The elderly and AIDS: Coping strategies and health consequences in rural Tanzania

Abstract

The elderly are often especially likely to be adversely affected by the death from AIDS of prime-aged adults. The authors use a longitudinal survey of households from northwestern Tanzania in 1991-94 to compare the activities and wellbeing of the elderly in households before and after the death of a prime-aged adult with those of the elderly in households that did not experience the death of an adult. A significant proportion of adults suffering from AIDS return to their parents’ home shortly before death. Time spent by the elderly performing household chores rises following an adult’s death, and their participation in wage employment falls; no evidence is found of increased participation in farm work among the elderly. Evidence shows that the physical well-being of the elderly as measured by body mass index is reduced before the death of an adult relative but recovers thereafter. These results suggest that interventions to prevent a decline in well-being should be focused on the elderly in households with an AIDS patient during the period of illness. Finally, the physical well-being of the elderly in poor and better-off households prior to an adult’s death is compared with that of the elderly in the poorest households that did not experience the death of an adult. The comparison indicates clearly that the poor have the lowest body mass index. Thus, deaths of adults from AIDS are likely to have the largest adverse impacts on the elderly in poor households. A broader group of elderly poor people with pervasive low health status should also be the focus of public policy designed to improve the welfare of the elderly.

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