Archives

  • 2018-07
  • 2018-10
  • 2018-11
  • 2019-04
  • 2019-05
  • 2019-06
  • 2019-07
  • 2019-08
  • 2019-09
  • 2019-10
  • 2019-11
  • 2019-12
  • 2020-01
  • 2020-02
  • 2020-03
  • 2020-04
  • 2020-05
  • 2020-06
  • 2020-07
  • 2020-08
  • 2020-09
  • 2020-10
  • 2020-11
  • 2020-12
  • 2021-01
  • 2021-02
  • 2021-03
  • 2021-04
  • 2021-05
  • 2021-06
  • 2021-07
  • 2021-08
  • 2021-09
  • 2021-10
  • 2021-11
  • 2021-12
  • 2022-01
  • 2022-02
  • 2022-03
  • 2022-04
  • 2022-05
  • 2022-06
  • 2022-07
  • 2022-08
  • 2022-09
  • 2022-10
  • 2022-11
  • 2022-12
  • 2023-01
  • 2023-02
  • 2023-03
  • 2023-04
  • 2023-05
  • 2023-06
  • 2023-07
  • 2023-08
  • 2023-09
  • 2023-10
  • 2023-11
  • 2023-12
  • 2024-01
  • 2024-02
  • 2024-03
  • 2024-04

    • The type of occupation of an individual

    2018-10-24

    The type of occupation of an individual may influence the place of death. We found that inno-206 most of the adult deaths occurred among those with elementary occupations, closely followed by those in agricultural and fishery occupations. However, with the exception of the skilled agricultural/fishery workers, more than half of the adult deaths occurred in a health facility. Before adjusting for other explanatory variables in the model, all the adult deaths by occupation were more likely to occur in a health facility when compared to the skilled agricultural/fishery workers. However, after controlling for other explanatory variables in the model, only legislators/senior officials/managers; service/shop/market sales workers; craft and related trade workers; and plant and machine operators/assemblers were more likely to die in a health facility when compared to the skilled agricultural/fishery worker decedents. We expected that adult decedents in white-collar occupations were more likely to die in a health facility as white-collar occupations are associated with high levels of education. Therefore, the type of occupation was a significant predictor of the place of death. Our finding, however, contradicts the study conducted in Ethiopia (Anteneh et al., 2013), that found no significant association between occupation type and the place of death, despite finding a high proportion of decedents who were professionals, managers or clerks dying in health facilities. Previous studies conducted in United States of America, Canada, Germany, Mexico, Japan, United Kingdom, did not include type of occupation in their examination of factors associated with place of death. Consistent with previous findings, we found empirical evidence that HIV/AIDS was the leading cause of death among adult decedents in Zambia (Central Statistical Office (CSO), 2014; Mudenda et al., 2011). More than half of the adult decedents with HIV/AIDS died in a health facility. Additionally, more than one-third of the adults with HIV/AIDS died at home. The cause of death has been associated with the place of death as certain health conditions can only be treated at a health facility. Among the causes of death, we found that only accidents and injuries were significantly associated with the place of death. Adult deaths attributed to accidents and injuries were less likely to occur in a health facility compared to HIV/AIDS decedents. This was expected as accidents and injuries mostly happen away from the health facilities, for example, victims may die on the spot in a road traffic accident. Our finding is in agreement with the study in Ethiopia (Anteneh et al., 2013). The study in Ethiopia also found a significant difference between HIV/AIDS and cardiovascular diseases, which we did not find. The study also did not find a significant difference between HIV/AIDS and respiratory health conditions, tuberculosis, infectious and parasitic diseases in Ethiopia, which we identified. This is expected to some extent as some of these diseases are AIDS-related and may therefore not be significantly different from HIV/AIDS. We anticipated that the notion of “going-home-to-die” among the HIV/AIDS decedents would be exhibited as reported in other studies (Foster & Williamson, 2000; Whyte, 2005) in sub-Saharan Africa, but this was not the case. We found about 67 per cent of the deceased adults whose cause of death was neoplasms died in a health facility. Black et al., (2016) found that those with cancer were more likely to die in hospitals whereas those with Ischaemic Heart Disease (IHD) their common place of death was at home.
    Limitations Our study has several limitations. First, the lack of specific information on the timing of the utilization of health services, that is, whether it was early, late, or very late among adult decedents, which would have an effect on the place of death. We were unable to determine this; however, it does not affect the findings. Second, the duration of an illness can also influence the place of death, however, this information was not collected and we were unable to determine the effect of the duration of illness on the place of death. It has not affected our findings. Third, due to the cross-sectional nature of the data utilized we could not establish causality as well as the direct linkage between place of death and access and utilization of health care services. We used place of death as a proxy for access and utilization of health care services (Marmot, Ryff, Bumpass, Shipley, & Marks, 1997; Reich et al., 2013; Reidpath & Allotey, 2007; Zyaambo et al., 2012). Fourth, the lack of detailed information on the income levels of the adult decedents meant that the effect of income on the place of death could not be determined, however, the use of variables such as education, type of residence and occupation that are associated with income is indicative of what the effect of income on the place of death would be. Fifth, the dataset we used did not have variables such as religion and ethnicity, as the survey did not collect this information. This meant that we were unable to establish the effect of religion on the place of death, which is important, as some religious beliefs have a profound impact on the place of death. We also could not establish the association between ethnicity and the place of death as previous studies did (Coupland et al., 2011; Lackan et al., 2009). In a sub-Saharan African context, cultural practices, customs and beliefs can influence the place of death. Sixth, we used verbal autopsy data, which has its own limitations in terms of biases in the reporting of events about the deceased. However, at the aggregate level, these biases are minimized and do not affect the study results (Mudenda et al., 2011).