The proposed work as an International Institute for Applied Systems Analysis (IIASA) Young Summer Scientist Program (YSSP) participant would extend the research by investigating the micro-level impact of social capital factors on the aging process by application of a novel methodological approach. The intellectual merit of the YSSP research collaboration with Warren Sanderson and Vegard Skirbekk is to address the fact that existing methodologies for multi-state life table (MSLT) calculation using longitudinal data are not able to incorporate time-varying covariates into analysis. In the context of sub-Saharan Africa (SSA), disaggregating individuals into meaningful sub-categories by time-invariant factors is difficult though age, sex, education, and regional differences may play a substantial role in the aging process, time-varying factors such as HIV status, presence of adult children (and their HIV status), marital status, and agricultural profits may also be important for healthy aging. MSLT models allow for the modeling of the complex processes of disablement and recovery inherent to the aging process, and generate expectancies of years lived in various categorizations of disability. Though not fully developed or widely used, Yang & Hall (2008) propose a potentially useful method of incorporating time-varying factors into a MSLT model using a simultaneous equations approach to limited dependent variable modeling. During the time at IIASA, the student would further develop and apply this method for incorporating time-varying covariates into MSLT calculation, and analyze how these covariates may reduce/delay disability onset and increase survivorship. The YSSP research will directly contribute to dissertation plans, as well as addressing a broader impact that is in substantial need of further research. Aging in SSA is an issue that will be of increasing importance in the near future--the population of adults aged 45+ will grow more rapidly in the next decades than that of any younger 10-year age group in many SSA countries, and currently available data suggest that mortality rates from chronic, disabling disease in SSA are higher than almost all other regions of the world (WHO 2005). Functional disability is an exceedingly important topic in rural communities of the developing world, where government-based social services may be lacking or nonexistent. Beyond the basics of population health, extremely little is known about processes of disability, morbidity, and mortality in these populations. Currently existing research on aging in the developing world has not been able to give a comprehensive overview of the transition pathways from healthy life to disability to death. The research will focus on how processes of aging and the development of functional disabilities play out in SSA. In particular, the focus would be on how these processes may differ by individual-level characteristics, something which has received very little previous research in this context. The primary aim of the proposed work is to remedy this blank area of our knowledge of health, disability, and the life course in SSA, both to contribute to the scholarly community and identify areas of need where donors/policymakers could effect change.

Project Report

The Role of Education in Adult Disability in a Lowest-Income Context Collin F. Payne University of Pennsylvania Email: collinp@sas.upenn.edu Introduction. A substantial body of contemporary research has found a strong relationship between formal education and adult health and mortality in the developed world. However, the form of the education-health relationship is less well known in developing settings, particularly in sub-Saharan Africa (SSA). Though the current age structure is quite young, the aging population in SSA will grow proportionately more rapidly than any other segment of the population (Fig. 1), and by 2060, persons aged 45+ will be about 25% of the total SSA population. By 2030, chronic non-communicable diseases are expected to cause 47% of deaths in Africa, compared with only 27% in 2008 (WHO 2008). Understanding the correlates of health among this growing population may provide useful information in predicting trends in health and the planning of health care provisions, particularly as the current health infrastructure in SSA is focused mainly on communicable disease and the younger population (Beard et al. 2012). Methodology. I use data from three waves of the Malawi Survey of Families and Households (MLSFH) to estimate annual probabilities of entering into physical disability and death by age, sex, and educational attainment. I then estimate the number of years that the average individual will live in active and disabled life by generating synthetic cohorts of individuals via microsimulation (Cai et al 2010), and analyzing the resulting disability trajectories. I test several exogenous factors that could confound the education-health relationship. Results/Conclusions. I find that individuals in SSA experience substantial disability and that individuals with more education are less likely to transition to disability and death. However, education is not significantly associated with recovery from stays in disability. Males with 4 or more years of education live on average 3 years longer than males with less than 4 years of education, with all of these additional years lived in active life (Fig. 2). Females with more education do not live longer overall, but do live proportionately more of their lives without disabilities. My findings show that increasing educational attainment in SSA could contribute substantially to increasing life expectancy and reducing the disability burden in this society. References UN Population Division. (2010) World population prospects, the 2010 revision: Standard (median) forecasts. United Nations, Department of Economic and Social Affairs, Population Division. WHO. (2005) Preventing Chronic Disease: A Vital Investment. (World Health Organization (WHO), Geneva, Swizerland). The estimates cited in the text reflect the 2008 online revision of the projections. Beard, J, Biggs, S, Bloom, D, Fried, L, Hogan, P, Kalache, A, & Olshansky, J. (2012) Global population ageing: Peril or promise? PGDAWorking Paper No. 89 (Global Agenda Council on Ageing Society). Cai L, Hayward MD, Saito Y, Lubitz J, Hagedorn A, Crimmins E. Estimation of multi-state life table functions and their variability from complex survey data using the SPACE Program. Demographic Research 2010 JAN 26;22:129-157

Agency
National Science Foundation (NSF)
Institute
Integrative and Collaborative Education and Research (IGERT)
Application #
1241147
Program Officer
Maria Uhle
Project Start
Project End
Budget Start
2012-06-01
Budget End
2012-11-30
Support Year
Fiscal Year
2012
Total Cost
$8,000
Indirect Cost
Name
Payne Collin F
Department
Type
DUNS #
City
Philadelphia
State
PA
Country
United States
Zip Code
19146