Do Health Inequalities Equalize in South African Adolescents? A Test of West’s Hypothesis Using Body Composition Outcomes

Paula Griffiths, Loughborough University
William Johnson, Loughborough University
Noel Cameron, Loughborough University
John M. Pettifor, University of the Witwatersrand
Shane Norris, University of the Witwatersrand

This paper examines the association between household/neighbourhood SES in infancy/16 years and body composition outcomes at 16 years to establish whether there is evidence of an equalising of inequalities in risk for poor health in adolescence. Using a sub-sample of the Birth to Twenty (Bt20) cohort (n=458, n=346 Black) with measurements taken at birth/16 years of age, linear regression analyses of household/neighbourhood biological and socio-demographic predictors of fat mass (FM), lean mass (LM), and body mass index (BMI) outcomes were undertaken. The only SES factor associated with body composition in fully adjusted models was poor infancy household water facilities, which resulted in higher BMI/FM. SES was only weakly associated with body composition in these 16 year olds, which is in contrast to earlier findings in Bt20 in 9/10 year olds where SES gradients were observed. This suggests support for West’s hypothesis of an equalising of health inequalities in adolescence in the Bt20 cohort.