The impact of pensions on health and wellbeing in rural South Africa: Does gender matter?
ABSTRACT Unique to Africa, a means-tested non-contributory pension is available to South Africans. In 2006, women over 60 and men over 65 were pension-eligible. To explore the effect of the pension for health and wellbeing indicators of rural South African men and women, we analyze data from the WHO-INDEPTH Study of Global Ageing and Adult Health Survey, carried out in the Agincourt sub-district by the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) in 2006. Because pension receipt was not measured directly, our findings represent intent-to-treat (ITT) rather than treatment-on-the-treated (TOT) effects using age as an indicator for intent-to-treat. Overall, women report poorer wellbeing compared to men. However, women have a "honeymoon" period at ages 60-64, the first years of pension-eligibility, in which they report lower levels of worry and sadness, and higher overall happiness, life satisfaction, and quality of life as compared to younger and older women. For men, in contrast, reports of wellbeing worsen in the pre-pension years, followed by a similar but not as prominent pattern of favorable reports in the five years following pension-eligibility, and a decline in the next five-year period. Thus, while pensions continue to enhance financial wellbeing, our results suggest that their effect on social wellbeing may be gendered and transitory. Further research is needed to improve understanding of these dynamics.
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ABSTRACT: To investigate the apparently incongruous coupling of poor physical functioning with high QoL. Face-to-face interview survey of random sample of 999 people aged 65+ across Britain. Twenty-one per cent of respondents reported fairly to very severe levels of functional difficulty, and 62% of these rated their QoL as 'good'. Better self-rated health, lower burden of chronic disease, not having fallen, higher social engagement and higher levels of perceived control ver life, distinguished between people who had difficulties with physical functioning and who perceived their QoL to be 'good', rather than 'not good'. The open-ended survey responses broadly supported the quantitative findings. People with difficulties with physical functioning, who perceived their QoL to be 'not good', as opposed to 'good', were adversely affected by a higher burden of disease and having fewer socio-psychological resources to help them to cope effectively.Age and Ageing 06/2007; 36(3):310-5. · 3.82 Impact Factor
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ABSTRACT: To use a multidisciplinary approach to describe the prevalence, lay beliefs, health impact, and treatment of hypertension in the Agincourt sub-district. A multidisciplinary team used a range of methods including a cross-sectional random sample survey of vascular risk factors in adults aged 35 years and older, and rapid ethnographic assessment. People who had suffered a stroke were identified by a screening questionnaire followed by a detailed history and examination by a clinician to confirm the likely diagnosis of stroke. Workshops were held for nurses working in the local clinics and an audit of blood pressure measuring devices was carried out. Some 43% of the population 35 and over had hypertension. There was no relationship with gender but a strong positive relationship with age. Illnesses were classified by the population as being either African, with personal or social causes, or White/Western, with physical causes. The causes of hypertension were stated to be both physical and social. Main sources of treatment were the clinics and hospitals but people also sought help from churches and traditional healers. Some 84% of stroke survivors had evidence of hypertension. Few people received treatment for hypertension, although good levels of control were achieved in some. Barriers to providing effective treatment included unreliable drug supply and unreliable equipment to measure blood pressure. Hypertension is a major problem among older people in Agincourt. There is potential for effective secondary prevention. The potential for primary prevention is less clear. Further information on diet is required.Scandinavian journal of public health. Supplement 09/2007; 69:52-9. · 1.44 Impact Factor
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ABSTRACT: This article analyses old-age security policy in South Africa within the wider context of social policy in twentieth-century South Africa. It focuses on old-age pensions as the major part of welfare provision for the elderly. Two main questions are addressed (1) Why did South Africa introduce old-age pensions for aged white elderly in 1928 and why did it broaden the system to include Africans in 1944? (2) What were the main economic and social consequences of this law, especially for Africans in rural communities, with particular reference to the mid-century Eastern Cape? It is argued that South African old-age pension policy was, inter alia , shaped by three factors: (1) capitalist industrialisation mediated by the character of existing public social provision and with regard to Africans segregationist policies; (2) cultural and ideological shifts; (3) class politics. As a consequence of state initiative, from an early stage, pension money became decisive for the economic survival of many African rural households and contributed indirectly to the increased self-respect and social status of African old-age pensioners. The linking of old-age pensions to chronological age did not lead to the emergence of old age as a chronologically-defined stage of life because pre industrial life-course models organised around the notion of 'building the umzi (homestead)' were still very much alive. Finally, it is argued that from its inception, the South African state welfare policy had some ageist aspects to it. The article concludes that the political economy approach to ageing cannot fully account for the complexities of the ageing experience in South Africa.Journal of Southern African Studies 08/2000; 26(3):523-553. · 0.46 Impact Factor