Age and Gender Differences in Social Network Composition and Social Support Among Older Rural South Africans: Findings From the HAALSI Study

Harling, Guy; Morris, Katherine; Manderson, Lenore; Perkins, Jessica M.; Berkman, Lisa F.

doi:10.1093/geronb/gby013

Cited by 62 publications

(71 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Women have longer life expectancy and, in this setting, are on average several years younger than their spouses. As a result, by age 80 years, less than 10% of women in this sample were living with a spouse, compared with more than 60% of men, and marital status has been shown to be highly predictive of social support ( Harling, Morris, et al, 2018 ). Some, but not all, studies from HICs have found a similar higher prevalence of unmet need among women ( Casado, van Vulpen, & Davis, 2011 ; Dubuc et al, 2011 ; Zhu, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

“…For each contact, participants reported frequency of contact and receipt of support. First, we calculated the number of person-days of in-person communication with others per month; second, we calculated the number of person-days of physical support received from others per month ( Harling, Morris, Manderson, Perkins, & Berkman, 2018 ). For analysis, we divided participants into ordered quartiles, as our interest was in the broad association of relative levels of support with need and care, rather than believing that each person-day reported was likely to have the same meaning to participants.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Impairment in Activities of Daily Living, Care Receipt, and Unmet Needs in a Middle-Aged and Older Rural South African Population: Findings From the HAALSI Study

et al. 2019

Self Cite

View full text Add to dashboard Cite

Objectives: The objective of this study is to analyze the degree to which care needs are met in an aging rural African population. Method: Using data from the Health and Aging in Africa: Longitudinal Study of an INDEPTH Community (HAALSI) baseline survey, which interviewed 5,059 adults aged older than 40 years in rural South Africa, we assessed the levels of limitations in activities of daily living (ADLs) and in unmet care for these ADLs, and evaluated their association with sociodemographic and health characteristics. Results: ADL impairment was reported by 12.2% of respondents, with the proportion increasing with age. Among those with ADL impairment, 23.9% reported an unmet need and 51.4% more a partially met need. Relatives provided help most often; formal care provision was rare. Unmet needs were more frequent among younger people and women, and were associated with physical and cognitive deficits, but not income or household size. Discussion: Unmet care needs in rural South Africa are often found among individuals less expected to require care.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Impairment in Activities of Daily Living, Care Receipt, and Unmet Needs in a Middle-Aged and Older Rural South African Population: Findings From the HAALSI Study

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Within these constructs culturally-dominant ideals of achievement, respectability and status contribute to shared age-related identities (25). Diversity of experiences informed by gender, power, class, place and time also influence and define multiple and continuous expressions of age within and across cultures (26)(27)(28).…”

Section: Theoretical Frameworkmentioning

confidence: 99%

‘Too old to test?’: A life course approach to HIV-related risk and self-testing among midlife-older adults in Malawi

Johnson

Kumwenda

Meghji

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Despite the aging HIV epidemic, increasing age can be associated with hesitancy to test. Addressing this gap is a critical policy concern and highlights the urgent need to identify the underlying factors, to improve knowledge of HIV-related risks as well as uptake of HIV testing and prevention services, in midlife-older adults.Methods We conducted five focus group discussions and 12 in-depth interviews between April 2013 and November 2016 among rural and urban Malawian midlife-older ( ≥ 30 years) men and women. Using a life-course theoretical framework we explored how social age is enacted and the implications for HIV testing and sexual risk behaviours. We also explore the potential for HIVST to be part of a broader strategy for engaging midlife-older adults in HIV testing, prevention and care. Thematic analysis was used to identify recurrent themes and variations.Results Life course and aging among midlife-older adults was associated with respectability and participants identified HIV as “a disease of youth” that would not affect them, with age protecting them against high sexual activity, infidelity and sexual risk-taking. HIV testing was felt to be stigmatizing, challenging age norms, threatening social status, and implying “lack of wisdom”. These norms drove self-testing preferences at home or other locations deemed age-gender appropriate. Awareness of the potential for long-standing undiagnosed HIV to be carried forward from past relationships was minimal, as was understanding of treatment-as-prevention. These norms led to HIV testing being perceived as a threat to status by older-adults, contributing to low levels of recent HIV testing in midlife-older adults compared to younger adults.Conclusions Characteristics associated with age-gender norms and social position encourage self-testing but drive poor HIV-risk perception and unacceptability of conventional HIV testing in midlife-older adults. There is an urgent need to provide targeted messages and services more appropriate to midlife-older adults in sub-Saharan Africa. HIVST which has often been highlighted as a tool for reaching young people, may be a valuable tool for engaging midlife-older age groups who may not otherwise test.

show abstract

“…After describing exposures and outcomes, we conducted multivariable regression using linear models for cognitive function Z-scores and Poisson models with robust variance structure for cognitive impairment (yes vs. no). All models were hierarchical, nesting respondents in interviewers, and adjusted for month of interview, since interviewer identity and interview month have previously been shown to systematically affect HAALSI social network responses (Harling, Perkins, et al, 2018). We began by assessing the association between binary cognitive impairment and monthly communication event count, first adjusting for respondents' age and gender, and then adding in turn: early life variables; current sociodemographics; and finally current health status.…”

Section: Discussionmentioning

confidence: 99%

“…If the respondent was married and living with their spouse, the spouse's name was added to the list of contacts ("alters") if not otherwise named. For each named alter, sociodemographic information (age, sex, kinship and residential location) was elicited, alongside frequency of communication and how frequently the alter provided emotional, informational, physical and financial support (Harling, Morris, Manderson, Perkins, & Berkman, 2018). Finally, respondents were asked how frequently they believed each named alter communicated with each other alter.…”

Section: Social Engagementmentioning

confidence: 99%

Social engagement and cognitive health in a population-based study of older men and women in rural South Africa

Harling¹,

Kobayashi²,

Farrell³

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

We investigated how patterns of social engagement and cognitive health in theHAALSI population-based study of over 5000 individuals aged ≥ 40 years in rural South Africafit with three existing theories of how social engagement and cognitive function areinterconnected in older age. We found that respondents with lower cognitive function hadsmaller, denser social networks that were more local and more kin-based than their peers.Lower cognitive function was associated with receipt of less social support in general, but thisdifference was stronger for emotional and informational than for financial and physicalsupport. These patterns suggest that cognitively impaired older adults in this setting rely ontheir core social networks for support, and that theories developed in higher-income andhigher-education settings may also apply elsewhere in the world.

show abstract

Age and Gender Differences in Social Network Composition and Social Support Among Older Rural South Africans: Findings From the HAALSI Study

Abstract: Marriage-related structural constraints impacted on older women's social networks in rural South Africa, but did not explain choice-based network contraction. These findings suggest that many older women in rural Africa, a growing population, may have an unmet need for social support.

Cited by 62 publications

References 40 publications

Impairment in Activities of Daily Living, Care Receipt, and Unmet Needs in a Middle-Aged and Older Rural South African Population: Findings From the HAALSI Study

Impairment in Activities of Daily Living, Care Receipt, and Unmet Needs in a Middle-Aged and Older Rural South African Population: Findings From the HAALSI Study

‘Too old to test?’: A life course approach to HIV-related risk and self-testing among midlife-older adults in Malawi

Social engagement and cognitive health in a population-based study of older men and women in rural South Africa

Contact Info

Product

Resources

About