participants into SES quintiles. Concentration indices (CIs) and concentration curves were computed to assess the magnitude and direction of SES-related inequalities. Inequality decomposition analysis was performed to quantify the contribution of SES to each risk factor's inequality. Results: Participants were predominantly female (63%) and younger than 50 years (58%), with the majority unemployed (60.3%) and possessing secondary-level education (63.1%). Low fruit and vegetable intake (88.7%) emerged as the most prevalent NCD risk factor, followed by alcohol consumption (35.2%) and hypertension (22.6%). Diabetes prevalence was significantly higher among individuals in higher SES groups ( Conclusion: The findings of the current study reveal a dual burden of NCD risk factors across socioeconomic groups; behavioral risks are concentrated among the poor, while metabolic conditions such as diabetes are more common among the affluent. Addressing these disparities requires context-specific interventions that target both behavioral and metabolic risk factors across all socioeconomic strata.
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