Gómez-Olivé, F. Xavier, Thorogood, Margaret, Bocquier, Phillippe, Mee, Paul, Kahn, Kathleen, Berkman, Lisa F. and Tollman, Stephen (2014) Social conditions and disability related to the mortality of older people in rural South Africa. International Journal of Epidemiology, Volume 43 (Number 5). pp. 1531-1541. doi:10.1093/ije/dyu093 ISSN 0300-5771.

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Abstract

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

Methods: Individual survey data and longer-term demographic data were used to describe factors associated with mortality. Individuals aged 50 years and over (n = 4085) answered a health and quality of life questionnaire in 2006 and were followed for 3 years thereafter. Additional vital events and socio-demographic data were extracted from the Agincourt Health and Demographic Surveillance System from 1993 to 2010, to provide longer-term trends in mortality. Cox regression analysis was used to determine factors related to survival.

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

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

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Mortality -- South Africa, Older people -- Mortality, People with disabilities -- Mortality
Journal or Publication Title:	International Journal of Epidemiology
Publisher:	Oxford University Press
ISSN:	0300-5771
Official Date:	October 2014
Dates:	Date Event October 2014 Published 15 May 2014 Available 26 March 2014 Accepted
Volume:	Volume 43
Number:	Number 5
Number of Pages:	11
Page Range:	pp. 1531-1541
DOI:	10.1093/ije/dyu093
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	28 December 2015
Date of first compliant Open Access:	28 December 2015
Funder:	National Institutes of Health (U.S.) (NIH), World Health Organization (WHO), Wellcome Trust (London, England), South African Medical Research Council, University of the Witwatersrand
Grant number:	1-P01-AG041710, 058893/Z/99/A (WT), 069683/Z/02/Z (WT)

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