Cardiovascular and metabolic disease burdens are projected to more than double over the next 20 years in Sub-Saharan Africa. While high rates of HIV prevalence have caused reductions in life expectancy in many countries, the increasing availability of antiretroviral treatment (ART) is beginning to reverse the declines. Little is understood about the nature of aging in the region, where life expectancies were relatively short even before the HIV epidemic. Today, overall gains in life expectancy due to socioeconomic and health improvements—as well as scale-up of ART—have meant that adults are now experiencing the onset of cardiovascular and metabolic diseases at unforeseen levels.
The Harvard Center for Population and Development Studies, in partnership with the University of Witwatersrand in South Africa, was awarded a P01 grant in 2013 from the National Institute on Aging to study the drivers and consequences of HIV and non-communicable diseases in an aging population in Agincourt, South Africa.
The Health and Aging Study in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) is led by an interdisciplinary team of collaborators from:
- Harvard T.H. Chan School of Public Health
- University of Witwatersrand in South Africa
- The INDEPTH Network, a global network of health and demographic surveillance systems based in Ghana
By surveying and testing a population-based cohort of Agincourt residents for HIV infection and cardiometabolic disease risk factors, and integrating that data with mortality data from the well-established INDEPTH Health and Demographic Surveillance System (HDSS) data at the MRC/Wits Agincourt research site, we aim to identify the determinants of ill health and disability and their effects on:
subjective well-being • household composition • household income & expenditure • labor force participation • physical & cognitive functioning
The study design used by HAALSI is finely tuned to capture characteristics specific to South Africa, as well as harmonize with other Health and Retirement Studies (HRS) in India, China, Brazil, the UK, Europe, and the U.S., providing a unique opportunity to conduct cross-country comparisons of the biological, social, and economic determinants of chronic diseases and their effects on functional and health outcomes in aging populations.
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