Date of Award

Spring 5-2010

Degree Type

Dissertation

Degree Name

Doctor of Public Health

Field of Study

Health Management and Policy

Department

School of Public Health

First Advisor

Dr. Nuha Lackan

Abstract

Exploring health disparities in access to health care is a subject of great relevance not only in the United States but also around the world. This dissertation focuses on access to health care in South Africa and perceptions of the government’s handling of health care. In order to explore these topics, data from Rounds 1 (2000) and 2.5 (2004) of the Afrobarometer Survey of South Africa were examined.

Logistic regression analysis was used to assess the relationship among four major ethnic groups in the perception of how the government is improving health services and if the respondent had gone without medical care controlling for the independent effects of selected sociodemographic, structure and health care need variables.

Blacks and Coloreds are the most disadvantaged groups in South Africa and despite having less access to medical care, perceive the government to be handling improving health care well compared to Whites. Blacks have a higher probability of going without medical care than any other ethnic group. A positive trend was identified between 2000 and 2004. The percentage of respondents reporting having gone without medical care decreased and the percentage that perceive that the government is handling health care well has increased for all ethnic groups. Although the percentages have improved, the regression analysis shows clear ethnic disparities. Blacks’ likelihood of perceiving the government to be handling health care well has decreased, dropping from eight times more likely to five times more likely than Whites in 2004. Blacks are still more likely than Whites to go without medical care, increasing from 1.5 to 2.0 times more likely in 2004.

Further research is needed to uncover the layers of health disparities currently burdening the country and the disconnect between the reality and perception of health care. The possibility that South Africa is again being divided by ethnic lines and that disparities are a result of these ethnic divides should be explored.

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