South African Human Development Pulse Survey – Wave One

In October 2021, CoE-HUMAN conducted a nationally representative survey of 3,402 South Africans across the country, aged 18 and older. The survey covered many aspects of adult health and development, particularly those that had been indicated previously to have been impacted by the COVID-19 pandemic i.e., food insecurity and coping strategies, social vulnerability, alcohol consumption and tobacco smoking behaviours, and mental health. The four research objectives were:

Major finding 1: Poor socio-economic circumstances contribute to greater risk of experiencing food insecurity and social vulnerability

 Overall, one in every five South African households lacked access to sufficient food. Poor households, especially Coloured and Black African households were most affected by food insecurity.

 Living in a food insecure household in South Africa during COVID-19 was associated with a higher risk of anxiety and depression.

 All coping strategies (e.g., “sending household members to beg for food”) used by South Africans to deal with food insecurity differentially associate with the risk of anxiety and depression.

 Twenty percent of participants were classified as socially vulnerable, with higher social vulnerability prevalence when respondents were poor and unemployed, lived in Mpumalanga or in rural areas, were Black African and/or female, or did not have a high school certificate. Social vulnerability was also higher in older participants, with prevalence increasing exponentially from 45 years of age.

 The risk of food insecurity was almost 3-fold higher in the socially vulnerable group compared to their counterparts. Specifically, those with poor socioeconomic indicators (e.g., poorer households, unemployed and not completed high school) were at greater risk of experiencing food insecurity.

Major finding 2: Alcohol use and heavy smoking remains prevalent in South African adults

 Approximately, 33.2% and 19.2% of adults in South Africa consume alcohol and have smoked, respectively. Notably, 50.3% of adults who drank reported potentially harmful alcohol use and 12.2% of those smoking reported heavy smoking.

 About 24.0% and 29.1% of those who drank alcohol and smoked tobacco reported increasing or starting the use of alcohol or tobacco during the pandemic.

 Being male, employed, living in certain provinces (Free State, Limpopo, Mpumalanga), and having started or increased alcohol drinking due to COVID-19 lockdowns were found to be significantly associated with potential moderate-severe alcohol use disorder.

 Surprisingly, many respondents reported a positive change in their smoking behaviour (reduction or quit smoking) since the onset of the COVID-19 lockdowns though this was less likely in heavy smokers.

Major finding 3: South Africa’s mental health challenges continue

 Nationally, 25.7%, 17.8% and 23.6% of respondents respectively reported scores of ≥ 10 on the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7), indicating probable depression or anxiety, and ≥ 4 Adverse Childhood Experiences (ACE), indicating a high exposure to childhood trauma.

 Respondents that were retired, older and widowed, divorced, or separated; who lived in metropolitan areas; or only had primary school education were more likely to experience probable depression and anxiety compared to their counterparts.

 Also, higher ACE exposure was associated with an increased risk of developing depression or anxiety.

Major finding 4: Social Vulnerability in South Africa

 South Africa’s socially vulnerable groups (those with fewer resources, unemployed, and without high school certificate) are at a greater risk of experiencing food insecurity.

 The South African government needs effective and innovative policies to reform the economy and invest in a decent education system so that social inequalities such as social vulnerability and food insecurity can be reduced or eliminated.

The research outputs from this national survey (in press) include:

Published: https://doi.org/10.1057/s41271-022-00370-w

 Mtintsilana, A., Dlamini, S. N., Mapanga, W., Craig, A., Du Toit, J., Ware, L. J., & Norris, S. A. (2022). Social vulnerability and its association with food insecurity in the South African population: Findings from a National Survey. Journal of Public Health Policy.

 Craig, A., Rochat, T., Naicker, S. N., Mapanga, W., Mtintsilana, A., Dlamini, S. N., Ware, L. J., Du Toit, J., Draper, C. E., Richter, L., & Norris, S. A. (2022). The prevalence of probable depression and probable anxiety, and associations with adverse childhood experiences and socio-demographics: A national survey in South Africa. Frontiers in Public Health, 10, 986531.

Doi: https://doi.org/10.3389/fpubh.2022.986531

In-review:

 Mapanga W, Craig A, Mtintsilana A, et al. 2022. The Effects of COVID-19 Pandemic Lockdowns on Alcohol Consumption and Tobacco Smoking Behaviour in South Africa: a national survey. European Addiction Research Journal

 Dlamini SN, Craig A, Mtintsilana A, et al. 2022. Food insecurity and coping strategies, and their association with anxiety and depression: a nationally representative South African survey. Public Health Nutrition

South African Human Development Pulse Survey – Wave Two

The CoE-HUMAN ran the Second Wave of its nationally representative survey in 2022 – the results and outputs will follow in 2023.