New Approaches to Measuring Ageing in South Africa

Chapter

Abstract

Background and Significance of the topic: Health expectancy is generally expressed as life expectancy free of disability and is a useful tool for assessing the interaction between health, ill-health and mortality with age. The present study explores ageing trajectories using health expectancy for the four population subgroups in South Africa, namely Black African, Indian/Asian, Coloured (of mixed descent) and White. It provides a fresh look at ageing in South Africa with important implications for evidence-based long-term plans and policies to address the current and future needs of older persons. Methodology: Estimated health expectancy was determined using the Sullivan method which requires the use of data on both morbidity and mortality. Application/Relevance to systems analysis: Research on health variation in older persons across population groups is central to demographic systems, and helps to reveal the socioeconomic vulnerability of the older adult population. Policy and/or practice implications: The research informs potential areas for policy change relating to older adults and highlights the planning required to enable the provision of age-appropriate services. Discussion and conclusion: The present study is important because it showed population group heterogeneity which characteristically gets masked at national level. The data indicated that in addition to age and sex variations, there is a population group hierarchy in health expectancy. The findings also supported the “health-survival paradox” in disability free life expectancy and the general differences in health expectancy suggested in the study has implications for retirement ages, which is currently 60. The study has clear policy implications, one of them being the need for age-appropriate planning for health and social services.

Keywords

Ageing Population groups Health expectancy Age-appropriate services Policy Life expectancy 

Notes

Acknowledgements

This is a revised version of a paper written at the 2013/14 Southern African Young Scientists Summer Programme (SA-YSSP). The author therefore acknowledges the International Institute of Applied Systems Analysis, University of the Free State, South Africa’s National Research Foundation and Department of Science and Technology for co-ordinating and funding the SA-YSSP and Statistics South Africa for allowing access to the datasets used for the study. Many thanks also go to Warren C. Sanderson, Sergei Scherbov and Nancy Phaswana-Mafuya, who introduced the concept of new ways of measuring ageing during the programme and helped to conceptualise and develop the research, and to anonymous individuals for invaluable comments on earlier drafts of the paper. The views expressed in this paper are however, those of the author and do not represent any organisations or individuals mentioned here.

References

  1. Anderson, N. B., Bulatao, R. A., Cohen, B., & National Research Council. (U.S.). (2004). Critical perspectives on racial and ethnic differences in health in late life. National Academies Press.Google Scholar
  2. Bah, S. (1999). The making and unmaking of a national but stratified vital statistics system in the republic of South Africa and the new making of a more comprehensive vital statistics system. South African Journal of Demography, 2001, 45–50.Google Scholar
  3. Bloom, D. E. & Canning, D. (2004). Proceedings—Economic policy symposium. http://www.nber.org/papers/w10817. Accessed February 2017.
  4. Chirinda, W., & Chen, H. (2017). Comparative study of disability-free life expectancy across six low- and middle-income countries. Geriatr Gerontol Int, 17(4), 637–644.CrossRefGoogle Scholar
  5. Christopher, A. J. (2002). ‘To define the indefinable’: Population classification and the census in South Africa. Area, 34(4), 401–408.CrossRefGoogle Scholar
  6. City of Cape Town. (2010). Discussion paper: Demographics Scenario.Google Scholar
  7. Coovadia, H., Jewkes, R., Barron, P., Sanders, D., & McIntyre, D. (2009). The health and health system of South Africa: Historical roots of current public health challenges. The Lancet, 374(9692), 817–834.CrossRefGoogle Scholar
  8. Craig, J. (1994). Replacement level fertility and future population growth. Population Trends, Winter (78), 20–22.Google Scholar
  9. Dorrington, R. (2013). Alternative South African midyear estimates, 2013. Centre for Actuarial Research Monograph 13, University of Cape Town.Google Scholar
  10. Dorrington, R., Bradshaw, D., & Laubscher, R. (2014). Rapid mortality surveillance report 2012. Cape Town: South African Medical Research Council.Google Scholar
  11. Golaz, V., Nowik, L., & Sajoux, M. (2012). Africa, a Young but Ageing Continent. Population & Societies, 491.Google Scholar
  12. Goodrick, W., & Pelser, A. (2014). The Greying of a rainbow nation: Policy responses to the implications of population ageing in South Africa. African Population Studies: Supplement on Population Issues in South Africa, 28(1).CrossRefGoogle Scholar
  13. Imai, K., & Soneji, S. (2007). On the estimation of disability-free life expectancy. Journal of the American Statistical Association, 102(480), 1199–1211. https://www.ncbi.nlm.nih.gov/pubmed/26279593.MathSciNetCrossRefGoogle Scholar
  14. Jagger, C., Oyen, H. V., & Robine, J-M. (2014). Health expectancy calculation by the Sullivan method: A practical guide. Newcastle University Institute of Ageing.Google Scholar
  15. Khalfani, A. K., Zuberi, T., Bah, S., & Lehohla, P. J. (2005). Population statistics. In T. Zuberi, A. Sibanda, & E. Udjo (Eds.), The demography of South Africa (Vol.). New York: M.E. Sharpe.Google Scholar
  16. Kinsella, K., & Ferreira, M. (1997). Aging trends: South Africa. International Brief: U.S. Bureau of the Census.Google Scholar
  17. Kinsella, K., & Velkoff, V. (2001). An aging world: 2001 P95/01-1. Washington: US Government Printing Office: US Census Bureau.Google Scholar
  18. Madans, J., Loeb, M., & Altman, B. (2011). Measuring disability and monitoring the UN convention on the rights of persons with disabilities: The work of the Washington group on disability statistics. BMC Public Health, 11(4), 1–8.Google Scholar
  19. Makiwane, M., & Kwizera, S. A. (2006). An investigation of quality of life of the elderly in South Africa, with specific reference to Mpumalanga. Applied Research in Quality of life, 1(3–4), 297–313.Google Scholar
  20. Malherbe, K. (2007). Older persons act: Out with the old and in the with the older? Law, Democracy & Development, 11(2001).Google Scholar
  21. Mathers, C. D., Sadana, R., Salomon, J. A., Murray, C. J. L., & Lopez, A. D. (2001). Healthy life expectancy in 191 countries, 1999. The Lancet, 357(9269), 1685–1691.CrossRefGoogle Scholar
  22. Moultrie, T., & Dorrington, R. (2011). Used for Ill; used for good: A century of collecting data on race in South Africa. Ethnic and Racial Studies, 35(8), 1447–1465.CrossRefGoogle Scholar
  23. Moultrie, T., & Timaeus, I. (2002). Trends in South African fertility between 1970 and 1998: An analysis of the 1996 census and the 1998 demographic and health survey technical report. Cape Town: Burden of Disease Research Unit: Medical Research Council.Google Scholar
  24. Oksuzyan A., Juel K., Vaupel J. W., & Christensen, K. (2008). Men: good health and high mortality. Sex differences in health and aging. Aging Clinical and Experimental Research, 20(2), 91–102.CrossRefGoogle Scholar
  25. Phaswana-Mafuya, N., Peltzer, K., Chirinda, W., Kose, Z., Hoosain, E., Ramlagan, S., et al. (2013). Self-rated health and associated factors among older South Africans: Evidence from the study on global ageing and adult health. Global Health Action, 6, 10.CrossRefGoogle Scholar
  26. Ralston, M., Schatz, E., Menken, J., Gómez-Olivé, F. X., & Tollman, S. (2016). Who benefits—or does not—from South Africa’s old age pension? Evidence from characteristics of rural pensioners and non-pensioners. International Journal of Environmental Research and Public Health, 13(2001), 85.  https://doi.org/10.3390/ijerph13010085.CrossRefGoogle Scholar
  27. Ramashala, M. F. (2002). Living arrangements, poverty and the health of older persons in Africa. Department of Economic and Social Affairs. Population Division. United Nations. http://www.un.org/esa/population/publications/bulletin42_43/ramashala.pdf. Accessed February 2017.
  28. Robine, J.-M., Romieu, I., & Cambois, E. (1999). Health expectancy indicators. Bulletin of the World Health Organization, 77(2), 181–185.Google Scholar
  29. Sagner, A., Dowd, E. J., & Lowal, P. (2002). Defining “Old Age”. Markers of old age in Sub-Saharan Africa and the implications for crosscultural research. Technical report Commissioned by WHO Minimum Data Set (MDS) Project. WHO.Google Scholar
  30. Samson, M., & Kaniki, S. (2008). Social pensions as developmental social security for Africa. In D. Hailu, & F. V. Soares (Eds.), Cash transfers in Africa and Latin America: An overview. Brazil: International Poverty Centre.Google Scholar
  31. Samson, M., MacQuene, K., & Van Niekerk, I. (2006). Social grants, South Africa (Policy brief 1). https://www.odi.org/sites/odi.org.uk/files/odi-assets/publications-opinion-files/1688.pdf. Accessed February 2017.
  32. Shisana, O., Rehle, T., Simbayi, L., Zuma, K., Jooste, S., N, Z., et al. (2014). South African national Hiv prevalence, incidence and behaviour survey, 2012. Cape Town: South Africa: HSRC Press.Google Scholar
  33. Shoko, M., Collinson, M. A, Lefakane, L., Kahn, K., & Tollman, S. M. (2016). What can we learn about South African households by comparing the national Census 2011 with the Agincourt Health and Demographic surveillance system data in rural northeast Mpumalanga? African Population Studies 30(2).Google Scholar
  34. Statistics South Africa. (2012a). Statisticial release (revised): Census 2011. Pretoria: South Africa.Google Scholar
  35. Statistics South Africa. (2012b). Cause of Death Certification: A Guide for Completing the Notice of Death/Stillbirth (DHA-1663). Pretoria: South Africa.Google Scholar
  36. Statistics South Africa. (2014a). Census 2011: Profile of older persons in South Africa. Pretoria: South Africa.Google Scholar
  37. Statistics South Africa. (2014b). Mortality and causes of death in South Africa, 2011: Findings from Death Notification. Pretoria: South Africa.Google Scholar
  38. Statistics South Africa. (2014c). Census 2011: Profile of persons with disabilities in South Africa. Pretoria: South Africa.Google Scholar
  39. Sullivan, D. F. (1971). A single index of mortality and morbidity. HSMHA Health Reports, 86(4), 347–354.CrossRefGoogle Scholar
  40. Udjo, E. (2011). Workforce and retirement age: Modelling the impact of mandatory retirement age on the size of the workforce in tertiary sector organisations in South Africa. South African Journal of Labour Relations, 35(2).Google Scholar
  41. Udjo, E. (2014). Estimating the demographic parameters from the 2011 South African Population Census. Supplement on Population Issues in South Africa, 28(1).Google Scholar
  42. Udjo, E. (2017). Can estimating completeness of death registration be used as evidence of inaccuracy of population size estimates from a census? The Case of the 2011 South African Population Census. African Population Studies 31(1).Google Scholar
  43. Udjo, E., & van Aardt, C. (2012). Evaluating the demographic, economic and socioeconomic aspects of the 2011 South African Census. UNISA Bureau of Market Research.Google Scholar
  44. UNDP. (2013). Human development report 2013: The rise of the south: Human progress in a diverse world. New York.Google Scholar
  45. WHO. (2016). Social determinants of health: Key concepts. http://www.who.int/social_determinants/thecommission/finalreport/key_concepts/en/. Accessed September 19, 2016.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Statistics South Africa and School of Public HealthUniversity of the WitwatersrandJohannesburgSouth Africa

Personalised recommendations