Socioeconomic disparities in the uptake of substances of abuse: results from a household cross-sectional survey in Murang’ a County, Kenya

Abstract

Background: Drug and substance abuse has adverse health effects and a substantial economic burden to the global economies and at the household level. There is, however, limited data on socio-economic disparities in the update of the substance of abuse in low-to-middle income countries such as Kenya. This study aimed to assess the socio-economic disparities among drugs and substances in Murang’a county of central Kenya. Method: The study design was cross-sectional, and data collection was conducted between November and December 2017. A total of 449 households with at least one person who has experienced substance abuse were sampled from four purposively selected sub-locations of Murang’ a County. Household heads answered questions on house characteristics and as an abuser or on behalf of abusers in their households. Structured questionnaires were used to collect data on types of drugs used, economic burden, and gender roles at the household level. Household socio-economic status (SES) was established (low, middle, and high SES) using principal component analysis (PCA) from a set of household assets and characteristics. Bivariable logistic regression analysis was used to assess the association between SES, gender, and other factors on the uptake of drugs and substance abuse. Results: Individuals in higher SES were more likely to use cigarettes (OR = 2.13; 95%CI = 1.25–3.61, p = 0.005) or piped tobacco (OR = 11.37; 95% CI, 2.55–50.8; p-value = 0.001) than those in low SES. The wealthier individuals were less likely to use legal alcohol (OR = 0.39; 95%CI = 0.21–0.71, p = 0.002) than the poorest individuals. The use of prescription drugs did not vary with SES. A comparison of the median amount of money spent on acquiring drugs showed that richer individuals spent a significantly lower amount than the poorest individuals (USD 9.71 vs. Ksh 14.56, p = 0.031). Deaths related to drugs and substance abuse were more likely to occur in middle SES than amongst the poorest households (OR = 2.96; 95%CI = 1.03–8.45, p = 0.042). Conclusion: Socioeconomic disparities exist in the use of drugs and substance abuse. Low-income individuals are at a higher risk of abuse, expenditures and even death. Strategies to reduce drugs and substance abuse must address socio-economic disparities through targeted approaches to individuals in low-income groups.