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Social Inequality in Living Conditions, Health, and Quality of Life in South Iowa State University Capstones, Theses and Retrospective Theses and Dissertations Dissertations 1998 Social inequality in living conditions, health, and quality of life in South Africa: development policy challenges and prospects Chukwudi Hezy Okafor Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/rtd Part of the Political Science Commons, Public Affairs, Public Policy and Public Administration Commons, Public Health Commons, and the Sociology Commons Recommended Citation Okafor, Chukwudi Hezy, "Social inequality in living conditions, health, and quality of life in South Africa: development policy challenges and prospects " (1998). Retrospective Theses and Dissertations. 12515. https://lib.dr.iastate.edu/rtd/12515 This Dissertation is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Retrospective Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly fi'om the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter fiice, while others may be fi-om any type of computer primer. The quality of this reproduction is dependent upon the quality of the copy submitted. 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Contact UMI directly to order. UMI A Bell & Ifowell Information Compaoy 300 North 2jeeb Road, Ann Aibor Ml 48106-1346 USA 313/761-4700 800/521-0600 NOTE TO USERS The original manuscript received by UMI contains pages with slanted print. Pages were microfilmed as received. This reproduction is the best copy available UMI Social inequality in lixing conditions, health, and quality of life in South Africa; Development policy challenges and prospects by Chukwudi Hezy Okafor A dissenation submitted to the graduate faculty in partial fulfillment of the requirement for the degree of DOCTOR OF PHILOSOPHY Major; Sociology Major Professor; Robert Mazur Iowa State University Ames, Iowa 1998 Copyright © Chukwudi Hezy Okafor. 1998. All rights reserved. xnci Number: 9911630 UMI Microform 9911630 Copyright 1999, by UMI Company. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. UMI 300 North Zeeb Road Ann Art>or, MI 48103 II Graduate College Iowa State University This is to certify that the Doctoral dissertation of Chukwudi Hezy Okafor Has met the dissertation requirements of Iowa State University Signature was redacted for privacy. Signature was redacted for privacy. ijor Program Signature was redacted for privacy. Ill TABLE OF CONTENTS Pages LIST OF TABLES iii CHAPTER 1. GENERAL INTRODUCTION 1 Introduction 1 Living conditions, health, and quality of life as key development goals and problems 2 Housing and living conditions 2 Health 4 Quality of life 6 Development theory and practice 8 Cultural explanations 8 Welfare policy explanation 10 Institutional discrimination and segregation perspective 11 Race, class and gender inequality in understanding living conditions, health and 16 quality of life Objectives of research 19 Relevance of South Africa as an illustrative case study 19 Methods of data collection and analysis 25 Unit of analysis 25 Data collection methods 26 Sampling -6 Operational measures of concepts in the model 28 Dissertation organization 29 IV Notes 30 References 31 CHAPTER 2. SOCIAL INEQUALITY IN HOUSING AND LIVING CONDITIONS IN 43 IN SOUTH AFRICA Abstract 43 Introduction 44 Theoretical framework 45 Explaining urban living conditions and housing inequality in sub-Saharan Africa 49 South Africa 50 Significance of household structure and other related social factors in understanding 53 living conditions and housing inequality Model of the factors determining housing and living conditions 55 Household sociodemographic characteristics 56 Household socioeconomic characteristics 57 Household expenditure 57 Housing and living conditions 57 Analysis of the model based on South African data 58 Unit of analysis 58 Data collection methods 59 Sampling 60 Operational measures of concepts in the model 60 Interpretation of the univariate analysis 62 Interpretation of the bivariate analysis 64 Housing type and density 64 V Water sources, toilet type and consumer durables 66 Intermediate factors 69 Income sources 69 Monthly expenditures per capita 70 Multivariate analysis 71 Formal housing, housing density (persons per room) and water supply 71 Rush toilets and consumer durables 74 Assessment of the relevance of this research 77 Policy to raise household Incomes and expenditures 78 Educational policies 78 Availability of household basic amenities 79 The struggle for housing and living condition 79 Acknowledgements 81 Notes 82 References 83 CHAPTER 3. SOCIAL INEQU.\LITY IN HOUSEHOLD LEVEL ILLNESS IN 94 SOUTH AFRICA Abstract 94 Introduction 95 Theoretical background 97 Explaining inequality in health care in urban sub-Saharan African 101 Health policies and conditions in South Africa 102 Significance of household structure and other related social factors in understanding 103 health inequality vi Model of the factors determining health status 106 Household sociodemographic characteristics 106 Household socioecononiic charactenstics 106 Analysis of the model based on South African data 108 Unit of analysis 108 Data collection methods 108 Sampling 109 Operational measures of concepts in the model 110 Interpretation of the univariate analysis 111 Interpretation of the bivariate analysis 113 Intermediate factors 118 Income sources 118 Monthly expenditures per capita 119 Multivariate analysis 119 Characteristics of "any illness, chronically and acutely ill" 120 Characteristics of childhood and adult illness 125 Discussion 128 The struggle for health 130 Acknowledgements 131 Notes 132 References 134 CHAPTER 4. SOCIAL INEQUALITY IN THE QUALITY OF LIFE IN SOUTH 147 AFRICA Abstract 147 vii Introduction 148 Theoretical framework 150 Explaining urban quality of life m sub-Saharan African 154 Quality of life in urban South Africa 156 Model of the factors determining quality of life 160 Analysis of the model based on South African data 161 Unit of analysis 161 Data collection methods 161 Sampling 162 Operational measures of concepts m the model 163 Interpretation of the univariate analysis 164 Interpretation of the bivariate analysis 167 Intermediate factors 171 Income sources 171 Monthly expenditures per capita 172 Multivariate analysis 173 The determinants of employment and housing needs 173 The determinants of security needs and perceived quality of life 176 Discussion 180 Conclusion 181 Acknowledgements 182 Notes 183 References 184 viii CHAPTER 5. GENERAL CONCLUSIONS 196 General discussion 196 The study limitations 199 Implications for policy and causality 202 Recommendations for future research 205 Notes 206 References 206 ACKNOWLEDGEMENTS 210 IX LIST OF TABLES CHAPTER I Table 1 Total Sample of South African Households by Location and Racial 27 Grouping (%) CHAPTER! Table 1 Factors Determining Housing Type and Persons Per Room 65 Table 2 Factors Determining Water Source. Toilet Type and Consumer 67 Durables Table 3 Multivariate Logistic Regression of Formal Housing, Housing 72 Density, and Water Supply Table 4 Multivariate Logistic Regression of Flush Toilets and Consumer 75 Durables CHAPTERS Table 1 Factors Determining Health Status 115 Table 2 Multivariate Logistic Regression of Any-illness, Chronic and Acute 121 illnesses Table 3 Multivariate Logistic Regression of Adult and Children illnesses 126 CHAPTER 4 Table 1 Factors Determining Quality of Life 168 Table 2 Multivariate Logistic Regression of Employment and Housing Needs 174 Table 3 Multivariate Logistic Regression of Security Needs and Perceived 177 Quality of life 1 CHAPTER 1. GENERAL INTRODUCTION Introduction Since the advent of colonial rule, European settlers of English and Dutch descent legally institutionalized a system of racial classification and discrinunation in South Africa. Race has determined access to economic and political power. Whites controlled and exploited South African human and natural resources by marginalizing Blacks (of various ethnic and tribal groups). Coloureds (mi.xed ancestry from inter-marring between Whites and Blacks), and Asians (descendants of indentured servants from India in the IQ'*" century). Although race-based political domination has been abolished,
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