Experience of Violence and Socioeconomic Position in South Africa: A National Study

BACKGROUND: Violence is a leading cause of morbidity and mortality in South Africa and needs to be researched from a public health perspective. Typically in violence research, socioeconomic position is used in the analysis to control for confounding. Social epidemiology approaches this variable as a primary determinant of interest and is used in this research to better understand the aetiology of violence in South Africa. We hypothesised that measures of socioeconomic position (employment, education and household wealth) would be inversely related to violence at the individual and household levels. METHODOLOGY/PRINCIPAL FINDINGS: Data came from the1998 South African Demographic and Health Survey (SADHS). Measures of socioeconomic position used were employment, education and household wealth. Eighty-eight people (0.2%) received treatment for a violent injury in the previous 30 days and 103 households (0.9%) experienced a violent death in the previous year. Risk factors for violence at the individual level included employment (41% of those who experienced violence were employed vs. 27% of those who did not, p = 0.02), and education (those who experienced violence had on average, one year more education than those who did not, p = 0.04). Belonging to a household in the wealthiest quintile was protective against violence (OR: 0.32; 95% CI: 0.12–0.89). In contrast, at the household level all three measures of socioeconomic position were protective against the experience of a violent death. The only association to persist in the multivariate analysis was that between the wealth of the household and violence at the individual level. CONCLUSIONS/SIGNIFICANCE: Our hypothesis was supported if household wealth was used as the measure of socioeconomic position at the individual level. While more research is needed to inform the conflicting results observed between the individual and household levels, this analysis has begun to identify the disparities across the socioeconomic structure with respect to violent outcomes.