Richer but poorer in health? The income gradient in chronic conditions: evidence from South Africa

Abstract: Extant evidence from developing countries is ambiguous on the relationship between income and chronic health conditions. The human capital framework suggests that individuals with higher incomes should be more likely to be aware of their health status and take preventive or remedial action. Using a unique nationally representative dataset from South Africa with objective health measures we analyse the differential effects of income on the prevalence and unawareness of having hypertension. We find that prevalence is concentrated amongst the rich, but only in a subgroup of men who are likely to be young and of either White or Asian race. There is no evidence of an income gradient for women. We find that a high proportion of hypertensive individuals are unaware of their status, but this unawareness is not concentrated amongst the poor indicating it is a serious public health concern across all income groups in South Africa.