Aging in Sub-Saharan Africa Recommendations for Furthering Research (2006) / Chapter Skim
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8. HIV/AIDS and Older People in South Africa
8. HIV/AIDS and Older People in South Africa
Pages 250-275
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From page 250... ...
The survival of the apartheid system in South Africa long after decolonization of the rest of the continent and the economic advantages of the country mean that older South Africans live in a very different 250
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From page 251... ...
We begin by describing some of the more important social, demographic, and economic aspects of older people's lives in South Africa and then discuss the direct and indirect consequences of the HIV epidemic for them. The last section of the paper presents data on the living arrangements of older people in rural KwaZulu-Natal in South Africa and examines their households' experience of adult mortality, in particular AIDS mortality.
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From page 252... ...
The Apartheid Group Areas Act and the labor migration system systematically divided African families by recruiting younger men and women to the centers of employment, including mining, farming, and urban areas. Restrictions on the movement and settlement of those not employed meant that most children, unemployed younger adults, and older people were required to live in rural or periurban areas (Leliveld, 1997; Mazur, 1998; Spiegel, 1987)
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From page 253... ...
. The 1990-1991 Multidimensional Survey of Elderly South Africans found that older Africans living in rural areas experienced greater health and financial problems than other older people.
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From page 254... ...
Many older people also use this income to support the basic needs of their family, including food, clothing, and school fees for children. For many rural African households, the state pension and, to a lesser extent, other government grants are the main source of income.
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. However, the old age pension may have slowed the loss of social status and increasing marginalization of older people relative to younger generations that has been described in other countries undergoing substantial social change and economic development (Du Toit, 1994; Johnson, 1989)
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From page 256... ...
Most of the seroprevalence data on South Africa have been collected from pregnant women seen at government antenatal clinics. However, the national HIV prevalence survey conducted by the Human Sciences Research Council collected HIV data on a small number of people age 55 or more (Human Sciences Research Council, 2002)
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From page 257... ...
Both in South Africa and elsewhere in the African region, most studies examining the indirect impact of HIV/AIDS on older people have focused on the role of older people in caring for people with AIDS or their orphaned children, rather than on outcomes for the older people themselves, such as effects on their physical and mental health, economic status, or living arrangements. The role of older people in the care of relatives with AIDS has been relatively well documented.
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From page 258... ...
. A qualitative study of grandmothers caring for a child with HIV/AIDS as well as their grandchildren in townships in the Western Cape province of South Africa found that the cost of caring for the sick person (transport, medical bills)
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From page 259... ...
OLDER PEOPLE'S LIVING ARRANGEMENTS AND MORTALITY IN RURAL KWAZULU-NATAL Demographic surveillance systems (DSS) with longitudinal observations on individuals and households provide opportunities to measure the sociodemographic impact of the HIV epidemic.
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From page 260... ...
. Because of the importance of the old-age pension in South Africa for both pensioners and other members of their household, our analysis of older people's living arrangements focuses on those of pensionable age.
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From page 261... ...
households with members under age 18 but no adult members below pensionable age. Older people are included in the analysis only as an index individual in the household in which they are resident, but we analyze the composition both of the other residents and of everyone recognized as a member of the household.
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From page 262... ...
Noumbissi and Zuberi (2001) present estimates of the living arrangements of older people in South Africa based on census and Demographic and Health Survey data.
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72.8 (6.4) Marital Status Distribution (%)
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264 TABLE 8-2 Percentage Distribution of Households with Resident Members of Pensionable Age According to the Age Composition of Their Other Resident Members and of All Their Other Members, January 1, 2000 All Other Household Members Alone or with With With Younger With Other Resident Members Older People Only Younger Adults Adults and Children Children Only Total Alone or with older people 3 2 1 <1 6 With younger adults 0 6 2 0 8 With younger adults and children 0 0 77 0 77 With children only 0 0 7 2 9 Total 3 7 87 2 N = 3,657
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From page 265... ...
One would expect to find a high proportion of skipped-generation households in South African census data simply because, as Merli and Palloni (this volume, Chapter 4) note, many children "lose a parent" to migration.
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From page 266... ...
Died in 2000-2001 Membership of Household in 2002 Alone or With With Younger With Ended Membership of Only with Younger Adults and Children Membership/ Number of Household in 2000 Older People Adults Children Only Died Older Residents Alone or only with older people 74 0 0 0 26 113 With younger adults 5 75 1 0 20 241 With younger adults and children 0 3 84 1 12 2,609 With children only 12 7 19 52 10 84 Was not yet a member/age less than 60 4 11 83 2 0 459 All households with older residents 4 9 74 2 11 3,506
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From page 267... ...
3c All Households with Resident Members of Pensionable Age Membership of Household in 2002 Alone or With With Younger With Ended Membership of Only with Younger Adults and Children Membership/ Number of Household in 2000 Older People Adults Children Only Died Older Residents Alone or only with older people 74 0 0 0 26 113 With younger adults 6 73 1 0 20 271 With younger adults and children 0 3 84 1 12 3,180 With children only 12 7 19 52 10 84 Was not yet a member/age less than 60 4 10 84 2 0 528 All households with older residents 3 8 75 2 11 4,176 TABLE 8-4 Percentage Distribution According to Age of the Other Residents in 2002 in Households with Residents of Pensionable Age by Age of the Other Residents in 2000 Residential Composition of Household in 2002 Alone or With With Younger With Ended Residential Composition Only with Younger Adults and Children Membership/ Number of Household in 2000 Older People Adults Children Only Died Older Residents Alone or only with older people 81 0 1 0 18 233 With younger adults 9 69 0 0 22 302 With younger adults and children 1 3 83 2 12 2,790 With children only 6 4 22 59 9 323 Was not yet a member/age less than 60 9 11 72 8 0 527 All households with older residents 7 8 66 7 11 4,175 267
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From page 268... ...
DISCUSSION The ACDIS data reveal the high level of younger adult mortality that older people are facing in rural South Africa, even in most their immediate social sphere, with 20 percent of them experiencing such a death in their households in the 2-year period considered. Given the relatively short period of follow-up, longer term changes in the living arrangements of older people experiencing a death in their household late in the period have not been observed.
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From page 269... ...
Even prior to the HIV epidemic in South Africa, older people played an enormously important role in the care of children and the maintenance of rural households. However, it remains fairly unusual for a household with young children and older people not to include any of the children's parents, aunts, or uncles (i.e., the older person's adult children)
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From page 270... ...
Few surveys collect data on the morbidity, nutritional status, or mental health of older people. There are also limited data with which to assess wider impacts of the HIV epidemic on older people, such as stigmatization and isolation following AIDS deaths in their households, increased financial insecurity and increased workloads, and deterioration in the availability and quality of health and welfare services.
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From page 271... ...
In addition, the fluid nature of households, the limited involvement of most of them in agricultural production, and the stretching of household groups due to migration -- all of which developed in response to the political economy of apartheid -- give social networks and living arrangements in South Africa a degree of flexibility that benefits many older people when adverse advents occur, such as the death of an adult child. REFERENCES Adamchak, D.J., Wilson, A.O., Nyanguru, A., and Hampson, J
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From page 272... ...
. Multidimensional survey of elderly South Africans, 1990-1991: Key findings.
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From page 273... ...
. The effects of restrictive South African migrant labor policy on the sur vival of rural households in Southern Africa: A case study from rural Swaziland.
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From page 274... ...
. Getting by: Benefits of noncontributory pension income for older South African households.
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From page 275... ...
. The living arrangements of older adults in sub-Saharan Africa in a time of HIV/AIDS.
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