Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa

Sub-Saharan Africa is in the midst of a demographic and epidemiological transition. Although the HIV epidemic caused reductions in life expectancy in many countries, the increasing availability of antiretroviral treatment (ART) has begun to reverse the declines. Socioeconomic and health improvements—in addition to the scale-up of ART—have led to overall gains in life expectancy throughout the region. These population-level shifts and increased life expectancies have been accompanied by a rise in chronic disease. Adults throughout sub-Saharan Africa are now experiencing the onset of cardiovascular and metabolic diseases at unforeseen levels, and the burden of these diseases is projected to more than double over the next 20 years. Yet to date, little is understood about the nature of aging in the region. 

The Harvard Center for Population and Development Studies, in partnership with the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) 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. From 2014-2015, baseline survey interview and biomarker data were collected from a sample of men and women aged 40 and older. The grant was renewed in 2017 for a five-year period, and subsequent waves of data collection took place in 2018 and are scheduled for 2021. 

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:

By integrating the HAALSI data with cause of death data from the well-established INDEPTH Health and Demographic Surveillance System (HDSS) data at the MRC/Wits Agincourt research site, we explore the interrelationships between: 

physical & cognitive functioning • lifestyle risk factors • household income & expenditure • depression & mental health • social networks & family composition • HIV infection • cardiometabolic disease

The HAALSI study design is finely tuned to capture characteristics specific to the aging process in rural South Africa, as well as to harmonize with the Health and Retirement Study (HRS) and sister studies in India, China, Brazil, the UK, Europe, and the U.S. In this way, the HAALSI data provide a unique opportunity to compare the biological, social, and economic determinants of chronic diseases and their effects on functional and health outcomes in aging populations.

Homepage photo: Jan Truter on Flickr