The socioeconomic dimensions of racial inequality in South Africa: A social space perspective.

It is well evidenced that South Africa is characterised by extreme socioeconomic inequality, which is strongly racialised. We offer an original sociological perspective, which departs from established perspectives considering the dynamics of vulnerability and poverty to focus on the structuring of classed and racialised privilege. We map how stocks of economic, cultural, and social capital intersect to generate systematic and structural inequalities in the country and consider how far these are associated with fundamental racial divides. To achieve this, we utilise rich, nationally representative data from the National Income Dynamics Study and employ Multiple Correspondence Analysis to construct a model of South African 'social space'. Our findings underscore how entrenched racial divisions remain within South Africa, with White people being overwhelmingly located in the most privileged positions. However, our cluster analysis also indicates that forms of middle-class privilege percolate beyond a core of the 8% of the population that is white. We emphasise how age divisions are associated with social capital accumulation. Our cluster analysis reveals that trust levels increase with economic and cultural capital levels within younger age groups and could therefore come to intensify social and racial divisions.

Socioeconomic-Related Inequalities in COVID-19 Vulnerability in South Africa.

Individuals' vulnerability to the risk of COVID-19 infection varies due to their health, socioeconomic, and living circumstances, which also affect the effectiveness of implementing non-pharmacological interventions (NPIs). In this study, we analysed socioeconomic-related inequalities in COVID-19 vulnerability using data from the nationally representative South African General Household Survey 2019. We developed a COVID-19 vulnerability index, which includes health and social risk factors for COVID-19 exposure and susceptibility. The concentration curve and concentration index were used to measure socioeconomic-related inequalities in COVID-19 vulnerability. Recentred influence function regression was then utilised to decompose factors that explain the socioeconomic-related inequalities in COVID-19 vulnerability. The concentration index estimates were all negative and highly significant (p < 0.01), indicating that vulnerability to COVID-19 was more concentrated among the poor. According to the decomposition analysis, higher income and education significantly (p < 0.01) positively impacted lowering socioeconomic-related COVID-19 vulnerability. Living in an urban region, being Black, and old all had significant (p < 0.01) positive impacts on increasing socioeconomic-related COVID-19 vulnerability. Our findings contribute to a better understanding of socially defined COVID-19-vulnerable populations in South Africa and the implications for future pandemic preparedness plans.

Spatial inequality through the prism of a pandemic: Covid-19 in South Africa.

In this paper, we examine whether pre-existing socio-economic inequalities relate to inequalities in vulnerability to COVID-19 infection in the context of South Africa using the 2016 Community Survey, which allows for a detailed geographical disaggregation of the analysis. For this purpose, we use a set of indicators of a household's vulnerability to COVID-19 infection and then aggregate these into an index of COVID-19 vulnerability. We use these indicators and their aggregate indices to profile COVID-19 vulnerability at the national, provincial and municipal levels as well providing an urban/rural breakdown. We find that pre-existing socio-economic inequalities are related to inequalities in vulnerability to COVID-19 infection. Poorer households are more vulnerable to infection due to their living conditions. While close to 30% of the population in the poorest two wealth quintiles may be considered vulnerable to the virus due to multiple vulnerability factors, the corresponding figure for the richest two wealth quintiles is less than 2%. There are also stark spatial inequalities in COVID-19 vulnerability. This has implications for budget allocations in response to the COVID-19 pandemic, especially as some of the government relief funding has been and will be apportioned according to municipal need.

Piketty comes to South Africa.

One of the most valuable features of Capital and Ideology is its concern to take history seriously and consider how the emergence of different political and economic regimes relate to discourses about fairness and justice across time. This paper pushes this agenda further by acknowledging that the experience of a few developed nations should not be taken as the template for the generalized study of inequality dynamics across time and space. In this paper, we interrogate Piketty's analysis and policy proposals against specificities that are central to understanding the production and reproduction of inequalities within South Africa. We reflect on the South African case, the structure of inequality and its changes since 1994. We review a battery of policy interventions that have been implemented to address inequality in the last 25 years. We emphasize that the long shadow cast by centuries of colonialism and various forms of apartheid strongly affirm Piketty's emphasis on understanding history. But this is both affirmation and critique given the foundational, imbedded impact that this specific legacy has had on post-apartheid society and its policies. Piketty is aware that the levels of inequality in South Africa are so high that this is "unknown territory." We map out some of this territory to reveal how these extreme initial wealth and racial inequities inform the reproduction of inequalities in all dimensions and undermine well intentioned policies. We claim that understanding extractive histories, imbedded wealth inequalities, and complex social and political institutions allows us to understand and confront some of the reasons why even in light of progressive policies, many of which are in line with the proposals from Piketty, government interventions have thus far failed to reduce inequality.

Housing, sanitation and living conditions affecting SARS-CoV-2 prevention interventions in 54 African countries.

The feasibility of non-pharmacological public health interventions (NPIs) such as physical distancing or isolation at home to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in low-resource countries is unknown. Household survey data from 54 African countries were used to investigate the feasibility of SARS-CoV-2 NPIs in low-resource settings. Across the 54 countries, approximately 718 million people lived in households with ⩾6 individuals at home (median percentage of at-risk households 56% (95% confidence interval (CI), 51% to 60%)). Approximately 283 million people lived in households where ⩾3 people slept in a single room (median percentage of at-risk households 15% (95% CI, 13% to 19%)). An estimated 890 million Africans lack on-site water (71% (95% CI, 62% to 80%)), while 700 million people lacked in-home soap/washing facilities (56% (95% CI, 42% to 73%)). The median percentage of people without a refrigerator in the home was 79% (95% CI, 67% to 88%), while 45% (95% CI, 39% to 52%) shared toilet facilities with other households. Individuals in low-resource settings have substantial obstacles to implementing NPIs for mitigating SARS-CoV-2 transmission. These populations urgently need to be prioritised for coronavirus disease 2019 vaccination to prevent disease and to contain the global pandemic.

Health outcomes for children born to teen mothers in Cape Town, South Africa.

This paper analyzes whether children born to teen mothers in Cape Town, South Africa are disadvantaged in terms of their health outcomes because their mother is a teen. Exploiting the longitudinal nature of the Cape Area Panel Study, we assess whether observable differences between teen mothers and slightly older mothers can explain why first-born children of teen mothers appear disadvantaged. Our balanced regressions indicate that observed characteristics cannot explain the full extent of disadvantage of being born to a teen mother, with children born to teen mothers continuing to have significantly worse child health outcomes, especially among coloured children. In particular, children born to teens are more likely to be underweight at birth and to be stunted with the disadvantage for coloured children four times the size for African children.

Distance decay and persistent health care disparities in South Africa.

BACKGROUND: Access to health care is a particular concern given the important role of poor access in perpetuating poverty and inequality. South Africa's apartheid history leaves large racial disparities in access despite post-apartheid health policy to increase the number of health facilities, even in remote rural areas. However, even when health services are provided free of charge, monetary and time costs of travel to a local clinic may pose a significant barrier for vulnerable segments of the population, leading to overall poorer health. METHODS: Using newly available health care utilization data from the first nationally representative panel survey in South Africa, together with administrative geographic data from the Department of Health, we use graphical and multivariate regression analysis to investigate the role of distance to the nearest facility on the likelihood of having a health consultation or an attended birth. RESULTS: Ninety percent of South Africans live within 7 km of the nearest public clinic, and two-thirds live less than 2 km away. However, 14% of Black African adults live more than 5 km from the nearest facility, compared to only 4% of Whites, and they are 16 percentage points less likely to report a recent health consultation (p < 0.01) and 47 percentage points less likely to use private facilities (p < 0.01). Respondents in the poorest income quintiles live 0.5 to 0.75 km further from the nearest health facility (p < 0.01). Racial differentials in the likelihood of having a health consultation or an attended birth persist even after controlling for confounders. CONCLUSIONS: Our results have two policy implications: minimizing the distance that poor South Africans must travel to obtain health care and improving the quality of care provided in poorer areas will reduce inequality. Much has been done to redress disparities in South Africa since the end of apartheid but progress is still needed to achieve equity in health care access.

Schooling as a Lottery: Racial Differences in School Advancement in Urban South Africa.

This paper analyzes the large racial differences in progress through secondary school in South Africa. Using recently collected longitudinal data we find that grade advancement is strongly associated with scores on a baseline literacy and numeracy test. In grades 8-11 the effect of these scores on grade progression is much stronger for white and coloured students than for African students, while there is no racial difference in the impact of the scores on passing the nationally standardized grade 12 matriculation exam. We develop a stochastic model of grade repetition that generates predictions consistent with these results. The model predicts that a larger stochastic component in the link between learning and measured performance will generate higher enrollment, higher failure rates, and a weaker link between ability and grade progression. The results suggest that grade progression in African schools is poorly linked to actual ability and learning. The results point to the importance of considering the stochastic component of grade repetition in analyzing school systems with high failure rates.

Orphanhood and Schooling in South Africa: Trends in the vulnerability of orphans between 1993 and 2005.

Using 10 nationally representative surveys conducted between 1993 and 2005 we assess the extent to which the vulnerability of orphans to poorer educational outcomes has changed over time as the AIDS crisis deepens in South Africa. In line with the existing literature we find that at every point in time orphans are at risk of poorer educational outcomes with maternal deaths generally having stronger negative effects than paternal deaths. However, despite a significant increase in the number of orphans over the last decade, we find no evidence of a systematic strengthening of these negative effects. In order to understand this we explore patterns of care giving for orphans. We find that these patterns have shifted over time. While orphans are still absorbed into extended families, single orphans are increasingly less likely to live with the surviving parent and there is an increasing reliance on grandparents as caregivers. Up to this point, these changing patterns of care giving within extended families seem to have avoided further worsening in the educational outcomes for the increasing number of orphans.

The impact of AIDS on intergenerational support in South Africa: Evidence from the Cape Area Panel Study.

This study uses panel data from Cape Town to document the role played by aging parents in caring for grandchildren who lose parents due to illnesses such as AIDS. We quantify the probabilities that older adults and their adult children provide financial support to orphaned grandchildren. We find significant transfers of public and private funds to older adults caring for orphans. Perhaps because of these transfers we find no differences in expenditure patterns between households with orphans and other older adult households. We also find no impact of either the death of a child or taking in orphaned grandchildren on adult well-being as measured by ability to work, depression, or self reported health. Our findings suggest that the combined public and private safety net in South Africa mitigates many of the consequences older adults could suffer when an adult child dies and leaves behind grandchildren needing care.

LINKING POVERTY AND INCOME SHOCKS TO RISKY SEXUAL BEHAVIOUR: EVIDENCE FROM A PANEL STUDY OF YOUNG ADULTS IN CAPE TOWN.

Is there a link between household income and income stress, and risky sexual behaviour of young people? Anecdotal and qualitative evidence suggests this may be the case, but there is little quantitative research measuring this relationship. We use two waves of new data from the Cape Area Panel Study to investigate this link for 2,993 African and coloured youths aged 14 to 22 in 2002. In the process, we discuss one type of research design that could allow for a causal interpretation of the effect of income poverty on HIV risk. This design plausibly separates out the effect of income stress from the effect of living in a poor household by comparing behaviours across households with and without negative economic shocks, conditional on baseline income. Our results indicate that females in poorer households are more likely to be sexually active in 2002 and more likely to sexually debut by 2005. In addition, girls in households experiencing negative economic shocks are more likely to reduce condom use between 2002 and 2005. However, they are less likely to have multiple partners in 2002 or have transitioned to multiple partners by 2005. Males who experienced a negative shock are more likely to have multiple partners. Despite the tight research design for assessing shocks, the findings on the impacts of shocks do not generate clear recommendations for policy. There appears to be no systematic difference in condom use at last sex by household income levels or income shocks.

Household and community income, economic shocks and risky sexual behavior of young adults: evidence from the Cape Area Panel Study 2002 and 2005.

OBJECTIVE: To describe recent trends in adolescent sexual behavior in Cape Town, South Africa, and to determine whether household and community poverty and negative economic shocks predict risky sexual behavior. DATA: Matched survey data on 2993 African and coloured youth from the Cape Area Panel Study 2002 and 2005. MAIN OUTCOME MEASURES: Sexual debut, multiple sexual partners in past year, condom use at last sex, measured in 2002 and 2005. METHODS: We tested for changes over time in reported sexual behavior and estimate multivariate probit models to measure the association between 2002 individual, household and community characteristics and 2005 sexual behavior. RESULTS: There was a statistically significant increase in condom use and a decrease in the incidence of multiple sexual partners between 2002 and 2005 for young women aged 17-22 years. Young women in households with 10% higher income were 0.53% less likely to debut sexually by 2005; young men in communities with a 10% higher poverty rate were 5% less likely to report condom use at last sex. Negative economic shocks are associated with a 0.04% increase in the probability of multiple partnerships for young women. Education is positively correlated with sexual debut for young women and with multiple partnerships for both sexes. CONCLUSION: Trends in sexual behavior between 2002 and 2005 indicate significant shifts towards safer practices. There is little evidence of a relationship between negative economic shocks, household and community poverty, and risky behavior. We hypothesize that the unexpected positive relationship between education and sexual debut may be driven by peer effects in schools with substantial age mixing.

The financial impact of HIV/AIDS on poor households in South Africa.

BACKGROUND: Rising mortality rates caused by HIV/AIDS in South Africa have substantial and lingering impacts on poor households. METHODS: This is a descriptive paper using a new dataset of daily income, expenditure and financial transactions collected over a year from a total of 181 poor households in South African rural and urban areas. One of the key pathways through which HIV/AIDS impacts on household wellbeing is through the socioeconomic impacts of death, which this dataset is especially useful in quantifying. RESULTS: The key impacts of death on households are funerals and the loss of income. Funerals often cost up to 7 months of income. Nearly all households in the sample attempt to cover such costs by holding a portfolio of funeral insurance. Despite these efforts to insure against funeral costs, 61% of households are underinsured against the cost of a funeral. Nearly half the sample households are dependent on a regular wage earner, and another quarter are dependent on a grant recipient. Eighty per cent of these households would lose over half of their monthly income should the highest income recipient in the household die. Even by selling liquid assets, only one third of the sample households would be able to maintain their pre-death living standards for a year or more. CONCLUSION: Death poses substantial and lingering burdens from the funerals that surviving household members need to finance and the ongoing loss of income once brought into the household by the deceased. These costs pose so great a threat to households that they dominate household saving and insurance behavior.

The sensitivity to key data imputations of recent estimates of income poverty and inequality in South Africa.

Existing literature using South African censuses reports an increase in both poverty and inequality over the 1996 to 2001 period. This paper assesses the robustness of these results to a number of weaknesses in the personal income variable. We use a sequential regression multiple imputation approach to impute missing values and to explicitly assess the influence of implausible income values and different rules used to convert income that is measured in bands into point incomes. Overall our results for 1996 and 2001 confirm the major findings from the existing literature while generating more reliable confidence intervals for the key parameters of interest than are available elsewhere.