Factors associated with the health and wellbeing of older people in a rural African setting

Gomez-Olive, Francesc Xavier

Factors associated with the health and wellbeing of older people in a rural African setting

dc.contributor.author	Gomez-Olive, Francesc Xavier
dc.date.accessioned	2015-03-27T08:36:12Z
dc.date.available	2015-03-27T08:36:12Z
dc.date.issued	2015-03-27
dc.description.abstract	Background South Africa is experiencing a massive HIV epidemic that together with the new epidemic of non-communicable diseases is directly affecting the health and wellbeing of older people. For policy makers, there is a crucial need for information on how this dual epidemic is evolving and how this may affect older people's health, mortality and health care needs. 2. Aims To better understand factors that influence the health, wellbeing and survival of older people, and their need for care in rural South Africa at a time of a growing dual epidemic of chronic diseases (non-communicable and communicable). To provide information which may assist in the planning of health services for older people. 3. Methods Applying the WHO Study on Global Ageing and Adult Health (SAGE) and a study on HIV and non-communicable diseases (NCD), we investigated the health, wellbeing and mortality of the population 50 years and older in the Agincourt sub-district in north-east South Africa which is underpinned by health and demographic surveillance. A random sample of the population 50 years and older was selected for the SAGE survey. A random sample of the population 15 years and older was selected for the HIV and NCD study. All available adults 50 plus were invited to participate in the SAGE module in the 2006 census round. We assessed self-reported health, anthropometric measures, blood pressure and HIV status using dried blood spots. Statistical analysis included simple frequencies, univariate and multivariate analysis and Cox proportional hazard models. 4. Findings The usual pattern of mortality, of increasing death rates with age, is not observed in this population, where those in their 50s have higher mortality compared to older age groups. The high prevalence of HIV in this age group (50 to 59) appears to be the main explanation for the observed pattern. Hypertension affects two thirds of this older population and, although there are no differences by gender, women are more aware of their condition. This is reflected in more women attending primary health care services. Reporting lower quality of life and greater disability are associated with higher likelihood of death. We observed gender differences in the process of ageing with women reporting higher prevalence of mortality risk factors but living longer than men, a phenomenon known as the "survival paradox".	en_ZA
dc.identifier.uri	http://hdl.handle.net/10539/17352
dc.language.iso	en	en_ZA
dc.subject	ageing
dc.subject	adult health
dc.subject	self-reported health
dc.subject	quality of life
dc.subject	disability
dc.subject	rural South Africa
dc.title	Factors associated with the health and wellbeing of older people in a rural African setting	en_ZA
dc.type	Thesis	en_ZA