The impact of the AIDS epidemic on the health of the elderly in Tanzania

Abstract

By the end of 1999, an estimated 24.5
\n million Africans were living with HIV/AIDS, accounting for
\n more that seventy percent of all global infections. In
\n Tanzania, an estimated 1.3 million people (of a total
\n population of 33 million) were believed to be infected with
\n HIV, and 140,000 had already died of AIDS. One in every 12
\n adults is infected. African couples have large families,
\n partly so there will be adult children to support parents in
\n old age. Instead, because of the AIDS epidemic, the elderly
\n are often caring for their infected children, or orphaned
\n grandchildren. The authors use longitudinal household data
\n from Tanzania's Kagera region, to measure the impact of
\n prime-age adult mortality on the level, and changes in
\n physical well-being (as measured by body mass index, or BMI)
\n of the elderly. They find that the elderly in non-poor
\n households have higher BMI. Non-poor households are more
\n likely to have an adult death, and the elderly in these
\n households are more likely to suffer declining BMI in the
\n months before the death of a prime-age adult. The elderly in
\n both poor, and non-poor households experience a significant
\n drop in BMI after an adult death, but BMI recovers over
\n time, and there is no long-run association with BMI levels,
\n and recent adult deaths. The elderly hit hardest are those
\n in households nor receiving private transfers. Private
\n transfers received by other household members raise the BMI
\n of the elderly, especially after a recent adult death. There
\n is no evidence that nongovernmental organizations, or public
\n assistance to the household affects short-run changes in
\n BMI. The elderly who have more living children are
\n physically better off, but short-run increases in the number
\n of teenagers in the household are associated with declines
\n in BMI. Improving the incomes, and assets of the poor is key
\n to improving the overall BMI of the elderly. The elderly who
\n have more assets (such as better quality dwellings) tend to
\n have higher BMI. Controlling for individual, and household
\n characteristics, the elderly in communities with roads that
\n are navigable year-round, have substantially higher BMI.
\n Prevention of communicable diseases is key to reducing
\n short-run fluctuations in BMI - through preventing HIV, and
\n community immunization programs that benefit the elderly.