The Meaning of Health in Rural South Africa Gender, the Life Course, and the Socioepidemiological Context

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 inclu...

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Bibliographic Details
Published in:Population and development review Vol. 48; no. 4; pp. 1061 - 1095
Main Authors: Mojola, Sanyu A., Ice, Erin, Schatz, Enid, Angotti, Nicole, Houle, Brian, Gómez-Olivé, F. Xavier
Format: Journal Article
Language:English
Published: New York Wiley 01.12.2022
Blackwell Publishing Ltd
Subjects:
Adults
Ageing
Aging
Biological markers
Biomarkers
Biometrics
Blood pressure
Chronic illnesses
Diabetes
Diabetes mellitus
Disease
Drugs
Epidemiology
Gender
Health
HIV
Human immunodeficiency virus
Hypertension
Interviews
Life course
Life history
Life transitions
Low income groups
Meaning
Older people
Polls & surveys
Qualitative analysis
Salience
Self evaluation
Surveys
Trend analysis
South Africa
ISSN:0098-7921, 1728-4457
Online Access:Get full text
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Summary: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.
Bibliography:Sanyu A. Mojola, Department of Sociology, School of Public and International Affairs and the Office of Population Research, Wallace Hall, Princeton University, Princeton, NJ 08544, USA and 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. Email
Erin Ice, Department of Sociology and Population Research Center, University of Michigan, Ann Arbor, MI, 4810, USA. Enid Schatz, Department of Public Health and Department of Women's & Gender Studies, University of Missouri, Columbia, MO 65211, USA and 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. Nicole Angotti, Department of Sociology, American University, Washington, DC 20016, USA and 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. Brian Houle, School of Demography, The Australian National University, Canberra, Australia and 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. F. Xavier Gόmez‐Olive, 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.
smojola@princeton.edu
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ISSN:0098-7921
1728-4457
DOI:10.1111/padr.12494