TY - JOUR
T1 - The Meaning of Health in Rural South Africa
T2 - Gender, the Life Course, and the Socioepidemiological Context
AU - Mojola, Sanyu A.
AU - Ice, Erin
AU - Schatz, Enid
AU - Angotti, Nicole
AU - Houle, Brian
AU - Gómez-Olivé, F. Xavier
N1 - Funding Information:
We thank all the respondents who participated in this study. We also thank the people of the Agincourt subdistrict for their long involvement with the Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit. We thank the Ha Na Kakelela and Izindaba za Badala/ HIV after 40 field and research teams. We are especially grateful to Samuel Clark as well as Jill Williams for significant contributions to the design, data collection, and intellectual underpinnings of the two projects respectively. This work was supported by the National Institute on Aging under Grant R01 AG049634—HIV after 40 in rural South Africa: Aging in the Context of an HIV epidemic (PI Sanyu Mojola); the National Institute on Aging under Grant R24 AG032112-05—Partnership for Social Science AIDS Research in South Africa's Era of ART Rollout (PI Jane Menken); the University of Colorado Innovative Seed Grant; the William and Flora Hewlett Foundation under Grant 2008-1840, and the Andrew W. Mellon Foundation. The MRC/Wits Rural Public Health and Health Transitions Research Unit and Agincourt Health and Socio-Demographic Surveillance System, a node of the South African Population Research Infrastructure Network (SAPRIN), is supported by the Department of Science and Innovation, the University of the Witwatersrand, and the Medical Research Council, South Africa, and previously the Wellcome Trust, UK under Grants 058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z; and 085477/B/08/Z. This work has also benefited from research, administrative, and computing support from the Office of Population Research (OPR) at Princeton University as well as the Wissenschaftskolleg zu Berlin. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
We thank all the respondents who participated in this study. We also thank the people of the Agincourt subdistrict for their long involvement with the Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit. We thank the field and research teams. We are especially grateful to Samuel Clark as well as Jill Williams for significant contributions to the design, data collection, and intellectual underpinnings of the two projects respectively. This work was supported by the National Institute on Aging under Grant R01 AG049634—HIV after 40 in rural South Africa: Aging in the Context of an HIV epidemic (PI Sanyu Mojola); the National Institute on Aging under Grant R24 AG032112‐05—Partnership for Social Science AIDS Research in South Africa's Era of ART Rollout (PI Jane Menken); the University of Colorado Innovative Seed Grant; the William and Flora Hewlett Foundation under Grant 2008‐1840, and the Andrew W. Mellon Foundation. The MRC/Wits Rural Public Health and Health Transitions Research Unit and Agincourt Health and Socio‐Demographic Surveillance System, a node of the South African Population Research Infrastructure Network (SAPRIN), is supported by the Department of Science and Innovation, the University of the Witwatersrand, and the Medical Research Council, South Africa, and previously the Wellcome Trust, UK under Grants 058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z; and 085477/B/08/Z. This work has also benefited from research, administrative, and computing support from the Office of Population Research (OPR) at Princeton University as well as the Wissenschaftskolleg zu Berlin. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Ha Na Kakelela and Izindaba za Badala/ HIV after 40
Publisher Copyright:
© 2022 The Authors. Population and Development Review published by Wiley Periodicals LLC on behalf of Population Council.
PY - 2022/12
Y1 - 2022/12
N2 - This article examines the meaning of health among middle-aged and older adults in a rural South African setting, where 72 percent of adults aged 40 and over are living with a major chronic condition, and 81 percent report good or very good health. We draw on a unique mixed-methods dataset that includes a population-based survey with disease biomarkers (hypertension, diabetes, HIV), self-assessments of health including self-rated health, functional ability and medication use, as well as nested qualitative life history interviews with survey participants including questions about lived experiences of health. We conduct survey trend analysis and ordinal logistic regression, as well as inductive and deductive coding of qualitative interviews, and triangulate findings across data sources. Overall, we find that self-rated health and functional ability are not associated with biometric disease indicators; however, we find that gendered familial expectations, life course stage, and the socioepidemiological context work together to regulate the salience of illness as people age. The study highlights the utility of research with multiple measures of health in illuminating the challenges of aging amidst the complex epidemiological transitions that increasingly characterize low- and middle-income countries.
AB - This article examines the meaning of health among middle-aged and older adults in a rural South African setting, where 72 percent of adults aged 40 and over are living with a major chronic condition, and 81 percent report good or very good health. We draw on a unique mixed-methods dataset that includes a population-based survey with disease biomarkers (hypertension, diabetes, HIV), self-assessments of health including self-rated health, functional ability and medication use, as well as nested qualitative life history interviews with survey participants including questions about lived experiences of health. We conduct survey trend analysis and ordinal logistic regression, as well as inductive and deductive coding of qualitative interviews, and triangulate findings across data sources. Overall, we find that self-rated health and functional ability are not associated with biometric disease indicators; however, we find that gendered familial expectations, life course stage, and the socioepidemiological context work together to regulate the salience of illness as people age. The study highlights the utility of research with multiple measures of health in illuminating the challenges of aging amidst the complex epidemiological transitions that increasingly characterize low- and middle-income countries.
KW - Ageing
KW - Gender
KW - Health
UR - http://www.scopus.com/inward/record.url?scp=85133690398&partnerID=8YFLogxK
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U2 - 10.1111/padr.12494
DO - 10.1111/padr.12494
M3 - Article
AN - SCOPUS:85133690398
SN - 0098-7921
VL - 48
SP - 1061
EP - 1095
JO - Population and Development Review
JF - Population and Development Review
IS - 4
ER -