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Fadiji AW, Khumalo IP, Wissing MP, Appiah R. A bibliometric review of positive psychology and well-being research in Africa. Front Psychol 2024; 15:1384362. [PMID: 38974101 PMCID: PMC11225939 DOI: 10.3389/fpsyg.2024.1384362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/22/2024] [Indexed: 07/09/2024] Open
Abstract
Positive Psychology rapidly developed into an influential field of study and intervention, initially situated in Psychology, and later becoming multidisciplinary. Research interest in the study of (psychological) well-being has gained global popularity, with increasing salience in Africa. Although the global trends of these developments are relatively well-known, a bibliometric analysis of positive psychology research in Africa was necessary to shed light on the present hotspots and trends and future trajectories in this region of the world. The data source of the present bibliometric analysis study was Scopus, from which Positive Psychology and well-being research literature from Africa between 1983 and 2023 were searched. Using biblioshiny and VOSviewer, the 622 extracted articles were analysed, from which findings about the current condition, research hotspots, and thematic developmental patterns could be made. Africa experienced an initial slow growth period from 1983 until 2005, after which a rapid growth in research productivity, relevance and impact was experienced. In this regard, the results show that the focal point of scientific productivity is South Africa, with the dominance of South African institutions, particularly the North-West University, from where most positive psychology research is produced and cited. Even with potential access to international journal, African researchers seem to prefer to place their publications in the regional journals such as Journal of Psychology in Africa and South African Journal of Psychology. The research reviewed tends to be characterised by more dominant thematic clusters of positive psychology, psychological well-being, and subjective well-being, with a focus on human individuals. An increasing concern for contextual factors and potential antecedents and dynamics of well-being is also observed. The findings provide a good map from which identification of future research priorities can be deduced. As such, we speculate that future positive psychology research in Africa ought to be concerned with the following: greater distribution and intercountry collaborations across the continent, questions of conceptual clarity of terms, better understanding of contextual factors which influence well-being, and well-being research embracing the complexity of bio-psycho-social-ecological well-being, and science concerned with health-promotion interventions.
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Affiliation(s)
- Angelina Wilson Fadiji
- Department of Psychology, De Montfort University, Leicester, United Kingdom
- Africa Unit for Transdisciplinary Health Research, North West University, Potchefstroom, South Africa
| | - Itumeleng P. Khumalo
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
| | - Marié Philipina Wissing
- Africa Unit for Transdisciplinary Health Research, North West University, Potchefstroom, South Africa
| | - Richard Appiah
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
- College of Health Sciences, University of Ghana, Accra, Ghana
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Yang J, Li Z, Zhang J, Zang Z. The impact of basic pension for urban and rural residents on the subjective well-being of the older adult in Chinese rural areas. Front Public Health 2024; 12:1394688. [PMID: 38832229 PMCID: PMC11144910 DOI: 10.3389/fpubh.2024.1394688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/03/2024] [Indexed: 06/05/2024] Open
Abstract
Introduction As an important component of the social security system, basic pension insurance for urban and rural residents is expected to improve the quality of life of rural older adult people and make their lives better and happier. This article mainly studies the relationship between the basic pension for urban and rural residents and the subjective well-being of older adult people in rural China. Methods This paper uses data from the China Health and Retirement Longitudinal Study (CHARLS) for the years 2018 and 2020. It selected samples of rural older adult people aged 60 and above, ultimately obtaining 9,310 samples. The impact of the basic pension for urban and rural residents on the subjective well-being of rural older adult people was estimated by constructing Ordinary Least Squares (OLS) estimation methods and ordered logistic regression models. The robustness of the results was verified by changing the regression methods, and the samples were divided into different groups for heterogeneity analysis according to three different standards. Results The results show that the basic pension for urban and rural residents significantly improves the life satisfaction of rural older adult, reduces their degrees of depression, and thereby enhances their subjective well-being. The impact of the basic pension for urban and rural residents is more significant for older adult individuals in areas with a higher gender ratio, those suffering from chronic diseases, and those in the eastern regions of the country. Further verification indicates that the basic pension for urban and rural residents enhances the subjective well-being of the rural older adult by improving their health status and reducing their labor supply. Discussion Most of the existing research on basic pension insurance for urban and rural residents and subjective well-being has been conducted from the perspective of whether individuals are enrolled in the pension scheme or whether they received a pension. However, there are few studies analyzing from the perspective of the amount of pension benefits received by residents. The results of this study help to enrich the research perspective on the basic pension insurance system for urban and rural residents in China and expand the understanding of the impact and value of the basic pension for urban and rural residents.
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Affiliation(s)
- Jianhai Yang
- School of Economics, Beijing Technology and Business University, Beijing, China
| | - Ziying Li
- School of Economics, Beijing Technology and Business University, Beijing, China
| | - Jiexin Zhang
- School of Economics, Beijing Technology and Business University, Beijing, China
| | - Zheng Zang
- School of Marxism, Soochow University, Suzhou, China
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Yu ST, Houle B, Schatz E, Angotti N, Kabudula CW, Gómez-Olivé FX, Clark SJ, Menken J, Mojola SA. Understanding Household Dynamics From the Ground Up: A Longitudinal Study From a Rural South African Setting. Demography 2024; 61:31-57. [PMID: 38240041 DOI: 10.1215/00703370-11146140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Investigations into household structure in low- and middle-income countries (LMICs) provide important insight into how families manage domestic life in response to resource allocation and caregiving needs during periods of rapid sociopolitical and health-related challenges. Recent evidence on household structure in many LMICs contrasts with long-standing viewpoints of worldwide convergence to a Western nuclearized household model. Here, we adopt a household-centered theoretical and methodological framework to investigate longitudinal patterns and dynamics of household structure in a rural South African setting during a period of high AIDS-related mortality and socioeconomic change. Data come from the Agincourt Health and Socio-Demographic Surveillance System (2003-2015). Using latent transition models, we derived six distinct household types by examining conditional interdependency between household heads' characteristics, members' age composition, and migration status. More than half of households were characterized by their complex and multigenerational profiles, with considerable within-typology variation in household size and dependency structure. Transition analyses showed stability of household types under female headship, while higher proportions of nuclearized household types dissolved over time. Household dissolution was closely linked to prior mortality experiences-particularly, following death of a male head. Our findings highlight the need to better conceptualize and contextualize household changes across populations and over time.
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Affiliation(s)
- Shao-Tzu Yu
- School of Demography, The Australian National University, Canberra, Australia
| | - Brian Houle
- School of Demography, The Australian National University, Canberra, Australia; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
| | - Enid Schatz
- Department of Public Health, University of Missouri-Columbia, Columbia, MO, USA; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
| | - Nicole Angotti
- Department of Sociology, American University, Washington, DC, USA; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Chodziwadziwa W Kabudula
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana
| | - Samuel J Clark
- Department of Sociology, The Ohio State University, Columbus, OH, USA; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana
| | - Jane Menken
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
| | - Sanyu A Mojola
- Department of Sociology, School of Public and International Affairs, and Office of Population Research, Princeton University, Princeton, NJ, USA; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Yan P, Li F, Nicholas S, Maitland E, Tan J, Chen C, Wang J. Impact of pension income on healthcare utilization of older adults in rural China. Int J Equity Health 2023; 22:166. [PMID: 37633941 PMCID: PMC10463592 DOI: 10.1186/s12939-023-01985-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/10/2023] [Indexed: 08/28/2023] Open
Abstract
OBJECTIVE In China, rural residents experience poorer health conditions and a higher disease burden compared to urban residents but have lower healthcare services utilization. Rather than an insurance focus on enhanced healthcare services utilization, we aim to examine that whether an income shock, in the form of China's New Rural Pension Scheme (NRPS), will affect outpatient, inpatient and discretionary over-the-counter drug utilization by over 60-year-old rural NRPS residents. METHODS Providing a monthly pension of around RMB88 (USD12.97), NRPS covered all rural residents over 60 years old. Fuzzy regression discontinuity design (FRDD) was employed to explore the NRPS causal effect on healthcare services utilization, measured by outpatient and inpatient visits and discretionary over-the-counter drug purchases. The nationwide China Health and Retirement Longitudinal Study (CHARLS) 2018 provided the data. RESULTS Without significant changes in health status and medication needs, 60-plus-year-old NRPS recipients significantly increased the probability of discretionary OTC drug purchases by 33 percentage points. NRPS had no significant effect on the utilization of outpatient and inpatient utilization. The increase in the probability of discretionary OTC drug purchases from the NRPS income shock was concentrated in healthier and low-income rural residents. Robustness tests confirmed that FRDD was a robust estimation method and our results are robust. CONCLUSION NRPS was an exogenous income shock that significantly increased the probability of discretionary over-the-counter drug purchases among over 60-year-old rural residents, but not the utilization of inpatient or outpatient healthcare services. Income remains an important constraint for rural residents to improve their health. We recommend policymakers consider including commonly used over-the-counter drugs in basic health insurance reimbursements for rural residents; provide health advice for rural residents to make discretionary over-the-counter drug purchases; and to mount an information campaign on over-the-counter drug purchasing in order to increase the health awareness of rural residents.
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Affiliation(s)
- Peizhe Yan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China
| | - Fenghang Li
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Australian Technology Park, Sydney, NSW, Australia
- Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia
| | | | - Jialong Tan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China
| | - Chen Chen
- Department of Global Health, School of Public Health, Wuhan University, Hubei Province, 115 Donghu Road, Wuhan, 430079, China.
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China.
- Center for Health Economics and Management at the School of Economics and Management, Wuhan University, Hubei Province, Room A201, Wuhan, 430079, China.
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Jock J, Kobayashi L, Chakraborty R, Chen X, Wing C, Berkman L, Canning D, Kabudula CW, Tollman S, Rosenberg M. Effects of Pension Eligibility Expansion on Men's Cognitive Function: Findings from Rural South Africa. J Aging Soc Policy 2023:1-20. [PMID: 36975023 PMCID: PMC10533724 DOI: 10.1080/08959420.2023.2195785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 11/11/2022] [Indexed: 03/29/2023]
Abstract
Two-thirds of people living with Alzheimer's disease and related dementias (ADRD) live in low- and middle-income countries, and this figure is expected to rise as these populations are rapidly aging. Since evidence demonstrates links between socioeconomic status and slower rates of cognitive decline, protecting older adults' cognitive function in resource-limited countries that lack the infrastructure to cope with ADRD is crucial to reduce the burden it places on these populations and their health systems. While cash transfers are a promising intervention to promote healthy cognitive aging, factors such as household wealth and level of education often confound the ability to make causal inferences on the impact of cash transfers and cognitive function. This study uses a quasi-experimental design, leveraging an exogenous expansion to the Old Age Pension for men in South Africa, to approximate causal associations with cognitive function. We found evidence that there is a potential benefit of cash transfers at an earlier age for older individuals. As such, transfers such as pensions or other forms of direct basic income transfers may hold promise as potential interventions to promote healthy cognitive aging.
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Affiliation(s)
- Janet Jock
- O'Neill School of Public and Environmental Affairs, Indiana University-Bloomington, Bloomington, U.S.A
| | - Lindsay Kobayashi
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, U.S.A
| | - Rishika Chakraborty
- Department of Environmental and Occupational Health, Indiana University School of Public Health-Bloomington, Bloomington, U.S.A
| | - Xiwei Chen
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, U.S.A
| | - Coady Wing
- O'Neill School of Public and Environmental Affairs, Indiana University-Bloomington, Bloomington, U.S.A
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Cambridge, U.S.A
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, Stephen Tollman, University of the Witwatersrand, Johannesburg, South Africa
| | - David Canning
- Harvard Center for Population and Development Studies, Cambridge, U.S.A
| | - Chodziwadziwa Whiteson Kabudula
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, Stephen Tollman, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, Stephen Tollman, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Health and Population Research Center, Accra, Ghana
- Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Molly Rosenberg
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, U.S.A
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, Stephen Tollman, University of the Witwatersrand, Johannesburg, South Africa
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Xiao L, Wu Y, Cao X. The health of the elderly and social security in the context of digital financial inclusion in China. Front Public Health 2023; 10:1079436. [PMID: 36699925 PMCID: PMC9868769 DOI: 10.3389/fpubh.2022.1079436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Affiliation(s)
- Lei Xiao
- School of Economics and Management, Kunming University, Kunming, Yunnan, China,*Correspondence: Lei Xiao ✉
| | - Yanyan Wu
- School of Economics and Management, Kunming University, Kunming, Yunnan, China
| | - Xin Cao
- Pan-Asia Business School, Yunnan Normal University, Kunming, Yunnan, China
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Riumallo Herl C, Kabudula C, Kahn K, Tollman S, Canning D. Pension exposure and health: Evidence from a longitudinal study in South Africa. JOURNAL OF THE ECONOMICS OF AGEING 2022; 23:None. [PMID: 36505964 PMCID: PMC9731801 DOI: 10.1016/j.jeoa.2022.100411] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Social protection schemes have been expanding around the world with the objective of protecting older persons during retirement. While theoretically they have been seen as tools to improve individual wellbeing, there are few studies that evaluate whether social pensions can improve health. In this study, we exploit the change in eligibility criteria for the South African Old Age grant to estimate the association between pension exposure eligibility and health of older persons. For this, we use data from the Health and Aging in Africa: A longitudinal Study of an INDEPTH Community in South Africa (HAALSI) and model pension exposure in terms of its cumulative effect. Our results show that pension exposure is associated with better health as measured by a set of health indices. Disentangling these effects, we find that pension exposure is most likely to improve health through the delayed onset of physical disabilities in the elderly population. Our study highlights the relevance of social protection schemes as a mechanism to protect older persons physical health.
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Affiliation(s)
- Carlos Riumallo Herl
- Erasmus School of Economics, Erasmus University Rotterdam, The Netherlands
- Tinbergen Institute, The Netherlands
| | - Chodziwadziwa Kabudula
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa
- INDEPTH Network, Accra, Ghana
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa
- INDEPTH Network, Accra, Ghana
| | - David Canning
- Global Health and Population, Harvard T.H. Chan School of Public Health
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López-Ortega M, Aguila E. Non -Contributory Pensions, Functional Limitations, and Unpaid Family Care for Older Adults in Mexico. J Aging Health 2022; 34:1213-1227. [PMID: 35739077 DOI: 10.1177/08982643221110093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: We explore the effects of non-contributory pensions on functional limitations and receipt of unpaid family care by gender and frequency of pension payment. Methods: We employ a difference-in-differences estimator to identify the causal effects of non-contributory pension programs disbursed monthly or every two months for adults 70 years and older in the state of Yucatan, Mexico. Results:The monthly payment program led to lower difficulties in functional limitations and less receipt of help from family or relatives for older men and women as compared to the bimonthly program. We found a larger decline on receipt of family care for older women than for men. Discussion:Our results suggest that more frequent pension payments may have greater health benefits for recipients. They also highlight the need for greater understanding of policies that prevent or delay functional limitations and that could indirectly alleviate unpaid caregiver burden.
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Affiliation(s)
- Mariana López-Ortega
- Research Department, National Institutes of Health, 233936National Institute of Geriatrics, Mexico City, Mexico
| | - Emma Aguila
- Research Department, National Institutes of Health, 233936National Institute of Geriatrics, Mexico City, Mexico
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Andersen AG, Kotsadam A, Somville V. Material resources and well-being - Evidence from an Ethiopian housing lottery. JOURNAL OF HEALTH ECONOMICS 2022; 83:102619. [PMID: 35436664 DOI: 10.1016/j.jhealeco.2022.102619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 04/03/2022] [Accepted: 04/03/2022] [Indexed: 06/14/2023]
Abstract
Do better material conditions improve well-being and mental health? Or does any positive relationship merely reflect that well-being promotes economic success? We compare winners and losers from a large Ethiopian housing lottery in a preregistered analysis. Winners gain access to better housing, experience a substantial increase in wealth, and report higher levels of overall life satisfaction and lower levels of financial distress. However, we find no average effects of winning on psychological distress. Our results suggest that not all aspects of well-being and mental health are equally sensitive to economic conditions.
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Affiliation(s)
| | - Andreas Kotsadam
- Ragnar Frisch Centre for Economic Research, Norway; PROMENTA Research Center Department of Psychology, University of Oslo, Norway
| | - Vincent Somville
- NHH Norwegian School of Economics, Norway; Chr. Michelsen Institute, Norway.
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Harling G, Gómez-Olivé FX, Tlouyamma J, Mutevedzi T, Kabudula CW, Mahlako R, Singh U, Ohene-Kwofie D, Buckland R, Ndagurwa P, Gareta D, Gunda R, Mngomezulu T, Nxumalo S, Wong EB, Kahn K, Siedner MJ, Maimela E, Tollman S, Collinson M, Herbst K. Protective Behaviors and Secondary Harms Resulting From Nonpharmaceutical Interventions During the COVID-19 Epidemic in South Africa: Multisite, Prospective Longitudinal Study. JMIR Public Health Surveill 2021; 7:e26073. [PMID: 33827046 PMCID: PMC8121138 DOI: 10.2196/26073] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/25/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In March 2020, South Africa implemented strict nonpharmaceutical interventions (NPIs) to contain the spread of COVID-19. Over the subsequent 5 months, NPI policies were eased in stages according to a national strategy. COVID-19 spread throughout the country heterogeneously; the disease reached rural areas by July and case numbers peaked from July to August. A second COVID-19 wave began in late 2020. Data on the impact of NPI policies on social and economic well-being and access to health care are limited. OBJECTIVE We aimed to determine how rural residents in three South African provinces changed their behaviors during the first COVID-19 epidemic wave. METHODS The South African Population Research Infrastructure Network nodes in the Mpumalanga (Agincourt), KwaZulu-Natal, (Africa Health Research Institute) and Limpopo (Dikgale-Mamabolo-Mothiba) provinces conducted up to 14 rounds of longitudinal telephone surveys among randomly sampled households from rural and periurban surveillance populations every 2-3 weeks. Interviews included questions on the following topics: COVID-19-related knowledge and behaviors, the health and economic impacts of NPIs, and mental health. We analyzed how responses varied based on NPI stringency and household sociodemographics. RESULTS In total, 5120 households completed 23,095 interviews between April and December 2020. Respondents' self-reported satisfaction with their COVID-19-related knowledge and face mask use rapidly rose to 85% and 95%, respectively, by August. As selected NPIs were eased, the amount of travel increased, economic losses were reduced, and the prevalence of anxiety and depression symptoms fell. When the number of COVID-19 cases spiked at one node in July, the amount of travel dropped rapidly and the rate of missed daily medications doubled. Households where more adults received government-funded old-age pensions reported concerns about economic matters and medication access less often. CONCLUSIONS South Africans complied with stringent, COVID-19-related NPIs despite the threat of substantial social, economic, and health repercussions. Government-supported social welfare programs appeared to buffer interruptions in income and health care access during local outbreaks. Epidemic control policies must be balanced against the broader well-being of people in resource-limited settings and designed with parallel support systems when such policies threaten peoples' income and access to basic services.
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Affiliation(s)
- Guy Harling
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Institute for Global Health, University College London, London, United Kingdom
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Francesc Xavier Gómez-Olivé
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- International Network for the Demographic Evaluation of Populations and Their Health Network, Accra, Ghana
| | - Joseph Tlouyamma
- Dikgale-Mamabolo-Mothiba Population Health Research Centre, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
- Department of Computer Science, School of Mathematical and Computer Sciences, Faculty of Science and Agriculture, University of Limpopo, Mankweng, South Africa
| | - Tinofa Mutevedzi
- Department of Science and Innovation-Medical Research Council South African Population Research Infrastructure Network, Johannesburg, South Africa
| | - Chodziwadziwa Whiteson Kabudula
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ruth Mahlako
- Dikgale-Mamabolo-Mothiba Population Health Research Centre, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
| | - Urisha Singh
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Daniel Ohene-Kwofie
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rose Buckland
- Institute for Global Health, University College London, London, United Kingdom
| | - Pedzisai Ndagurwa
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Dickman Gareta
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Resign Gunda
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | | | | | - Emily B Wong
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Division of Infectious Diseases, University of Alabama, Birmingham, Birmingham, AL, United States
| | - Kathleen Kahn
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- International Network for the Demographic Evaluation of Populations and Their Health Network, Accra, Ghana
| | - Mark J Siedner
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Harvard Medical School and the Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, United States
| | - Eric Maimela
- Dikgale-Mamabolo-Mothiba Population Health Research Centre, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
- Department of Public Health, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
| | - Stephen Tollman
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- International Network for the Demographic Evaluation of Populations and Their Health Network, Accra, Ghana
| | - Mark Collinson
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Science and Innovation-Medical Research Council South African Population Research Infrastructure Network, Johannesburg, South Africa
| | - Kobus Herbst
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Department of Science and Innovation-Medical Research Council South African Population Research Infrastructure Network, Johannesburg, South Africa
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Hessel P, Bermeo López LM, López Franco LC, Ham A, Pinilla-Roncancio M, González-Uribe C. Association Between Social Pensions With Depression, Social, and Health Behaviors Among Poor Older Individuals in Colombia. J Gerontol B Psychol Sci Soc Sci 2021; 76:968-973. [PMID: 33165527 DOI: 10.1093/geronb/gbaa195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Many low- and middle-income countries have introduced social pensions to alleviate extreme poverty and improve the well-being of older individuals. However, evidence remains inconclusive about the potential effects of such programs on mental health, social, and health behaviors. METHODS Data for individuals aged 60 or older came from the nationally representative Encuesta Nacional de Salud, Bienestar y Envejeciamiento survey in Colombia 2015 (N = 9,456). We used propensity score matching to estimate the association between the country's social pension program (Colombia Mayor) with depression, self-rated health, food insecurity, alcohol consumption, social participation, and labor force participation. RESULTS Results show that receiving the program does not significantly affect the likelihood of suffering from depression or self-rated health among either men or women. However, receiving the program is associated with significant reductions in the likelihood of experiencing food insecurity and significant increases in the likelihood of participating socially. Among women, receiving the program is associated with significant reduction in the likelihood of participating in the labor force. DISCUSSION The absence of a measurable effect on depression and self-rated health may be explained, at least partly, by the program's comparatively small cash benefit and the sharing of resources with other family members. Policymakers should assess possibilities to maximize the health and social benefits of social pensions.
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Affiliation(s)
- Philipp Hessel
- Alberto Lleras Camargo School of Government, University of the Andes, Bogotá, Colombia
| | | | | | - Andrés Ham
- Alberto Lleras Camargo School of Government, University of the Andes, Bogotá, Colombia
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12
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Ko PC, Möhring K. Chipping In or Crowding-Out? The Impact of Pension Receipt on Older Adults' Intergenerational Support and Subjective Well-Being in Rural China. J Cross Cult Gerontol 2021; 36:139-154. [PMID: 33768407 DOI: 10.1007/s10823-020-09422-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2020] [Indexed: 11/26/2022]
Abstract
With the introduction of the New Rural Social Pension Scheme (NRSPS), pension coverage in rural China has increased substantially during the last decade. We investigate how the new public pension benefits influence intergenerational transfers and subjective well-being of older adults in rural China using panel data from the 2011 and 2013 waves of the China Health and Retirement Longitudinal Study (CHARLS). The results of our first-difference regression models show that receiving a public pension goes along with an increase in intergenerational financial support and has a positive impact on the subjective well-being of older adults in rural China. Our analysis represents one of the first studies examining the effects of the introduction of the NRSPS from a longitudinal perspective. The results demonstrate that public pension benefits as a form of institutional financial support are beneficial to the well-being of older adults, while they do not hinder intergenerational exchange.
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Affiliation(s)
- Pei-Chun Ko
- Centre for University Core, Singapore University of Social Sciences, 463 Clementi Road, Singapore, 599494, Singapore.
| | - Katja Möhring
- School for Social Sciences, University of Mannheim, Mannheim, Germany
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13
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Ma X, Oshio T. The impact of social insurance on health among middle-aged and older adults in rural China: a longitudinal study using a three-wave nationwide survey. BMC Public Health 2020; 20:1842. [PMID: 33261609 PMCID: PMC7709307 DOI: 10.1186/s12889-020-09945-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/19/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Many studies have examined the impact of social insurance on health, but the results have generally been mixed, presumably because they have not fully addressed potential biases related to the study's cross-sectional design. In this study, we conducted a longitudinal analysis to investigate how participation in two social insurance programs in China-the New Rural Social Pension Insurance (NRSPI) and the New Rural Cooperative Medical Scheme (NRCMS)-was associated with health outcomes among middle-aged and older adults in rural China. METHODS Using three-wave longitudinal data from the China Health and Retirement Longitudinal Study conducted in 2011, 2013, and 2015, we estimated the dynamic fixed-effects regression models to examine the association between participation in the NRCMS/NRSPI and six types of health outcomes. RESULTS Participation in the NRSPI was positively associated with some health outcomes, but the associations were relatively modest and were observed only for some specific age and household income groups. Participation in NRCMS was not associated with any health outcomes. CONCLUSIONS The results provide limited evidence of the positive impact of social insurance on health among middle-aged and older adults in rural China. Thus, social insurance programs should be reformed to enhance their positive impact on health.
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Affiliation(s)
- Xinxin Ma
- Faculty of Social Sciences, University of Toyama, 3190 Gofuku, Toyama, 930-8555 Japan
| | - Takashi Oshio
- Institute of Economic Research, Hitotsubashi University, 2-1 Naka, Kunitachi-shi, Tokyo, 186-8603 Japan
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14
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Harling G, Gómez-Olivé FX, Tlouyamma J, Mutevedzi T, Kabudula CW, Mahlako R, Singh U, Ohene-Kwofie D, Buckland R, Ndagurwa P, Gareta D, Gunda R, Mngomezulu T, Nxumalo S, Wong EB, Kahn K, Siedner MJ, Maimela E, Tollman S, Collinson M, Herbst K. Protective behaviours and secondary harms from non-pharmaceutical interventions during the COVID-19 epidemic in South Africa: a multisite prospective longitudinal study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020. [PMID: 33200146 PMCID: PMC7668759 DOI: 10.1101/2020.11.12.20230136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: In March 2020 South Africa implemented strict non-pharmaceutical interventions (NPIs) to contain Covid-19. Over the subsequent five months NPIs were eased in stages according to national strategy. Covid-19 spread throughout the country heterogeneously, reaching rural areas by July and peaking in July-August. Data on the impact of NPI policies on social and economic wellbeing and access to healthcare is limited. We therefore analysed how rural residents of three South African provinces changed their behaviour during the first epidemic wave. Methods: The South African Population Research Infrastructure Network (SAPRIN) nodes in Mpumalanga (Agincourt), KwaZulu-Natal (AHRI) and Limpopo (DIMAMO) provinces conducted longitudinal telephone surveys among randomly sampled households from rural and peri-urban surveillance populations every 2-3 weeks. Interviews included questions on: Covid-19 knowledge and behaviours; health and economic impact of NPIs; and mental health. Results: 2262 households completed 10,966 interviews between April and August 2020. By August, self-reported satisfaction with Covid-19 knowledge had risen from 48% to 85% and facemask use to over 95%. As selected NPIs were eased mobility increased, and economic losses and anxiety and depression symptoms fell. When Covid-19 cases spiked at one node in July, movement dropped rapidly, and missed daily medication rates doubled. Economic concerns and mental health symptoms were lower in households receiving a greater number of government-funded old-age pensions. Conclusions: South Africans reported complying with stringent Covid-19 NPIs despite the threat of substantial social, economic and health repercussions. Government-supported social welfare programmes appeared to buffer interruptions in income and healthcare access during local outbreaks. Epidemic control policies must be balanced against impacts on wellbeing in resource-limited settings and designed with parallel support systems where they threaten income and basic service access.
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Affiliation(s)
- Guy Harling
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,Institute for Global Health, University College London, London, United Kingdom.,Department of Epidemiology & Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Joseph Tlouyamma
- DIMAMO Population Health Research Centre, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Limpopo, South Africa.,Faculty of Science and Agriculture, School of Mathematical and Computer Sciences, Department of Computer Science, University of Limpopo, Limpopo, South Africa
| | - Tinofa Mutevedzi
- DSI-MRC South African Population Research Infrastructure Network, South Africa
| | - Chodziwadziwa Whiteson Kabudula
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ruth Mahlako
- DIMAMO Population Health Research Centre, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Limpopo, South Africa
| | - Urisha Singh
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Daniel Ohene-Kwofie
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rose Buckland
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Pedzisai Ndagurwa
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Dickman Gareta
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Resign Gunda
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | | | | | - Emily B Wong
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,Division of Infectious Diseases, University of Alabama Birmingham, Birmingham, AL, USA
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,INDEPTH Network, Accra, Ghana
| | - Mark J Siedner
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,Harvard Medical School and the Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
| | - Eric Maimela
- DIMAMO Population Health Research Centre, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Limpopo, South Africa.,Department of Public Health, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, Limpopo, South Africa
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,INDEPTH Network, Accra, Ghana
| | - Mark Collinson
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,DSI-MRC South African Population Research Infrastructure Network, South Africa
| | - Kobus Herbst
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,DSI-MRC South African Population Research Infrastructure Network, South Africa
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15
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The impact of old-age pensions on the happiness level of elderly people – evidence from China. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20001452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
As an important source of income for elderly people, pensions have a great impact on their wellbeing. There are three different pension systems in China (the Old-age Insurance System for Government Agencies and Institutions (OISGAI), the Basic Old-age Insurance System for Urban Employees (BOISUE) and the Social Insurance of the Old-age Pension for Urban and Rural Residents (SIOPURR)). This study empirically analyses the impact of various pension types on the happiness of elderly people in China and further explores the potential impact mechanism using the 2014 China Family Panel Studies data. The study suggests that first, receiving pensions from OISGAI, BOISUE and SIOPURR is positively correlated with the happiness level of elderly people. Second, the sense of happiness of elderly people who receive BOISUE is higher than that of those receiving SIOPURR, which is mainly caused by the difference in the level of pension benefits. When the level of benefits is controlled for, there is no significant difference between these two groups. Third, when they have the same level of pension benefits, the happiness of elderly people who receive OISGAI is significantly higher than that of those who receive pensions from the other two systems, which is possibly related to the hidden ‘special’ government guarantee and the difference of the growth rate of the benefit level.
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16
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Kim J, Lee TJ, Kim CS. The Association Between the Basic Old-Age Pension and Depression of the Older Adults in Korea. J Prev Med Public Health 2020; 53:332-341. [PMID: 33070505 PMCID: PMC7569015 DOI: 10.3961/jpmph.20.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/16/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The purpose of this study was to investigate the association between the Basic Old-Age Pension (BOP), which is a noncontributory pension, and depression in BOP beneficiaries in Korea. METHODS We used the second and third waves (2007-2008) of the Korea Welfare Panel Study to identify the effect of the BOP on mental health in the year of its introduction. The Center for Epidemiological Studies-Depression Scale, applied in a Korean context, was used to evaluate mental health. To analyze the effect of the BOP, a difference-in-difference approach was used in analyses of all subjects and subgroups. RESULTS For this study population of 760 adults, the BOP did not have a statistically significant relationship with depression in its beneficiaries. After controlling for type of household, the BOP was still not associated with lower reporting of depression, either in single-beneficiary or double-beneficiary households, in the year of the benefit. CONCLUSIONS The BOP policy had no significant relationship with the level of depression among recipients. However, this should not be interpreted as implying that income subsidy programs for older adults, such as the BOP, do not affect mental health, considering the importance of economic hardship in this population and the program's socioeconomic effects.
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Affiliation(s)
- Jaewon Kim
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Tae-Jin Lee
- Institute of Health and Environment, Seoul National University, Seoul, Korea
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea
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17
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Harling G, Morris KA, Manderson L, Perkins JM, Berkman LF. Age and Gender Differences in Social Network Composition and Social Support Among Older Rural South Africans: Findings From the HAALSI Study. J Gerontol B Psychol Sci Soc Sci 2020; 75:148-159. [PMID: 29590472 PMCID: PMC6909436 DOI: 10.1093/geronb/gby013] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 03/05/2018] [Indexed: 01/05/2023] Open
Abstract
Objectives Drawing on the “Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa” (HAALSI) baseline survey, we present data on older adults’ social networks and receipt of social support in rural South Africa. We examine how age and gender differences in social network characteristics matched with patterns predicted by theories of choice- and constraint-based network contraction in older adults. Method We used regression analysis on data for 5,059 South African adults aged 40 and older. Results Older respondents reported fewer important social contacts and less frequent communication than their middle-aged peers, largely due to fewer nonkin connections. Network size difference between older and younger respondents was greater for women than for men. These gender and age differences were explicable by much higher levels of widowhood among older women compared to younger women and older men. There was no evidence for employment-related network contraction or selective retention of emotionally supportive ties. Discussion Marriage-related structural constraints impacted on older women’s social networks in rural South Africa, but did not explain choice-based network contraction. These findings suggest that many older women in rural Africa, a growing population, may have an unmet need for social support.
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Affiliation(s)
- Guy Harling
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Institute for Global Health, University College London, UK
| | | | - Lenore Manderson
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Institute at Brown for Environment and Society, Brown University, Providence, Rhode Island
| | - Jessica M Perkins
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts.,Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, Tennessee
| | - Lisa F Berkman
- Vanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, Tennessee.,MRC/Wits Rural Public Health and Heath Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Cambridge, Massachusetts
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18
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Aguila E, Smith JP. Supplemental income program design: A cluster-randomized controlled trial to examine the health and wellbeing effects on older adults by gender, duration, and payment frequency. Soc Sci Med 2020; 259:113139. [PMID: 32623230 PMCID: PMC7394009 DOI: 10.1016/j.socscimed.2020.113139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND We documented results from a cluster-randomized controlled trial we designed to supplement incomes in poor towns among adults 70 or older. We analyzed effects on health by gender, persistence over time, and variation by payment frequency. METHODS We compared supplemental income effects over an 18-month period for two towns in Yucatan, Mexico: Valladolid, where eligible individuals received a monthly income supplement over the entire analysis period, and Motul, a demographically matched control town, where eligible individuals received a bimonthly income supplement over the last 12 months of the analysis period. While differing in frequency of payment, supplements provided similar levels of income. We conducted three surveys of recipients: (1) at baseline, (2) six months after baseline, and (3) 18 months after baseline. RESULTS The primary outcomes we examined were peak expiratory flow, hemoglobin level, and verbal recall. The secondary outcomes were health care use and food availability. We found health benefits persisted for at least eighteen months for the monthly income supplement, with both males and females benefiting. Bimonthly income supplements had smaller health benefits. CONCLUSIONS Older people in the developing world who lack social security benefits and health care may benefit most from monthly income programs. The greater payment frequency of monthly programs may influence how household resources are allocated. Supplemental income programs are common in low- and middle-income countries; hence, our results have implications for program design in many nations.
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Affiliation(s)
- Emma Aguila
- Sol Price School of Public Policy, USC, 650 Childs Way, RGL Hall, Room 226, Los Angeles, CA, 90089, USA.
| | - James P Smith
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, USA
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19
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Lloyd-Sherlock P, Amoakoh-Coleman M. A critical review of intervention and policy effects on the health of older people in sub-Saharan Africa. Soc Sci Med 2020; 250:112887. [PMID: 32135461 DOI: 10.1016/j.socscimed.2020.112887] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 02/19/2020] [Accepted: 02/24/2020] [Indexed: 11/20/2022]
Abstract
This paper provides a critical review of publications containing information about specific health effects on older adults of interventions and policies in sub-Saharan Africa. Interventions and policies fell into the following categories: testing or treating HIV, the provision of pensions, screening for non-communicable diseases (NCDs), health service financing and interventions related to visual conditions. The review finds that the relevant literature is very limited relative to the size of older populations in the region. Conditions of particular relevance to older adults, such as NCDs, are under-represented and most studies treat older people as a single category, typically including all adults aged 50 and over. The paper concludes that evidence about the health effects of interventions and policies on the region's rapidly growing older populations remains minimal, and that this both reflects and reinforces a bias against older people in health policy.
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Affiliation(s)
- Peter Lloyd-Sherlock
- School of International Development, University of East Anglia, Earlham Road, Norwich, NR4 7HT, UK.
| | - Mary Amoakoh-Coleman
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
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20
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21
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Lu P, Shelley M. Retirement, Pensions, and Depressive Symptoms Among Older Adults in China, England, Mexico, and the United States. Int J Aging Hum Dev 2019; 92:40-64. [PMID: 31409091 DOI: 10.1177/0091415019868227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study explores the associations of retirement, and of public and private pensions, with older adults' depressive symptoms by comparing differences between countries and age groups. Harmonized data were analyzed from the family of Health and Retirement Study in 2012-2013 from China, England, Mexico, and the United States (n = 97,978). Respondents were asked if they were retired and received public or private pensions. Depressive symptom was measured by the Center for Epidemiologic Studies Depression Scale. Retirement was significantly associated with higher depressive symptoms for the United States and with lower depressive symptoms for Mexico and England. Public pension was significantly associated with lower depressive symptoms for Mexico and with higher depressive symptoms for the United States and China. Private pension was significantly associated with lower depressive symptoms for the United States, China, and England. Our study shows that continuity theory demonstrates cross-national variation in explaining the association between retirement and depressive symptoms.
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Affiliation(s)
- Peiyi Lu
- Iowa State University, Ames, IA, USA
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22
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Zhang T, Liu C, Ni Z. Association of Access to Healthcare with Self-Assessed Health and Quality of Life among Old Adults with Chronic Disease in China: Urban Versus Rural Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142592. [PMID: 31330818 PMCID: PMC6679116 DOI: 10.3390/ijerph16142592] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 07/15/2019] [Accepted: 07/19/2019] [Indexed: 11/16/2022]
Abstract
This study examined urban-rural differences in the association of access to healthcare with self-assessed health and quality of life (QOL) among old adults with chronic diseases (CDs) in China. The data of 5796 older adults (≥60) with self-reported CDs were collected from the Study on Global Ageing and Adult Health in China, including indicators of self-assessed health and QOL and information on access to healthcare. Associations of access to healthcare with self-assessed health and QOL at the 10th, 50th, and 90th conditional quantiles were determined after controlling individual and household factors, showing that urban patients who received healthcare within two weeks gave higher ratings on self-assessed health scores at the 10th and 50th quantiles. In rural areas, one-year and two-week access to healthcare was found to be associated with QOL scores at the 10th and 90th quantiles, respectively. Marginal effects of using needed health service decreased with a growth in QOL and self-assessed health scores in both urban and rural locations despite these effects being significant across the whole distribution. Overall, access to healthcare affects the self-assessed health and QOL of the elderly with CDs in China, especially in patients with poor health, though differently for urban and rural patients. Policy actions targeted at vulnerable and rural populations should give priority to reducing barriers to seeking health services.
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Affiliation(s)
- Tao Zhang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 43003, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne 3086, Australia
| | - Ziling Ni
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 43003, China.
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23
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Knight L, Schatz E, Lewis KR, Mukumbang FC. 'When you take pills you must eat': Food (in)security and ART adherence among older people living with HIV. Glob Public Health 2019; 15:97-110. [PMID: 31318639 DOI: 10.1080/17441692.2019.1644361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
South Africa has increasing numbers of persons living with HIV on antiretroviral treatment (ART). There is evidence for a relationship between food, food security and HIV. Despite increasing rates of people older than 50 living with HIV coinciding with greater levels of co-morbidity, the existing research is largely limited to those aged 15-49 years. In this paper, we therefore explore how older people living with HIV (OPLWH) in two urban communities within South Africa negotiate and ensure they have sufficient access to food and how food insecurity may affect their retention in care and ART adherence. This study used exploratory qualitative semi-structured in-depth interviews with 23 OPLWH to collect data in isiXhosa. Data were analysed using thematic content analysis. Factors at the community, household and individual levels influence (a) access to sufficient and quality food, and (b) beliefs about ART and food based on (mis)understandings of messaging from health care providers. The results demonstrate the need to explore further and clarify the nutritional guidelines that OPLWH receive from providers to ensure this does not result in reduced adherence or retention in care. They also demonstrate the role that social welfare and family or kin obligations plays in ensuring the food security of OPLWH.
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Affiliation(s)
- Lucia Knight
- School of Public Health, University of the Western Cape, Bellville, Cape Town, South Africa
| | - Enid Schatz
- Department of Public Health, School of Health Professions, University of Missouri, Columbia, MO, USA
| | - Kaleea R Lewis
- Department of Public Health, School of Health Professions, University of Missouri, Columbia, MO, USA
| | - Ferdinand C Mukumbang
- School of Public Health, University of the Western Cape, Bellville, Cape Town, South Africa
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24
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Aguila E, Casanova M. Short-Term Impact of Income on Cognitive Function: Evidence From a Sample of Mexican Older Adults. J Aging Health 2019; 32:591-603. [PMID: 30947596 DOI: 10.1177/0898264319841155] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To estimate the short-run (6-9 months) impact and mediating mechanisms of an intervention providing supplemental income to individuals 70 years and above from the Mexican state of Yucatan on markers of cognitive functioning (immediate and delayed word recall). Method: Regression-adjusted difference-in-differences (DID) analysis using baseline and follow-up data collected at treatment and control sites from an experiment. Results: The intervention improved immediate and delayed recall scores for men and women. We found no effects on diagnoses of dementia risk factors, depression, and activities of daily living (ADLs). The intervention increased health care use and decreased anemia for men and women, and improved food availability for men. The effects on cognitive outcomes were mediated by health care use for both men and women, and food availability for men. Discussion: In low- and middle-income countries, supplemental income for elderly may be an effective strategy to improve cognitive function by increasing food security and health care utilization.
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Affiliation(s)
- Emma Aguila
- University of Southern California, Los Angeles, USA
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25
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Kelly G, Mrengqwa L, Geffen L. "They don't care about us": older people's experiences of primary healthcare in Cape Town, South Africa. BMC Geriatr 2019; 19:98. [PMID: 30947709 PMCID: PMC6449977 DOI: 10.1186/s12877-019-1116-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 03/24/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND As older people age, they have different health needs compared to younger people. South African elder care policy places a strong emphasis on ageing in community rather than institutional settings, but the primary healthcare system is not geared to address the health needs of older people living in community settings. METHODS This paper presents findings of nine focus groups conducted with community-dwelling older adults in three areas (high, medium and low-income) in Cape Town, South Africa over 2 months in 2017. These discussions addressed primary health services available to older persons, their ability to access these services and their expectations and experiences of care. RESULTS Findings showed that while participants in the high-income area had few challenges accessing quality care or support services, services available in lower-income areas were much less responsive and participants displayed low trust in the healthcare system, feeling that their needs were overlooked. Participants who experienced poor doctor-patient communication often failed to comply with treatment, while those who experienced patient-centered communication, either through the private sector or NGO-public sector partnerships had better perceptions of care. CONCLUSIONS Older persons' complex health needs cannot be adequately addressed by a process-driven approach to care. Supporting patient-centered communication and care may help health workers to understand older persons health needs and improve patient understanding, trust and co-operation. This paper suggests the importance of community support services in enhancing health access and developing systems that enable healthcare providers to better understand and respond to older persons' needs in resource-constrained settings.
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Affiliation(s)
- Gabrielle Kelly
- Samson Institute for Ageing Research, University of Cape Town, 234 Upper Buitenkant St, Cape Town, 8001 South Africa
| | - Lindeka Mrengqwa
- Samson Institute for Ageing Research, University of Cape Town, 234 Upper Buitenkant St, Cape Town, 8001 South Africa
| | - Leon Geffen
- Samson Institute for Ageing Research, University of Cape Town, 234 Upper Buitenkant St, Cape Town, 8001 South Africa
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Hessel P, Avendano M, Rodríguez-Castelán C, Pfutze T. Social Pension Income Associated With Small Improvements In Self-Reported Health Of Poor Older Men In Colombia. Health Aff (Millwood) 2019; 37:456-463. [PMID: 29505368 DOI: 10.1377/hlthaff.2017.1284] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The countries of Latin American are aging rapidly. Because most countries in the region lack adequate social protection systems, many Latin American governments have introduced noncontributory pension programs to reduce poverty and food shortages. This study assessed the effects of a large national noncontributory pension program on the health and health care use of older people in Colombia. Using an instrumental variables approach that exploited differential rollout of the program across municipalities, we found evidence that the program led to significant but small improvements in self-reported health and reductions in hospitalizations among men. No significant effects were found among women or among men for other health and health care use outcomes. A small noncontributory pension was associated with improvements in self-reported measures of health for vulnerable older men, but these effects are small in magnitude. Researchers and policy makers should assess ways to maximize the health benefits of cash transfers to poor older people.
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Affiliation(s)
- Philipp Hessel
- Philipp Hessel ( ) is an associate professor in the Alberto Lleras School of Government, University of the Andes, in Bogotá, Colombia
| | - Mauricio Avendano
- Mauricio Avendano is a professor of public policy and global health in the Department of Global Health and Social Medicine at King's College London, in England, and an adjunct associate professor in the Department of Social and Behavioral Sciences at the Harvard T. H. Chan School of Public Health, in Boston, Massachusetts
| | - Carlos Rodríguez-Castelán
- Carlos Rodríguez-Castelán is a senior economist and global lead for markets and institutions in the Poverty and Equity Global Practice at the World Bank, in Washington, D.C
| | - Tobias Pfutze
- Tobias Pfutze is an assistant professor of economics at Florida International University, in Miami
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Maniragaba F, Nzabona A, Asiimwe JB, Bizimungu E, Mushomi J, Ntozi J, Kwagala B. Factors associated with older persons' physical health in rural Uganda. PLoS One 2019; 14:e0209262. [PMID: 30650092 PMCID: PMC6334921 DOI: 10.1371/journal.pone.0209262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 12/03/2018] [Indexed: 12/22/2022] Open
Abstract
Introduction The proportion of older persons in developing countries is increasing with no clear evidence of improvement in physical health. The aim of this paper was to examine the factors associated with older persons’ physical health in rural Uganda. Methods This paper is based on a cross-sectional study of 912 older persons age 60 years and older across four major regions of Uganda. The study was conceptualized basing on World Health Organization quality of life BREF (WHOQOL-BREF). Analysis was done at three levels, that is, frequency distributions were generated to describe background characteristics of respondents and cross-tabulations were done to determine associations between dependent and each of the independent variables. Ordinal logistic regression was used to determine the predictors of physical health. Results The likelihood of good physical health is high among older persons (Ops) who controlled their household assets (OR = 3.64; CI = 1.81–7.30) or the household assets controlled by their spouses (OR = 4.44; CI = 1.91–10.32) relative to those whose household assets were controlled by their children. There is high likelihood of good physical health among those who engage in physical activities (OR = 2.28; CI = 1.52–3.43) compared to those who do not. Conclusion The findings have various policy implications, including creating an enabling environment and building capacities of older persons to remain in control of their household assets. Interventions focusing on deepening sensitization of older persons about importance of physical exercises could be a viable strategy for improving physical health of older persons.
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Affiliation(s)
- Fred Maniragaba
- Department of Population Studies, Makerere University, Kampala, Uganda
- * E-mail:
| | - Abel Nzabona
- Department of Population Studies, Makerere University, Kampala, Uganda
| | - John Bosco Asiimwe
- Department of Planning and Applied Statistics, Makerere University, Kampala, Uganda
| | | | - John Mushomi
- Department of Population Studies, Makerere University, Kampala, Uganda
| | - James Ntozi
- Department of Population Studies, Makerere University, Kampala, Uganda
| | - Betty Kwagala
- Department of Population Studies, Makerere University, Kampala, Uganda
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Ralston M, Schatz E, Menken J, Gómez-Olivé FX, Tollman S. Policy Shift: South Africa's Old Age Pensions' Influence on Perceived Quality of Life. J Aging Soc Policy 2018; 31:138-154. [PMID: 30474517 DOI: 10.1080/08959420.2018.1542243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Noncontributory pensions serve as an important resource for poverty-affected households in low- and middle-income countries. This study explores how a recent policy change to pension receipt influences perceived quality of life among older South Africans. We use survey data from the longitudinal World Health Organization Study on global AGEing and adult health and from the Agincourt Health and Socio-Demographic Surveillance System census. We find pension receipt to have a positive impact on both men's and women's perceived quality of life. These findings hold when controlling for prior well-being status. We find a significant moderating factor of physical limitations on the relationship between pension receipt and quality of life. Individuals reporting the highest levels of physical limitation report a larger increase in their quality of life upon pension receipt than those with less severe physical limitations. We conclude that despite the well-documented household income-pooling in this population, pension receipt still leads to a significant positive impact on pensioners' perceived quality of life.
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Affiliation(s)
- Margaret Ralston
- a Department of Sociology , Mississippi State University , Mississippi , Mississippi State , USA
| | - Enid Schatz
- b Departments of Health Sciences, and Women's & Gender Studies , University of Missouri , Columbia , Missouri , USA.,c MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Jane Menken
- c MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,d CU Population Center, Institute of Behavioral Science , University of Colorado , Boulder , Colorado , USA
| | - Francesc Xavier Gómez-Olivé
- c MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa
| | - Stephen Tollman
- c MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.,e INDEPTH Network , Accra , Ghana
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Perceived quality of life and living arrangements among older rural South Africans: do all households fare the same? AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThis study explores how living arrangements influence perceived quality of life in an elderly population in rural South Africa. We use data from the longitudinal World Health Organization Study of Global Ageing and Adult Health Survey (WHO-SAGE) and from the Agincourt Health and Socio-Demographic Surveillance System (HDSS). On average, older men and women who reside in single-generation and complex-linked multigenerational households report worse quality of life than those in two-generation and linear-linked multigenerational households. However, after controlling for prior wellbeing status, we find living arrangements to have a significant impact on women's perceived quality of life only, and that it is moderated by age. We conclude that not all multigenerational arrangements are protective of older adults’ wellbeing and highlight the gendered impact of living arrangements on quality of life. These results suggest the necessity to understand how living arrangements influence the social roles of older adults and change with age.
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Sasaki I, Kondo K, Kondo N, Aida J, Ichikawa H, Kusumi T, Sueishi N, Imanaka Y. Are pension types associated with happiness in Japanese older people?: JAGES cross-sectional study. PLoS One 2018; 13:e0197423. [PMID: 29782505 PMCID: PMC5962056 DOI: 10.1371/journal.pone.0197423] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 05/02/2018] [Indexed: 11/18/2022] Open
Abstract
Background Although many previous studies have examined the determinants of happiness in older adults, few have investigated the association between pension types and happiness. When compared to other conventional socioeconomic indicators, pension types may be more indicative of long-term socioeconomic status as they can reflect a person’s job history over their life course. This study examined the association between pension types and happiness in Japanese older people. Methods Cross-sectional survey data from the Japan Gerontological Evaluation Study were used to analyze the association between pension types and happiness. The study population comprised 120152 participants from 2013. We calculated the prevalence ratios of happiness for the different pension types using Poisson regression models that controlled for age, sex, marital status, equivalent income, wealth, education level, working status, occupation, depression, and social support. Results After controlling for socioeconomic indicators, the prevalence ratios (95% confidence intervals) of happiness for no pension benefits, low pension benefits, and moderate pension benefits relative to high pension benefits were 0.77 (0.73–0.81), 0.95 (0.94–0.97), and 0.98 (0.97–0.99), respectively. However, the inclusion of depression as a covariate weakened the association between pension types and happiness. Conclusions While pension types were associated with happiness after adjusting for other proxy measures of socioeconomic status, the association diminished following adjustment for depression. Pension types may provide rich information on socioeconomic status and depression throughout the course of life. In addition to conventional socioeconomic indicators, pension types should also be considered when assessing the determinants of happiness in older adults.
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Affiliation(s)
- Ichiro Sasaki
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Naoki Kondo
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Hiroshi Ichikawa
- Department of Medical Life Systems, Graduate School of Life and Medical Sciences, Doshisha University, Kyoto, Japan
| | - Takashi Kusumi
- Division of Cognitive Psychology in Education, Graduate School of Education, Kyoto University, Kyoto, Japan
| | - Naoya Sueishi
- Graduate School of Economics, Kobe University, Kobe, Japan
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- * E-mail:
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Golomski C. Elder Care and Private Health Insurance in South Africa: The Pathos of Race-Class. Med Anthropol 2018; 37:311-326. [DOI: 10.1080/01459740.2017.1417279] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Casey Golomski
- Department of Anthropology, University of New Hampshire, Durham, New Hampshire, USA
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Ralston M. The Role of Older Persons' Environment in Aging Well: Quality of Life, Illness, and Community Context in South Africa. THE GERONTOLOGIST 2018; 58:111-120. [PMID: 28655162 PMCID: PMC5881707 DOI: 10.1093/geront/gnx091] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/13/2017] [Indexed: 11/12/2022] Open
Abstract
Purpose of the Study This article evaluates the influence of local district conditions on subjective quality of life of older South African adults. Policymakers increasingly recognize that "successful" aging policies must not only address physical health needs but also factors that influence subjective well-being. Design and Methods To investigate the influence of area-level distribution of "public goods" on well-being in a low- and middle-income setting, nationally representative WHO-Study of Global AGEing and Adult Health (WHO-SAGE) survey data is combined with district-level data that captures built resources and health system distribution. Multilevel regression modeling is utilized to explore how community context, including built resources and health infrastructure quality, influence older persons' quality of life and how chronic health conditions may moderate this relationship while controlling for important individual characteristics. Results While controlling for individual and district level factors, it is found community level provision of built resources of basic services (i.e., water, sanitation, electricity, housing) has a modest but significant impact on older persons' subjective well-being. Further, this effect on older persons' perceptions of quality of life is moderated by individual chronic health status; individuals with a chronic health condition do not receive an equivalent benefit from district built condition like those without an illness do. Implications This work adds to the literature concerning the effect of environments in low- and middle-income countries on older adults' subjective well-being. It also adds to the growing literature on the complex relationship between subjective well-being and health in diverse contexts.
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Affiliation(s)
- Margaret Ralston
- Department of Sociology, Mississippi State University, Mississippi State, Mississippi
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Madhavan S, Schatz E, Gómes-Olivé FX, Collinson M. Social Positioning of Older Persons in Rural South Africa: Change or Stability? JOURNAL OF SOUTHERN AFRICAN STUDIES 2017; 43:1293-1307. [PMID: 30686854 PMCID: PMC6344040 DOI: 10.1080/03057070.2017.1365522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The South African context challenges the conventional categorisation of older persons as dependent after a certain age. The concurrence of old-age pensions, high unemployment, high HIV prevalence, and frailty related to ageing necessitate a more dynamic approach to understanding older persons' social positioning. We examine the extent of change in older persons' social positioning within their households and the correlates of change in a rural community in South Africa. Using data from the Agincourt Health and socio-Demographic Surveillance System and a new typology of older persons' social positioning based on living arrangements, we (1) describe older persons' living arrangements in two time periods; (2) calculate transition probabilities of older persons' changing living arrangements over time; (3) identify possible drivers of change. Results show that while older persons experience stability in living arrangements over time, this stability is more prevalent among those who start in productive roles. Moreover, those who change arrangements are likely to move into productive roles. Taken together, these findings suggest that older South Africans fulfil productive roles in households while simultaneously experiencing ageing-related frailty and diminished labour capacity. These findings underscore the importance of considering ageing as both an individual and a relational process, with implications for older persons and their families.
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‘It really saves us’ versus‘it doesn't cover everything’: the benefits and limitations of a non-contributory pension in the Bolivian Altiplano. AGEING & SOCIETY 2017. [DOI: 10.1017/s0144686x17000460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTNon-contributory pensions have become extremely popular in the last decade, with 78 developing countries currently distributing money in this way, and their acclaimed impacts are increasingly celebrated. Studies have found them to contribute not only to ‘obvious’ needs such as increased consumption and income security but also to investments in productivity, social relationships, health, increased access to credit and savings, while it has become common to claim that they contribute to intangible goals such as dignity and citizenship. The danger of some of these claims is that they assume that wellbeing is heavily responsive to monetary wealth, rather than other areas. To study this, an ethnographic methodology, based on participant observation and semi-structured interviews, was employed in two rural communities located in the La Paz department in the highland Altiplano region of Bolivia close to Lake Titicaca. Our analysis shows that while the Renta Dignidad increases older persons’ livelihood security, its contributions to other areas where non-contributory pensions are claimed to have major impacts, such as productive investment, health care and relational wellbeing, are actually relatively limited. The policy implication of this is that a more integral approach needs to be adopted to older persons' wellbeing, going beyond cash transfers to greater efforts to bring health-care services to older people in remote rural areas.
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Mugomeri E, Chatanga P, Khetheng T, Dhemba J. Quality of Life of the Elderly Receiving Old Age Pension in Lesotho. J Aging Soc Policy 2017; 29:371-393. [PMID: 28535113 DOI: 10.1080/08959420.2017.1328952] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The southern African country of Lesotho introduced an old age pension scheme in 2004 with the aim of enhancing the quality of life (QoL) of the nation's elderly population. This study is the first to assess the physical, psychological, social, and environmental aspects of the health-related QoL of the elderly in Lesotho since the pension scheme was adopted. Data for this study were gathered using the World Health Organization QoL-BREF questionnaire. Mean QoL scores were compared across demographic, socioeconomic, and clinical variables using analysis of variance, t test, and regression analysis. Findings indicate that respondents were least satisfied with the environmental and physical domains of QoL. They also indicate that the overall QoL of the elderly in Lesotho was mainly affected by marital status, level of education, type of housing, source of income, and level of satisfaction with income. These factors should thus be taken into account when developing interventions aimed at improving the QoL of the elderly in Lesotho.
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Affiliation(s)
- Eltony Mugomeri
- a Lecturer, Department of Pharmacy , National University of Lesotho , Maseru , Lesotho
| | - Peter Chatanga
- b Senior Lecturer, Department of Biology , National University of Lesotho , Maseru , Lesotho
| | - Ts'ele Khetheng
- c Clinical Nurse, Department of Nursing , National University of Lesotho , Maseru , Lesotho
| | - Jotham Dhemba
- d Senior Lecturer, Department of Sociology, Anthropology, and Social Work , National University of Lesotho , Maseru , Lesotho
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Park SM. The gendered impact of the National Pension Scheme on late-life economic well-being: evidence from the Korean retirement and income study. QUALITY IN AGEING AND OLDER ADULTS 2017. [DOI: 10.1108/qaoa-01-2015-0002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to analyse the effect of the National Pension Scheme (NPS) on the economic well-being of older people in South Korea.
Design/methodology/approach
It analyses older people aged 60 and over sampled from the third wave of the Korean retirement and income study.
Findings
The analysis shows a gendered effect. The NPS is positively associated with the economic well-being of only older men. This gendered impact is probably attributable to the inherent patriarchal structure of the NPS that is based on the strong male bread-winner model.
Originality/value
The results suggest that promoting the female labour market participation, and also reforming the gender structure of the NPS and South Korean labour market, can be a potential policy option to amend gendered economic well-being in later life.
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37
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Silva SGD, Duca GFD, Nahas MV. Self-reported well-being and associated factors among industrial workers in Brazil: findings from a national survey. CAD SAUDE PUBLICA 2017; 33:e00191215. [DOI: 10.1590/0102-311x00191215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/02/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract: The purpose of this study was to estimate self-perception of well-being and associated factors among industrial workers in Brazil. A cross-sectional survey was carried out with a representative sample from 23 Brazilian states and the Federal District. Self-reported of well-being was investigated by questionnaire. Multinomial logistic regression was used in unadjusted and adjusted analyses. For 93% of the 47,477 industrial workers, the perception of well-being was positive. Those who had the highest chances of being in the category of best perception of well-being were: male workers (OR = 1.35; 95%CI: 1.28; 1.43); those aged under thirty years old (OR = 1.24; 95%CI: 1.12; 1.39); those from Southern Brazil (OR = 1.99; 95%CI: 1.83; 2.16); and people with a high income. The prevalence of positive well-being was high. Sociodemographic, behavioral and social support characteristics, as well as the characteristics related to self-report on health were associated with well-being.
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Nawrotzki RJ, Schlak AM, Kugler TA. Climate, migration, and the local food security context: Introducing Terra Populus. POPULATION AND ENVIRONMENT 2016; 38:164-184. [PMID: 27974863 PMCID: PMC5152917 DOI: 10.1007/s11111-016-0260-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Studies investigating the connection between environmental factors and migration are difficult to execute because they require the integration of microdata and spatial information. In this article, we introduce the novel, publically available data extraction system Terra Populus (TerraPop), which was designed to facilitate population-environment studies. We showcase the use of TerraPop by exploring variations in the climate-migration association in Burkina Faso and Senegal based on differences in the local food security context. Food security was approximated using anthropometric indicators of child stunting and wasting derived from Demographic and Health Surveys (DHS) and linked to the TerraPop extract of climate and migration information. We find that an increase in heat waves was associated with a decrease in international migration from Burkina Faso, while excessive precipitation increased international moves from Senegal. Significant interactions reveal that the adverse effects of heat waves and droughts are strongly amplified in highly food insecure Senegalese departments.
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Affiliation(s)
- Raphael J. Nawrotzki
- University of Minnesota, Minnesota Population Center, 225 19th Avenue South, 50 Willey Hall, Minneapolis, MN 55455, U.S.A. Phone: +001 (612) 367-6751
| | - Allison M. Schlak
- University of Minnesota, Minnesota Population Center, 225 19th Avenue South, 50 Willey Hall, Minneapolis, MN 55455, U.S.A
| | - Tracy A. Kugler
- University of Minnesota, Minnesota Population Center, 225 19th Avenue South, 50 Willey Hall, Minneapolis, MN 55455, U.S.A
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Tollman SM, Norris SA, Berkman LF. Commentary: The value of life course epidemiology in low- and middle-income countries: an ageing perspective. Int J Epidemiol 2016; 45:997-999. [PMID: 27880688 PMCID: PMC5841777 DOI: 10.1093/ije/dyw109] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2016] [Indexed: 11/14/2022] Open
Affiliation(s)
- Stephen M Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,
- INDEPTH Network, Accra, Ghana
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa F Berkman
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Center for Population and Development Studies, Harvard University, Cambridge, MA, USA and
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Mugisha JO, Schatz EJ, Randell M, Kuteesa M, Kowal P, Negin J, Seeley J. Chronic disease, risk factors and disability in adults aged 50 and above living with and without HIV: findings from the Wellbeing of Older People Study in Uganda. Glob Health Action 2016; 9:31098. [PMID: 27225792 PMCID: PMC4880619 DOI: 10.3402/gha.v9.31098] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/27/2016] [Accepted: 04/27/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Data on the prevalence of chronic conditions, their risk factors, and their associations with disability in older people living with and without HIV are scarce in sub-Saharan Africa. OBJECTIVES In older people living with and without HIV in sub-Saharan Africa: 1) to describe the prevalence of chronic conditions and their risk factors and 2) to draw attention to associations between chronic conditions and disability. METHODS Cross-sectional individual-level survey data from people aged 50 years and over living with and without HIV were analyzed from three study sites in Uganda. Diagnoses of chronic conditions were made through self-report, and disability was determined using the WHO Disability Assessment Schedule (WHODAS). We used ordered logistic regression and calculated predicted probabilities to show differences in the prevalence of multiple chronic conditions across HIV status, age groups, and locality. We used linear regression to determine associations between chronic conditions and the WHODAS. RESULTS In total, 471 participants were surveyed; about half the respondents were living with HIV. The prevalence of chronic obstructive pulmonary disease and eye problems (except for those aged 60-69 years) was higher in the HIV-positive participants and increased with age. The prevalence of diabetes and angina was higher in HIV-negative participants. The odds of having one or more compared with no chronic conditions were higher in women (OR 1.6, 95% CI 1.1-2.3) and in those aged 70 years and above (OR 2.1, 95% CI 1.2-3.6). Sleep problems (coefficient 14.2, 95% CI 7.3-21.0) and depression (coefficient 9.4, 95% CI 1.2-17.0) were strongly associated with higher disability scores. CONCLUSION Chronic conditions are common in older adults and affect their functioning. Many of these conditions are not currently addressed by health services in Uganda. There is a need to revise health care policy and practice in Uganda to consider the health needs of older people, particularly as the numbers of people living into older age with HIV and other chronic conditions are increasing.
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Affiliation(s)
- Joseph O Mugisha
- MRC/UVRI, Uganda Research Unit on AIDS, Uganda
- Department of Health Sciences, University of Missouri Columbia, Missouri, USA;
| | - Enid J Schatz
- Department of Health Sciences, University of Missouri Columbia, Missouri, USA
| | | | | | - Paul Kowal
- World Health Organization, Study on global AGEing and adult health, Geneva, Switzerland
- Research Centre for Gender, Health and Ageing, University of Newcastle, Australia
| | - Joel Negin
- School of Public Health, University of Sydney, Australia
| | - Janet Seeley
- MRC/UVRI, Uganda Research Unit on AIDS, Uganda
- London School of Hygiene and Tropical Medicine, London UK
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41
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Vale B, Thabeng M. Redeeming Lost Mothers: Adolescent Antiretroviral Treatment and the Making of Home in South Africa. Med Anthropol 2016; 35:489-502. [PMID: 26814018 DOI: 10.1080/01459740.2016.1145218] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In this article, we explore how adolescent antiretroviral treatment (ART) might be signified to repair sociality in Eastern Cape homes that have been ruptured by HIV/AIDS and maternal loss. The post-apartheid period has exposed these families to new forms of social fragmentation, propelled by the disintegration of wage labor, declining marriage rates, and a rampant HIV/AIDS epidemic. Drawing on eight months of ethnographic fieldwork (August 2013-April 2014), we show that in the homes of some adolescents born with HIV, these present-day domestic ruptures were discursively connected to the past shortcomings of their dead and absent mothers. In some familial narratives lost mothers were accused of disobeying their elders, neglecting their children, and flouting custom; their social transgressions were made manifest in their child's inherited HIV. By signifying adolescent ART-taking as an enactment of the discipline and care purportedly absent in their mothers, these families might also attempt to imbue ART, beyond its biomedical function, as a means of social repair.
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Affiliation(s)
- Beth Vale
- a Department of Social Policy and Intervention , Oxford University , Oxford , United Kingdom
| | - Mildred Thabeng
- b Department of Social Work , University of South Africa , East London , South Africa
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42
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Mopane worm (Imbrasia belina) and rural household food security in Limpopo province, South Africa. Food Secur 2016. [DOI: 10.1007/s12571-015-0536-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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43
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Who Benefits--Or Does not--From South Africa's Old Age Pension? Evidence from Characteristics of Rural Pensioners and Non-Pensioners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:85. [PMID: 26712777 PMCID: PMC4730476 DOI: 10.3390/ijerph13010085] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/08/2015] [Accepted: 12/22/2015] [Indexed: 11/17/2022]
Abstract
Social protection grants play a critical role in survival and livelihoods of elderly individuals in South Africa. Rarely is it possible to assess how well a social program reaches its target population. Using a 2010 survey and Agincourt Health Demographic Surveillance System census data we conduct multivariate logistic regression to predict pension receipt in rural South Africa. We find only 80% of age-eligible individuals report pension receipt. Pension non-recipients tend to be male, have poor socio-economic status, live in smaller households, be of Mozambican origin, and have poorer physical function; while older persons living in households receiving other grants are more likely to report pension receipt. We conclude that a reservoir of older persons exists who meet eligibility criteria but who are not yet receiving pensions. Ensuring that they and their households are properly linked to all available social services—whether for child or old-age social grants—is likely to have beneficial and synergistic effects.
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44
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van der Pas S, Ramklass S, O’Leary B, Anderson S, Keating N, Cassim B. Features of home and neighbourhood and the liveability of older South Africans. Eur J Ageing 2015; 12:215-227. [PMID: 26366144 PMCID: PMC4559096 DOI: 10.1007/s10433-015-0343-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
While older people live in developing countries, little is known about the relative importance of features of their communities in influencing their liveability. We examine components of home and neighbourhood among older South Africans. Linear regression analyses revealed that features of home (basic amenities, household composition, financial status and safety) and neighbourhood (ability to shop for groceries, participate in organizations and feel safe from crime) are significantly associated with life satisfaction. Approaches to liveability that are person-centred and also set within contexts beyond home and neighbourhood are needed to address boundaries between home and neighbourhood; incorporate personal resources into liveability models and import broader environmental contexts such as health and social policy.
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Affiliation(s)
- Suzan van der Pas
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Serela Ramklass
- Department of Geriatrics, University of KwaZulu-Natal, Durban, South Africa
| | | | - Sharon Anderson
- Department of Human Ecology, University of Alberta, Edmonton, Canada
| | - Norah Keating
- Department of Human Ecology, University of Alberta, Edmonton, Canada
- Centre for Innovative Ageing, Swansea University, Swansea, UK
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa
| | - Bilkish Cassim
- Department of Geriatrics, University of KwaZulu-Natal, Durban, South Africa
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45
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Schatz E, Madhavan S, Collinson M, Gómez-Olivé FX, Ralston M. Dependent or Productive? A New Approach to Understanding the Social Positioning of Older South Africans Through Living Arrangements. Res Aging 2015; 37:581-605. [PMID: 25651584 PMCID: PMC4510281 DOI: 10.1177/0164027514545976] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
South Africa's population is aging. Most of the older Black South Africans continue to live in extended household structures with children, grandchildren, and other kin. They also constitute a source of income through a means-tested noncontributory state-funded pension available at age 60. Using census data from the Agincourt Health and Demographic Surveillance System in 2000, 2005, and 2010, we develop a typology of living arrangements that is reflective of the social positioning of elderly persons as dependent or productive household members and analyze changes in the distribution over time. Older persons, in general, live in large, complex, and multigenerational households. Multigenerational households with "productive" older persons are increasing in proportion over the period, although there are few differences by gender or pension eligibility at any time point.
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Affiliation(s)
- Enid Schatz
- University of Missouri, Columbia, MO, USA University of Colorado, Boulder, CO, USA MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Sangeetha Madhavan
- University of Colorado, Boulder, CO, USA MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa University of Maryland, College Park, MD, USA
| | - Mark Collinson
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa Umeå Centre for Global Health Research, Umeå University, Sweden Migration, Urbanisation and Health Working Group, INDEPTH Network, Ghana
| | - F Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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46
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Hsu HC, Chang WC, Chong YS, An JS. Happiness and social determinants across age cohorts in Taiwan. J Health Psychol 2015; 21:1828-39. [PMID: 25609408 DOI: 10.1177/1359105314567208] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to examine happiness and social determinants across age cohorts in Taiwan. The data were obtained from the 2011 Taiwan Social Change Survey (aged 18 +, n = 2,199). The social determinants of happiness included socioeconomic status and social connection. Happiness was not different across the age groups. Receiving less family support, less formal support, more social trust and more control over life were significant for the younger group. Being married and having more social participation were significant for the middle-aged. Receiving less family support and having a higher economic status were significant for the older group.
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Affiliation(s)
- Hui-Chuan Hsu
- Asia University, Taiwan, Republic of China China Medical University, Taiwan, Republic of China
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47
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Salinas-Rodríguez A, Torres-Pereda MDP, Manrique-Espinoza B, Moreno-Tamayo K, Téllez-Rojo Solís MM. Impact of the non-contributory social pension program 70 y más on older adults' mental well-being. PLoS One 2014; 9:e113085. [PMID: 25409468 PMCID: PMC4237374 DOI: 10.1371/journal.pone.0113085] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 10/19/2014] [Indexed: 11/28/2022] Open
Abstract
Background In 2007, a non-contributory pension program was launched in rural areas of Mexico. The program consisted in a non-conditional cash transfer of US$40 monthly to all older adults (OA) aged 70 and over. We evaluate the effect of the program on mental well-being of its beneficiaries. Methods and Findings Quantitative and qualitative methods were used. For the quantitative component, we used the selection criteria established by the program (age and locality size) to form the Intervention (OA aged 70–74 residing in rural localities, <2500 inhabitants) and Control groups (OA aged 70–74, in localities with 2501–2700 inhabitants). Baseline data collection was conducted in 2007 where 5,465 OA were interviewed. The follow-up survey was conducted in 2008, and it was possible to interview 5,270 OA, with a response rate of 96%. A difference-in-difference linear probability model with individual fixed effect was used to estimate the impact of the program on mental well-being indicators. In 2009 a qualitative component was designed to explore possible causal pathways of such effect. Results After a year of exposure, the program had a significant effect on reduction of depressive symptoms (β = −0.06, CI95% −0.12; −0.01) and an increase in empowerment indicators: OA participated in important household decisions (β = 0.09, CI95% 0.03;0.15); and OA participated in household decisions pertaining to expenses (β = 0.11, CI95% 0.05;0.18). Qualitative analysis found a strong trend showing a reduction of sadness, and feeling of increasing empowerment. Conclusions These results suggest that a non-conditional transfer in older ages have an impact beyond the economic sphere, impacting even the mental well-being. This effect could be explained because the pension produces feelings of safety and welfare. It is recommendable that governments should invest efforts towards universalizing the non-contributory pension programs in order to ensure a basic income for the elderly.
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Affiliation(s)
- Aarón Salinas-Rodríguez
- Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Betty Manrique-Espinoza
- Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Mexico
- * E-mail:
| | - Karla Moreno-Tamayo
- Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Mexico
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Lloyd-Sherlock P, Agrawal S. Pensions and the health of older people in South Africa: is there an effect? THE JOURNAL OF DEVELOPMENT STUDIES 2014; 50:1570-1586. [PMID: 25535435 PMCID: PMC4271780 DOI: 10.1080/00220388.2014.936399] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Peter Lloyd-Sherlock
- Peter Lloyd-Sherlock, School of International Development, University of East Anglia, Norwich, UK, NR4 7TJ.
| | - Sutapa Agrawal
- Sutapa Agrawal, Public Health Foundation of India, Delhi, India.
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Nawrotzki RJ, Robson K, Gutilla MJ, Hunter LM, Twine W, Norlund P. Exploring the impact of the 2008 global food crisis on food security among vulnerable households in rural South Africa. Food Secur 2014; 6:283-297. [PMID: 26594259 PMCID: PMC4650887 DOI: 10.1007/s12571-014-0336-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Recurring food crises endanger the livelihoods of millions of households in developing countries around the globe. Owing to the importance of this issue, we explore recent changes in food security between the years 2004 and 2010 in a rural district in Northeastern South Africa. Our study window spans the time of the 2008 global food crises and allows the investigation of its impacts on rural South African populations. Grounded in the sustainable livelihood framework, we examine differences in food security trajectories among vulnerable sub populations. A unique panel data set of 8,147 households, provided by the Agincourt Health and Demographic Surveillance System (Agincourt HDSS), allows us to employ a longitudinal multilevel modeling approach to estimate adjusted growth curves for the differential change in food security across time. We observe an overall improvement in food security that leveled off after 2008, most likely resulting from the global food crisis. In addition, we discover significant differences in food security trajectories for various sub populations. For example, female-headed households and those living in areas with better access to natural resources differentially improved their food security situation, compared to male-headed households and those households with lower levels of natural resource access. However, former Mozambican refugees witnessed a decline in food security. Therefore, poverty alleviation programs for the Agincourt region should work to improve the food security of vulnerable households, such as former Mozambican refugees.
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Affiliation(s)
- Raphael J. Nawrotzki
- University of Colorado at Boulder, Institute of Behavioral Science, CU Population Center, U.S.A
| | - Kristin Robson
- University of Colorado at Denver, Colorado School of Public Health, Department of Environmental and Occupational Health, U.S.A
| | - Margaret J. Gutilla
- University of Colorado at Anschutz Medical Campus, Colorado School of Public Health, U.S.A
| | - Lori M. Hunter
- University of Colorado at Boulder, Institute of Behavioral Science, CU Population Center, U.S.A., University of Witwatersrand, School of Public Health, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), South Africa
| | - Wayne Twine
- University of the Witwatersrand, School of Animal, Plant and Environmental Sciences, South Africa
| | - Petra Norlund
- University of Colorado at Boulder, Department of Geography, U.S.A
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50
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Abstract
Linking household composition of older persons and material well-being is an important step toward understanding quality of life among elders in less developed settings. The association is particularly important in sub-Saharan Africa, given the poverty in the region. Ordinary least square regressions using data from 23 countries examine how age composition among all households and presence of offspring and grandchildren among older person households associates with a wealth index that is based on ownership of resources and housing characteristics, and whether the association is consistent across countries. Results indicate older-person-only households, and older persons with youth, have, generally, less wealth than households with other age compositions. Among older person households, those without offspring or grandchildren and skip-generation households fare worst in most countries. Findings highlight the importance of considering older persons households when assessing material well-being and chances of living in poverty in poor regions of the world.
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