Doctoral Dissertations
Date of Award
12-2022
Degree Type
Dissertation
Degree Name
Doctor of Philosophy
Major
Comparative and Experimental Medicine
Major Professor
Agricola Odoi
Committee Members
Agricola Odoi, Marcy Souza, Cristina Barroso, David Ader
Abstract
South Africa has achieved improvements in many health measures over the past 30 years, yet significant disparities in healthcare utilization and health outcomes persist. There is evidence that healthcare utilization has a strong influence on health outcomes and life satisfaction. Unfortunately, rural areas tend to have poorer accessibility and utilization of health services, leading to disparities in health outcomes. In rapidly urbanizing countries such as South Africa, identification of disparities and predictors of public healthcare utilization and life satisfaction may provide information that can be used to guide development of programs aimed at improving population health outcomes, quality-of-life, and overall life satisfaction. Therefore, the objectives of this study were to investigate: (i) rural/urban disparities and sociodemographic predictors of utilization of public healthcare services in South Africa; and (ii) socioeconomic and demographic predictors of life satisfaction among residents of Gauteng province, South Africa.
Retrospective cross-sectional studies were conducted using data from the 2019 South African General Household Survey and 2017-2018 Gauteng Quality-of-Life Survey. Descriptive analyses were performed to assess: (a) characteristics of households using public and private healthcare services, and (b) disparities in healthcare utilization and life satisfaction. Weighted multinomial logistic and partial proportional odds models were used to investigate predictors of public healthcare use and life satisfaction, respectively.
Three-quarters of the households reported using public healthcare services and nearly one-fifth reported a chronic condition among members. Predictors of public healthcare utilization were lower age of household head, lower educational attainment of household head, larger household size, rural residence, and at least one chronic condition among household members. Similarly, predictors of higher reported life satisfaction were older age, greater educational attainment, smaller household size, living with spouse, good/excellent health, and satisfaction with public health services. Additionally, respondents from suburban and rural municipalities tended to have greater odds of higher life satisfaction than those from urban Johannesburg.
The identified disparities and predictors highlight the critical roles of poverty, education, rural residence, and healthcare accessibility in public healthcare use and life satisfaction. The findings suggest that targeted public healthcare accessibility initiatives may improve both healthcare utilization and overall life satisfaction.
Retrospective cross-sectional studies were conducted using data from the 2019 South African General Household Survey and 2017-2018 Gauteng Quality-of-Life Survey. Descriptive analyses were performed to assess: (a) characteristics of households using public and private healthcare services, and (b) disparities in healthcare utilization and life satisfaction. Weighted multinomial logistic and partial proportional odds models were used to investigate predictors of public healthcare use and life satisfaction, respectively.
Three-quarters of the households reported using public healthcare services and nearly one-fifth reported a chronic condition among members. Predictors of public healthcare utilization were lower age of household head, lower educational attainment of household head, larger household size, rural residence, and at least one chronic condition among household members. Similarly, predictors of higher reported life satisfaction were older age, greater educational attainment, smaller household size, living with spouse, good/excellent health, and satisfaction with public health services. Additionally, respondents from suburban and rural municipalities tended to have greater odds of higher life satisfaction than those from Johannesburg.
The identified disparities and predictors highlight the critical roles of poverty, education, rural residence, and healthcare accessibility in public healthcare use and life satisfaction. The findings suggest that targeted public healthcare accessibility initiatives may improve both healthcare utilization and overall life satisfaction.
Recommended Citation
Chavez-Lindell, Tamara, "Healthcare Service Utilization and Life Satisfaction in South Africa. " PhD diss., University of Tennessee, 2022.
https://trace.tennessee.edu/utk_graddiss/7632