Age, gender and household infrastructural inequality in COVID-19: Contextual analysis of Mamelodi

Background: Age, gender and household infrastructure are important social determinants affecting health inequalities. This study aims to assess the ways that age and gender of the household head and household infrastructure intersect to create relative advantage and disadvantage in COVID-19 vulnerab...

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Main Authors: Simon M. Marcus, Caitlin V. Gardiner
Format: Article
Language:English
Published: AOSIS 2024-07-01
Series:South African Family Practice
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Online Access:https://safpj.co.za/index.php/safpj/article/view/5924
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author Simon M. Marcus
Caitlin V. Gardiner
author_facet Simon M. Marcus
Caitlin V. Gardiner
author_sort Simon M. Marcus
collection DOAJ
description Background: Age, gender and household infrastructure are important social determinants affecting health inequalities. This study aims to assess the ways that age and gender of the household head and household infrastructure intersect to create relative advantage and disadvantage in COVID-19 vulnerability. Methods: Using household primary care survey data from Mamelodi, Gauteng, headed households were sorted into three risk categories for each of the relevant infrastructural determinants of COVID-19. Bivariate ordinal logistic regression was used to determine the odds of households falling into each risk category. The proportion of high-risk (HR) categories and dwelling types was also calculated. Results: Households headed by someone ≥ 65 years were less likely to be in all HR categories and more frequently had formal houses. Male-head households were more likely to be HR for water, sanitation and hygiene infrastructure and indoor pollution; however, female-headed households (FHHs) were at higher risk for crowding. In Mamelodi, households headed by ≥ 65 years olds were relatively infrastructurally protected, likely because of pro-equity housing policy, as were FHHs, except for crowding. The care load on FHHs results in their infrastructural protection benefiting more community members, while simultaneously incurring risk. Conclusion: Infrastructural support based on the household head’s age and gender could improve targeting and the effectiveness of health interventions. These results demonstrate the importance of a contextual understanding of gender and age inequalities and tailoring public health support based on this understanding. Contribution: This research describes patterns of health-related infrastructural inequality, identifies ways to improve health interventions, and demonstrates the importance of equity-focused policy in an African context.
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2078-6204
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spelling doaj-art-7571df6c0c694f83bbe8e4fc32e856702025-08-20T04:03:12ZengAOSISSouth African Family Practice2078-61902078-62042024-07-01661e1e810.4102/safp.v66i1.59244446Age, gender and household infrastructural inequality in COVID-19: Contextual analysis of MamelodiSimon M. Marcus0Caitlin V. Gardiner1Department of Family Medicine, Faculty of Health Science, University of the Witwatersrand, JohannesburgDepartment of Global Health and Social Medicine, King’s College, London, United Kingdom; and, SAMRC/Wits Developmental Pathways for Health Research Unity, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, JohannesburgBackground: Age, gender and household infrastructure are important social determinants affecting health inequalities. This study aims to assess the ways that age and gender of the household head and household infrastructure intersect to create relative advantage and disadvantage in COVID-19 vulnerability. Methods: Using household primary care survey data from Mamelodi, Gauteng, headed households were sorted into three risk categories for each of the relevant infrastructural determinants of COVID-19. Bivariate ordinal logistic regression was used to determine the odds of households falling into each risk category. The proportion of high-risk (HR) categories and dwelling types was also calculated. Results: Households headed by someone ≥ 65 years were less likely to be in all HR categories and more frequently had formal houses. Male-head households were more likely to be HR for water, sanitation and hygiene infrastructure and indoor pollution; however, female-headed households (FHHs) were at higher risk for crowding. In Mamelodi, households headed by ≥ 65 years olds were relatively infrastructurally protected, likely because of pro-equity housing policy, as were FHHs, except for crowding. The care load on FHHs results in their infrastructural protection benefiting more community members, while simultaneously incurring risk. Conclusion: Infrastructural support based on the household head’s age and gender could improve targeting and the effectiveness of health interventions. These results demonstrate the importance of a contextual understanding of gender and age inequalities and tailoring public health support based on this understanding. Contribution: This research describes patterns of health-related infrastructural inequality, identifies ways to improve health interventions, and demonstrates the importance of equity-focused policy in an African context.https://safpj.co.za/index.php/safpj/article/view/5924social determinants of healthlmicsurban healthhealth inequalitiesvulnerable populationshealth policy
spellingShingle Simon M. Marcus
Caitlin V. Gardiner
Age, gender and household infrastructural inequality in COVID-19: Contextual analysis of Mamelodi
South African Family Practice
social determinants of health
lmics
urban health
health inequalities
vulnerable populations
health policy
title Age, gender and household infrastructural inequality in COVID-19: Contextual analysis of Mamelodi
title_full Age, gender and household infrastructural inequality in COVID-19: Contextual analysis of Mamelodi
title_fullStr Age, gender and household infrastructural inequality in COVID-19: Contextual analysis of Mamelodi
title_full_unstemmed Age, gender and household infrastructural inequality in COVID-19: Contextual analysis of Mamelodi
title_short Age, gender and household infrastructural inequality in COVID-19: Contextual analysis of Mamelodi
title_sort age gender and household infrastructural inequality in covid 19 contextual analysis of mamelodi
topic social determinants of health
lmics
urban health
health inequalities
vulnerable populations
health policy
url https://safpj.co.za/index.php/safpj/article/view/5924
work_keys_str_mv AT simonmmarcus agegenderandhouseholdinfrastructuralinequalityincovid19contextualanalysisofmamelodi
AT caitlinvgardiner agegenderandhouseholdinfrastructuralinequalityincovid19contextualanalysisofmamelodi