Dataset Information

Social conditions and disability related to the mortality of older people in rural South Africa.

ABSTRACT:

Background

South Africa is experiencing a health and social transition including an ageing population and an HIV epidemic. We report mortality experience of an older rural South African population.

Methods

Individual survey data and longer-term demographic data were used to describe factors associated with mortality. Individuals aged 50 years and over (n¼4085) answered a health and quality of life questionnaire in 2006 and were followed for 3 years thereafter. Additional vital events and socio-demographic data were extracted from the Agincourt Health and Demographic Surveillance System from 1993 to 2010, to provide longer-term trends in mortality. Cox regression analysis was used to determine factors related to survival.

Results

In 10 967 person-years of follow-up between August 2006 and August 2009,377 deaths occurred. Women had lower mortality {hazard ratio [HR] 0.35 [95% confidence interval (CI) 0.28–0.45]}. Higher mortality was associated with being single[HR 1.48 (95% CI 1.16–1.88)], having lower household assets score [HR 1.79 (95%CI 1.28–2.51)], reporting greater disability [HR 2.40 (95% CI 1.68–3.42)] and poorer quality of life [HR 1.59 (95% CI 1.09–2.31)]. There was higher mortality in those aged under 69 as compared with those 70 to 79 years old. Census data and cause specific regression models confirmed that this was due to deaths from HIV/TB in the younger age group.

Conclusions

Mortality due to HIV/TB is increasing in men, and to some extent women,aged over 50. Policy makers and practitioners should consider the needs of this growing and often overlooked group.

SUBMITTER: Gomez-Olive FX

PROVIDER: S-EPMC4190514 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Social conditions and disability related to the mortality of older people in rural South Africa.

Gómez-Olivé F Xavier FX Thorogood Margaret M Bocquier Philippe P Mee Paul P Kahn Kathleen K Berkman Lisa L Tollman Stephen S

International journal of epidemiology 20141001 5

<h4>Background</h4>South Africa is experiencing a health and social transition including an ageing population and an HIV epidemic. We report mortality experience of an older rural South African population.<h4>Methods</h4>Individual survey data and longer-term demographic data were used to describe factors associated with mortality. Individuals aged 50 years and over (n¼4085) answered a health and quality of life questionnaire in 2006 and were followed for 3 years thereafter. Additional vital eve ...[more]

PMID: 24836326

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Project description:BACKGROUND: Little is known about social capital and health among older adults in South Africa. This study investigates the association between social capital and several health variables, namely: self-rated health, depressive symptoms, cognitive functioning and physical inactivity, among older South Africans. METHODS: We conducted a national population-based cross-sectional study with a national probability sample of 3840 individuals aged 50 years or older who participated in the Study of Global Ageing and Adults Health (SAGE wave 1) in 2008 in South Africa. Measures included socio-demographic characteristics, health variables, cognitive functioning and physical activity. Social capital was assessed with six components, namely: marital status, social action, sociability, trust and solidarity, safety, and civic engagement. RESULTS: The social capital assessment revealed that 56% of the respondents were married or cohabiting, 45% reported low (0) social action, 42% reported medium (2-3) sociability, 43% reported high (2) trust and solidarity, 50% reported high (2-4) civic engagement and 42% reported medium (6) psychological resources. In multivariate analysis, self-reported good health was associated with younger age, having secondary education and higher social capital (being married or cohabiting, high trust and solidarity and greater psychological resources). Depressive symptoms were associated with lower social capital (not being married or cohabiting, lack of high trust and solidarity and low psychological resources). Better cognitive functioning was associated with younger age, higher educational level, greater wealth and higher social capital (being married or cohabiting, high trust and solidarity, lack of safety, higher civic engagement and greater psychological resources). Physical inactivity was associated with older age and lower social capital (lower social action, lack of safety, lower civic engagement and poorer psychological resources). CONCLUSIONS: Given the basis of these findings on cross sectional data and subsequent limitation, it was found that these study findings mimic the findings of many European and American studies. Social capital among the elderly generation in South Africa is imperative for better health.

Project description:The MRC/Wits University Agincourt research centre, part of the INDEPTH Network, has documented mortality in a defined population in the rural northeast of South Africa for 20 years (1992-2011) using long-term health and socio-demographic surveillance. Detail on the unfolding, at times unpredicted, mortality pattern has been published. This experience is reviewed here and updated using more recent data.To present a review and summary of mortality patterns across all age-sex groups in the Agincourt sub-district population for the period 1992-2011 as a comprehensive basis for public health action.Vital events in the Agincourt population have been updated in annual surveys undertaken since 1992. All deaths have been rigorously recorded and followed by verbal autopsy interviews. Responses to questions from these interviews have been processed retrospectively using the WHO 2012 verbal autopsy standard and the InterVA-4 model for assigning causes of death in a standardised manner.Between 1992 and 2011, a total of 12,209 deaths were registered over 1,436,195 person-years of follow-up, giving a crude mortality rate of 8.5 per 1,000 person-years. During the 20-year period, the population experienced a major HIV epidemic, which resulted in more than doubling of overall mortality for an extended period. Recent years show signs of declining mortality, but levels remain above the 1992 baseline recorded using the surveillance system.The Agincourt population has experienced a major mortality shock over the past two decades from which it will take time to recover. The basic epidemic patterns are consistent with generalised mortality patterns observed in South Africa as a whole, but the detailed individual surveillance behind these analyses allows finer-grained analyses of specific causes, age-related risks, and trends over time. These demonstrate the complex, somewhat unpredicted course of mortality transition over the years since the dawn of South Africa's democratic era in 1994.

Dataset Information

Social conditions and disability related to the mortality of older people in rural South Africa.

Background

Methods

Results

Conclusions

Publications

Social conditions and disability related to the mortality of older people in rural South Africa.

Similar Datasets

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