New Approaches to Measuring Ageing in South Africa
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.
KeywordsAgeing Population groups Health expectancy Age-appropriate services Policy Life expectancy
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.
- 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
- 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
- Bloom, D. E. & Canning, D. (2004). Proceedings—Economic policy symposium. http://www.nber.org/papers/w10817. Accessed February 2017.
- City of Cape Town. (2010). Discussion paper: Demographics Scenario.Google Scholar
- Craig, J. (1994). Replacement level fertility and future population growth. Population Trends, Winter (78), 20–22.Google Scholar
- Dorrington, R. (2013). Alternative South African midyear estimates, 2013. Centre for Actuarial Research Monograph 13, University of Cape Town.Google Scholar
- Dorrington, R., Bradshaw, D., & Laubscher, R. (2014). Rapid mortality surveillance report 2012. Cape Town: South African Medical Research Council.Google Scholar
- Golaz, V., Nowik, L., & Sajoux, M. (2012). Africa, a Young but Ageing Continent. Population & Societies, 491.Google Scholar
- 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
- 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
- Kinsella, K., & Ferreira, M. (1997). Aging trends: South Africa. International Brief: U.S. Bureau of the Census.Google Scholar
- Kinsella, K., & Velkoff, V. (2001). An aging world: 2001 P95/01-1. Washington: US Government Printing Office: US Census Bureau.Google Scholar
- 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
- 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
- Malherbe, K. (2007). Older persons act: Out with the old and in the with the older? Law, Democracy & Development, 11(2001).Google Scholar
- 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
- 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
- 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.
- Robine, J.-M., Romieu, I., & Cambois, E. (1999). Health expectancy indicators. Bulletin of the World Health Organization, 77(2), 181–185.Google Scholar
- 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
- 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
- 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.
- 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
- 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
- Statistics South Africa. (2012a). Statisticial release (revised): Census 2011. Pretoria: South Africa.Google Scholar
- Statistics South Africa. (2012b). Cause of Death Certification: A Guide for Completing the Notice of Death/Stillbirth (DHA-1663). Pretoria: South Africa.Google Scholar
- Statistics South Africa. (2014a). Census 2011: Profile of older persons in South Africa. Pretoria: South Africa.Google Scholar
- Statistics South Africa. (2014b). Mortality and causes of death in South Africa, 2011: Findings from Death Notification. Pretoria: South Africa.Google Scholar
- Statistics South Africa. (2014c). Census 2011: Profile of persons with disabilities in South Africa. Pretoria: South Africa.Google Scholar
- The World Bank (2017). GINI index (World Bank estimate). http://databank.worldbank.org/data/Views/Metadata/MetadataWidget.aspx?Name=GINI%20index%20(World%20Bank%20estimate)&Code=SI.POV.GINI&Type=S&ReqType=Metadata&ddlSelectedValue=SAU&ReportID=43276&ReportType=Table. Accessed October 2017.
- 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
- 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
- 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
- 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
- UNDP. (2013). Human development report 2013: The rise of the south: Human progress in a diverse world. New York.Google Scholar
- WHO. (2016). Social determinants of health: Key concepts. http://www.who.int/social_determinants/thecommission/finalreport/key_concepts/en/. Accessed September 19, 2016.