Stephen Tollman
Biographic Data
| ID | 274162 |
|---|---|
| NAME | Stephen Tollman |
| GIVEN NAMES | Stephen |
| FAMILY NAME | Tollman |
| SIGNATURE | TOLLMAN S |
| AFFILIATIONS | University of the Witwatersrand |
| ORCID | 0000-0003-0744-7588 |
| VERIFIED | Yes |
| TOTAL WORKS | 119 |
| TOTAL CITATIONS | 226 |
| AUTHOR COUNT | 119 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1990 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 9 |
Intergenerational Education and Late-life Cognitive Performance: A Comparison Between Rural Mexico and South Africa
The economic cost of outpatient primary care of adults with multimorbidity (HIV, diabetes, and hypertension) in rural South Africa
Sub-Saharan Africa (SSA) is experiencing an epidemiological transition where non-communicable diseases are becoming the leading cause of disability and mortality alongside infectious diseases such as HIV/AIDS. Multimorbidity, the coexistence of two or more long-term conditions, is increasing in SSA. However, the cost of managing multimorbidity is largely unknown. This study aimed to estimate the economic cost of public outpatient primary care for…
Changes in the provision and utilisation of health care services for chronic health conditions during the Covid-19 pandemic in rural northeast South Africa: An interrupted time series analysis
Background: The COVID-19 pandemic has impacted the provision and utilisation of health care services with varying magnitude across settings due to spatial temporal variation in the burden of COVID-19 cases and the roll-out of local COVID-19 response policies. This study assesses changes in the provision and utilisation of health care services for three major chronic health conditions (HIV/AIDS, hypertension, and diabetes) over the pre-COVID-19 an…
Associations between cohort derived dementia and Covid-19 serological diagnosis among older Black adults in rural South Africa
Objectives This study investigates the association between cohort derived dementia and serologically confirmed SARS-CoV-2 infection, an underexplored phenomena in low-and middle-income countries. Examining this relationship in a rural South African community setting offers insights applicable to broader healthcare contexts. Methods Data were collected from Black South Africans in the Mpumalanga province who participated in the Health and Aging in…
Leadership, cohesion, and stress in primary care facilities and retention in chronic care in rural northeast South Africa before and during the Covid-19 pandemic: A longitudinal study
Background: Human immunodeficiency virus (HIV) and hypertension are major contributors to morbidity and mortality in South Africa. Effective management of these conditions is critical to population health, yet patient management and retention varies by facility for reasons that are not fully understood. We assessed whether measures of clinic leadership, cohesion, and stress were associated with retention for HIV and hypertension in a cohort of pa…
Indirect effects of Covid-19 on maternal and child health in South Africa
BACKGROUND: The unfinished burden of poor maternal and child health contributes to the quadruple burden of disease in South Africa with the direct and indirect effects of the COVID-19 pandemic yet to be fully documented. OBJECTIVE: To investigate the indirect effects of COVID-19 on maternal and child health in different geographical regions and relative wealth quintiles. METHODS: We estimated the effects of COVID-19 on maternal and child health f…
The adolescent HIV executive function and drumming (Ahead) study, a feasibility trial of a group drumming intervention amongst adolescents with HIV
AHEAD feasibility trial assessed the feasibility and acceptability of an 8-session group drumming programme aiming to improve executive function, depression and anxiety symptoms, and perceived social support in adolescents living with HIV in a rural low-income South African setting. Sixty-eight 12- to 19-year-old adolescents participated. They were individually randomised. The intervention arm (n = 34) received weekly hour-long group drumming ses…
Disease awareness and healthcare utilization in rural South Africa: A comparative analysis of HIV and diabetes in the Haalsi cohort
Our results suggest that older adult PLHIV may visit public clinics more often than their HIV-negative counterparts but spend similarly on a per-visit basis. This provides preliminary evidence that the positive health outcomes observed among PLHIV in rural South Africa may be explained by different healthcare engagement patterns. Through our illustrative comparison between PLHIV and diabetics, we show that shifting disease burdens towards chronic…
Estimating the Prevalence of over- and Under-Reporting in HIV Testing, Status and Treatment in Rural Northeast South Africa: A Comparison of a Survey and Clinic Records
Essential health services delivery in South Africa during Covid-19: Community and healthcare worker perspectives
Background: Between May 2020 and February 2022, South Africa's health system bore strain as it battled mitigating the coronavirus pandemic. The country's pandemic response was scrutinized. This period also brought into focus pre-existing shortcomings in the healthcare system and its governing bodies. Contextually, there is a paucity in literature on the experiences of healthcare providers and users. This study aimed to contribute information on C…
Covid-19 vaccine hesitancy in rural South Africa: Deepening understanding to increase uptake and access
Background: To date, COVID-19 vaccine coverage in the African region falls far too short of global goals. Increasing vaccination rates requires understanding barriers to vaccination so that effective interventions that sensitively and effectively address barriers to vaccination can be implemented. Methods: To assess COVID-19 vaccination levels and identify major barriers to vaccine uptake we conducted a population-based, cross-sectional survey am…
Burden of mortality linked to community-nominated priorities in rural South Africa
BACKGROUND: Community knowledge is a critical input for relevant health programmes and strategies. How community perceptions of risk reflect the burden of mortality is poorly understood. OBJECTIVE: To determine the burden of mortality reflecting community-nominated health risk factors in rural South Africa, where a complex health transition is underway. METHODS: Three discussion groups (total 48 participants) representing a cross-section of the c…
The double-edged role of accessed status on health and well-being among middle- and older-age adults in rural South Africa: The Haalsi study
Supporting social capital theory, we find that having higher accessed status is associated with better health and well-being for older adults in a setting with limited formal support resources. However, the explanatory power of both theories appears to depending on other key factors, such as gender and network size, highlighting the importance of contextualizing theories in practice
Long-term household material socioeconomic resources and cognitive health in a population-based cohort of older adults in rural northeast South Africa, 2001–2015
Material resources owned by households that affect daily living conditions may be salient for cognitive health during aging, especially in low-income settings, but there is scarce evidence on this topic. We investigated relationships between long-term trends in household material resources and cognitive function among older adults in a population-representative study in rural South Africa. Data were from baseline interviews with 4580 adults aged …
We Were Afraid”: Mental Health Effects of the Covid-19 Pandemic in Two South African Districts
The impacts of pandemics are recognized to go beyond infection, physical suffering, and socio-economic disruptions. Other consequences include psychological responses. Using a mental wellbeing lens, we analyzed COVID-19-related stressors in healthcare workers (HCWs) and community members who provided and regularly accessed health services in South Africa, respectively. From February to September 2021, during the second COVID-19 wave we conducted …
Estimating the burden of cardiovascular risk in community dwellers over 40 years old in South Africa, Kenya, Burkina Faso and Ghana
INTRODUCTION: Cardiovascular disease (CVD) risk factors are increasing in sub-Saharan Africa. The impact of these risk factors on future CVD outcomes and burden is poorly understood. We examined the magnitude of modifiable risk factors, estimated future CVD risk and compared results between three commonly used 10-year CVD risk factor algorithms and their variants in four African countries. METHODS: In the Africa-Wits-INDEPTH partnership for Genom…
Validation of Oxford Cognitive Screen: Executive Function (OCS‐EF), a tablet‐based executive function assessment tool amongst adolescent females in rural South Africa
Short, reliable, easily administered executive function (EF) assessment tools are needed to measure EF in low‐ and middle‐income countries, particularly in sub‐Saharan Africa given the prevalence of human immunodeficiency virus (HIV)‐associated neurocognitive disorder. We administered Oxford Cognitive Screen—Executive Function (OCS‐EF) to 932 rural South African females (mean age 19.7 years). OCS‐EF includes seven tasks: two hot inhibition tasks …
Adolescents’ understanding of obesity: A qualitative study from rural South Africa
BACKGROUND: Levels of obesity are rising in South Africa, notably among adolescent females. Excessive energy-dense diets and physical inactivity are among the factors contributing to this increase. Given that these factors are largely behavioural, understanding young people's views of obesity can contribute to more targeted behavioural interventions. Yet little is known of how rural South African adolescents view obesity. OBJECTIVES: The aim of t…
Mortality transition over a quarter century in rural South Africa: Findings from population surveillance in Agincourt 1993-2018
BACKGROUND: Mortality burden in South Africa since the mid-1990s has been characterized by a quadruple disease burden: HIV/AIDS and tuberculosis (TB); other communicable diseases (excluding HIV/AIDS and TB), maternal causes, perinatal conditions and nutritional deficiencies; non-communicable diseases (NCDs); and injuries. Causes from these broad groupings have persistently constituted the top 10 causes of death. However, proportions and rankings …
The relationship between executive function, risky behaviour and HIV in young women from the HPTN 068 study in rural South Africa
Executive function (EF) may predict sexual risk-taking and HIV risk in young women in rural South Africa. We tested associations between EF and seven risky behavioural outcomes: binge drinking, illicit substance use, unprotected vaginal sex, concurrent sexual relationships, transactional sex, herpes simplex virus type 2 (HSV-2) infection, and HIV infection. We compared EF in young women with HIV to matched controls. 1080 young women underwent cog…
Internal migration and health in South Africa: Determinants of healthcare utilisation in a young adult cohort
Migrants and non-migrants in the study population in South Africa were found to utilise health services differently, both in overall use and in the type of healthcare consulted. The study helps improve upon the limited stock of knowledge on how migrants interface with healthcare systems in low and middle-income country settings. Findings can assist in guiding policies and programmes to be directed more effectively to the populations most in need,…
Alcohol Consumption and Sexual Risk Behavior in an Aging Population in Rural South Africa
Older Adults Vastly Overestimate Both HIV Acquisition Risk and HIV Prevalence in Rural South Africa
Perceptions of HIV acquisition risk and prevalence shape sexual behavior in sub-Saharan Africa (SSA). We used data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa baseline survey. Data were collected through home-based interviews of 5059 people ≥ 40 years old. We elicited information on perceived risk of HIV acquisition and HIV prevalence among adults ≥ 15 and ≥ 50 years old. We first describe the…
Time-critical conditions: Assessment of burden and access to care using verbal autopsy in Agincourt, South Africa
Background: Time-critical conditions (TCC) are estimated to cause substantial mortality in low and middle-income countries. However, quantification of deaths and identification of contributing factors to those deaths are challenging in settings with poor health records. Aim: To use verbal autopsy (VA) data from the Agincourt health and sociodemographic surveillance system in rural South Africa to quantify the burden of deaths from TCC and to eval…
The impact of HIV status on the distance traveled to health facilities and adherence to care. A record-linkage study from rural South Africa
BACKGROUND: For people living with HIV (PLWH), the burden of travelling to a clinic outside of one's home community in order to reduce the level of stigma experienced, may impact adherence to treatment and accelerate disease progression. METHODS: This study is set in the Agincourt Health and Demographic Surveillance System (HDSS) in South Africa. Probabilistic and interactive methods were used to individually link HDSS data with medical records. …
The impact of pensions on health and wellbeing in rural South Africa: Does gender matter
Assessing Changes in Household Socioeconomic Status in Rural South Africa, 2001-2013: A Distributional Analysis Using Household Asset Indicators
Children's residence patterns and educational attainment in rural South Africa, 1997
Using data collected by the Agincourt Health and Population Programme in a rural sub-district of South Africa's Northern Province, this paper describes the residential arrangements of a population in rural South Africa, and analyses the impact of these arrangements on children's educational attainment. Children with co-resident parents generally have higher levels of schooling than those who have one or no co-resident parents. However, having a f…
Premarital Fertility in Rural South Africa: A Challenge to Existing Population Policy
The age pattern of fertility in a rural area of South Africa under demographic surveillance (Agincourt subdistrict) was investigated over the 1992–97 period. The total fertility rate (TFR) averaged 3.3 births per woman of reproductive age over the period, a major drop from earlier estimates in the same area (6.0 births in 1970–74). Age‐specific fertility rates showed an atypical bimodal pattern. They were decomposed into two components of similar…
Trends in Internal Labour Migration from Rural Limpopo Province, Male Risk Behaviour, and Implications for the Spread of HIV/Aids in Rural South Africa
Given improvements in the transport infrastructure and the end of travel restrictions characteristic of the apartheid period, there could be a reasonable expectation that male risk behaviour in sexual relations would be reduced as rural-urban connections were enhanced. Using the example of Limpopo Province, South Africa, this research draws on an existing demographic surveillance system and a specialised survey to test the hypothesis. We find tha…
Public health initiatives in South Africa in the 1940s and 1950s: Lessons for a post-apartheid era
Inspiration drawn from South African public health initiatives in the 1940s played an important role in the development of the network of community and migrant health centers in the United States. The first such center at Pholela in Natal emphasized the need for a comprehensive (preventive and curative) service that based its practices on empirical data derived from epidemiological and anthropological research. In addition, community consultation…
Community oriented primary care: Origins, evolution, applications
Childhood deprivation and later-life cognitive function in a population-based study of older rural South Africans
Let's Talk about Sex, Maybe: Interviewers, Respondents, and Sexual Behavior Reporting in Rural South Africa
Researchers are often skeptical of sexual behavior surveys: Respondents may lie or forget details of their intimate lives, and interviewers may exercise authority in how they capture responses. We use data from a 2010-2011 cross-sectional sexual behavior survey in rural South Africa to explore who says what to whom about their sexual lives. Results show an effect of fieldworker age across outcomes: Respondents report "safer," more "responsible" s…
Understanding Marital and Premarital Fertility in Rural South Africa
The age pattern of fertility in a rural area of South Africa under health and demographic surveillance (Agincourt subdistrict) was investigated over the 1992–1997 period. The total fertility rate (number of children born, on average, to the women of this population) averaged 3.3 over the period, a major drop from earlier estimates in the same area (6.0 in 1970–1974). Age-specific fertility rates showed an atypical bimodal pattern composed of two …
The age pattern of increases in mortality affected by HIV: Bayesian fit of the Heligman-Pollard Model to data from the Agincourt HDSS field site in rural northeast South Africa
BACKGROUND: We investigate the sex-age-specific changes in the mortality of a prospectively monitored rural population in South Africa. We quantify changes in the age pattern of mortality in a parsimonious way by estimating the eight parameters of the Heligman-Pollard (HP) model of age-specific mortality. In its traditional form this model is difficult to fit and does not account for uncertainty. OBJECTIVE: 1. To quantify changes in the sex-age p…
Use of applied theatre in health research dissemination and data validation: A pilot study from South Africa
This article reports on a pilot study of the use of applied theatre in the dissemination of health research findings and validation of data. The study took place in South Africa, as part of the Southern Africa Stroke Prevention Initiative (SASPI) and was based at the University/Medical Research Council Rural Public Health and Health Transitions Research Unit (also known as the Agincourt Unit). The aim of SASPI was to investigate the prevalence of…
Social contact, social support, and cognitive health in a population-based study of middle-aged and older men and women in rural South Africa
The patterns we found suggest that cognitively impaired older adults in this setting rely on their core social networks for support, and that theories relating to social connectedness and cognitive function developed in higher-income and higher-education settings may also apply in lower-resource settings elsewhere
Cognitive Function in Low-Income and Low-Literacy Settings: Validation of the Tablet-Based Oxford Cognitive Screen in the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in So…
The OCS-Plus represents a major methodological advance in dementia studies in LMICs, and enhances understanding of cognitive aging
Rural Poverty Dynamics and Refugee Communities in South Africa: A Spatial–Temporal Model
The assimilation of refugees into their host community economic structures is often problematic. The paper investigates the ability of refugees in rural South Africa to accumulate assets over time relative to their host community. Bayesian spatial-temporal modelling was employed to analyse a longitudinal database that indicated that the asset accumulation rate of former Mozambican refugee households was similar to their host community; however, t…
Roots, Shoots, but Too Little Fruit: Assessing the Contribution of Copc in South Africa
Community-oriented primary care (COPC) originated in South Africa during the 1940s and 1950s, where it served to inform local church-based and nongovernmental organization–based initiatives during the apartheid years. During the 1990s, COPC played an inspirational role in the process of national health policy formulation. Yet COPC’s contribution to current health practice remains more symbolic than substantive. Despite a policy framework that fav…
Rethinking collaboration: Developing a learning platform to address under-five mortality in Mpumalanga province, South Africa
Following 50 years of apartheid, South Africa introduced visionary health policy committing to the right to health as part of a primary health care (PHC) approach. Implementation is seriously challenged, however, in an often-dysfunctional health system with scarce resources and a complex burden of avoidable mortality persists. Our aim was to develop a process generating evidence of practical relevance on implementation processes among people excl…
Unpacking Self-Rated Health and Quality of Life in Older Adults and Elderly in India: A Structural Equation Modelling Approach
Impact of supplemental immunisation activity (SIA) campaigns on health systems: Findings from South Africa
BACKGROUND: Supplemental immunisation activity (SIA) campaigns provide children with an additional dose of measles vaccine and deliver other child health interventions including vitamin A supplements, deworming medications and oral polio vaccines. They also require the mobilisation of a large health workforce. We assess the impact of the implementation of SIA campaigns on selected routine child and maternal health services in South Africa (SA). M…
The epidemiology of ‘bewitchment’ as a lay-reported cause of death in rural South Africa
BACKGROUND: Cases of premature death in Africa may be attributed to witchcraft. In such settings, medical registration of causes of death is rare. To fill this gap, verbal autopsy (VA) methods record signs and symptoms of the deceased before death as well as lay opinion regarding the cause of death; this information is then interpreted to derive a medical cause of death. In the Agincourt Health and Demographic Surveillance Site, South Africa, aro…
The Links between Legal Status and Environmental Health: A Case Study of Mozambican Refugees and Their Hosts in the Mpumalanga (Eastern Transvaal) Lowveld, South Africa
This article relates the legal status of Mozambicans in South Africa from 1985 onwards to key findings of a demographic census taken in 1992, an environmental health survey conducted in 1993, and in-depth fieldwork in some of the surveyed settlements in 1995. The case study area on the border with Mozambique is typical of South Africa's rural former homelands, with the exception that it has a large and long-standing refugee population. The enviro…
Impairment in Activities of Daily Living, Care Receipt, and Unmet Needs in a Middle-Aged and Older Rural South African Population: Findings From the Haalsi Study
Objectives: The objective of this study is to analyze the degree to which care needs are met in an aging rural African population. Method: Using data from the Health and Aging in Africa: Longitudinal Study of an INDEPTH Community (HAALSI) baseline survey, which interviewed 5,059 adults aged older than 40 years in rural South Africa, we assessed the levels of limitations in activities of daily living (ADLs) and in unmet care for these ADLs, and ev…
Quality of integrated chronic disease care in rural South Africa: User and provider perspectives
The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the qualit…
Evaluating Reporting Heterogeneity in Self-Rated Health Among Adults Aged 50 Years and Above in India: An Anchoring Vignettes Analytic Approach
Our study provides strong evidence of RH in self-rated mobility and cognition. We highlight the need to formally test basic assumptions before using vignettes to adjust self-rating responses for RH
Planning professional education at schools of public health
OBJECTIVES. Professional education in public health should equip graduates with adequate knowledge and skills to manage diverse and complex problems. How best to address this challenge is widely debated. We describe the Harvard School of Public Health's self-evaluation and development of a practice-oriented program. METHODS. As part of Harvard's schoolwide review of the master of public health (MPH), self-administered questionnaires were distribu…
Health maintenance organizations in developing countries: What can we expect
Health maintenance organizations (HMOs) are a relatively new and alternative means of providing health care, combining a risk-sharing (insurance) function with health service provision. Their potential for lowering costs has attracted great interest in the USA and elsewhere, and has raised questions regarding their applicability to other settings. Little attention, however, has been given to critically reviewing the experience with HMOs in other …
Community oriented primary care: Origins, evolution, applications
Planning professional education at schools of public health
OBJECTIVES. Professional education in public health should equip graduates with adequate knowledge and skills to manage diverse and complex problems. How best to address this challenge is widely debated. We describe the Harvard School of Public Health's self-evaluation and development of a practice-oriented program. METHODS. As part of Harvard's schoolwide review of the master of public health (MPH), self-administered questionnaires were distribu…
Public health initiatives in South Africa in the 1940s and 1950s: Lessons for a post-apartheid era
Inspiration drawn from South African public health initiatives in the 1940s played an important role in the development of the network of community and migrant health centers in the United States. The first such center at Pholela in Natal emphasized the need for a comprehensive (preventive and curative) service that based its practices on empirical data derived from epidemiological and anthropological research. In addition, community consultation…
The Links between Legal Status and Environmental Health: A Case Study of Mozambican Refugees and Their Hosts in the Mpumalanga (Eastern Transvaal) Lowveld, South Africa
This article relates the legal status of Mozambicans in South Africa from 1985 onwards to key findings of a demographic census taken in 1992, an environmental health survey conducted in 1993, and in-depth fieldwork in some of the surveyed settlements in 1995. The case study area on the border with Mozambique is typical of South Africa's rural former homelands, with the exception that it has a large and long-standing refugee population. The enviro…
Premarital Fertility in Rural South Africa: A Challenge to Existing Population Policy
The age pattern of fertility in a rural area of South Africa under demographic surveillance (Agincourt subdistrict) was investigated over the 1992–97 period. The total fertility rate (TFR) averaged 3.3 births per woman of reproductive age over the period, a major drop from earlier estimates in the same area (6.0 births in 1970–74). Age‐specific fertility rates showed an atypical bimodal pattern. They were decomposed into two components of similar…
Understanding Marital and Premarital Fertility in Rural South Africa
The age pattern of fertility in a rural area of South Africa under health and demographic surveillance (Agincourt subdistrict) was investigated over the 1992–1997 period. The total fertility rate (number of children born, on average, to the women of this population) averaged 3.3 over the period, a major drop from earlier estimates in the same area (6.0 in 1970–1974). Age-specific fertility rates showed an atypical bimodal pattern composed of two …
Roots, Shoots, but Too Little Fruit: Assessing the Contribution of Copc in South Africa
Community-oriented primary care (COPC) originated in South Africa during the 1940s and 1950s, where it served to inform local church-based and nongovernmental organization–based initiatives during the apartheid years. During the 1990s, COPC played an inspirational role in the process of national health policy formulation. Yet COPC’s contribution to current health practice remains more symbolic than substantive. Despite a policy framework that fav…
Children's residence patterns and educational attainment in rural South Africa, 1997
Using data collected by the Agincourt Health and Population Programme in a rural sub-district of South Africa's Northern Province, this paper describes the residential arrangements of a population in rural South Africa, and analyses the impact of these arrangements on children's educational attainment. Children with co-resident parents generally have higher levels of schooling than those who have one or no co-resident parents. However, having a f…
Use of applied theatre in health research dissemination and data validation: A pilot study from South Africa
This article reports on a pilot study of the use of applied theatre in the dissemination of health research findings and validation of data. The study took place in South Africa, as part of the Southern Africa Stroke Prevention Initiative (SASPI) and was based at the University/Medical Research Council Rural Public Health and Health Transitions Research Unit (also known as the Agincourt Unit). The aim of SASPI was to investigate the prevalence of…
Trends in Internal Labour Migration from Rural Limpopo Province, Male Risk Behaviour, and Implications for the Spread of HIV/Aids in Rural South Africa
Given improvements in the transport infrastructure and the end of travel restrictions characteristic of the apartheid period, there could be a reasonable expectation that male risk behaviour in sexual relations would be reduced as rural-urban connections were enhanced. Using the example of Limpopo Province, South Africa, this research draws on an existing demographic surveillance system and a specialised survey to test the hypothesis. We find tha…
Research into health, population and social transitions in rural South Africa: Data and methods of the Agincourt Health and Demographic Surveillance System1
Rationale for study: Vital registration is generally lacking in infrastructurally weak areas where health and development problems are most pressing. Health and demographic surveillance is a response to the lack of a valid information base that can provide high-quality longitudinal data on population dynamics, health, and social change to inform policy and practice. Design and measurement procedures: Continuous demographic monitoring of an entire…
Returning home to die: Circular labour migration and mortality in South Africa 1
Aim: To examine the hypothesis that circular labour migrants who become seriously ill while living away from home return to their rural homes to convalesce and possibly to die. Methods: Drawing on longitudinal data collected by the Agincourt health and demographic surveillance system in rural northeastern South Africa between 1995 and 2004, discrete time event history analysis is used to estimate the likelihood of dying for residents, short-term …
Migration, settlement change and health in post-apartheid South Africa: Triangulating health and demographic surveillance with national census data1
Background: World population growth will be increasingly concentrated in the urban areas of the developing world; however, some scholars caution against the oversimplification of African urbanization noting that there may be ``counterurbanization'' and a prevailing pattern of circular rural—urban migration. The aim of the paper is to examine the ongoing urban transition in South Africa in the post-apartheid period, and to consider the health and …
A cross-sectional study of vascular risk factors in a rural South African population: Data from the Southern African Stroke Prevention Initiative (Saspi)
We found a high prevalence of hypertension, obesity in women, and a suggestion of subclinical atheroma despite relatively favourable cholesterol levels in a rural South African population. South Africa is facing the challenge of an emerging epidemic of vascular disease. Research to establish the social determinates of these risk factors and interventions to reduce both individual and population risk are required
The implications of long term community involvement for the production and circulation of population knowledge
Demographic surveillance systems (DSS) depend on community acceptance and involvement to produce high quality longitudinal data. Ensuring community support also exposes power relations usually concealed in the research process. We discuss the Agincourt Health and Demographic Surveillance System in South Africa to argue that: 1) long-term presence and community involvement contribute to high response rates and data quality, 2) to maintain communit…
The burden of non-communicable diseases in South Africa
Space and time clustering of mortality in rural South Africa (Agincourt HDSS), 1992–2007
BACKGROUND: Detailed information regarding the spatial and/or spatial-temporal distribution of mortality is required for the efficient implementation and targeting of public health interventions. OBJECTIVES: Identify high risk clusters of mortality within the Agincourt subdistrict for targeting of public health interventions, and highlight areas for further research. DESIGN: Mortality data were extracted from the Agincourt health and socio-demogr…
Assessing health and well-being among older people in rural South Africa
BACKGROUND: The population in developing countries is ageing, which is likely to increase the burden of non-communicable diseases and disability. OBJECTIVE: To describe factors associated with self-reported health, disability and quality of life (QoL) of older people in the rural northeast of South Africa. DESIGN: Cross-sectional survey of 6,206 individuals aged 50 and over. We used multivariate analysis to examine relationships between demograph…
Assessing a population's exposure to heat and humidity: An empirical approach
BACKGROUND: It is widely accepted that assessing the impact of heat on populations is an important aspect of climate change research. However, this raises questions about how best to measure people's exposure to heat under everyday living conditions in more detail than is possible by relying on nearby sources of meteorological data. OBJECTIVE: This study aimed to investigate practical and viable approaches to measuring air temperature and humidit…
Health inequalities among older men and women in Africa and Asia: Evidence from eight Health and Demographic Surveillance System sites in the INDEPTH WHO-Sage Study
BACKGROUND: Declining rates of fertility and mortality are driving demographic transition in all regions of the world, leading to global population ageing and consequently changing patterns of global morbidity and mortality. Understanding sex-related health differences, recognising groups at risk of poor health and identifying determinants of poor health are therefore very important for both improving health trajectories and planning for the heal…
Improving public health training and research capacity in Africa: A replicable model for linking training to health and socio-demographic surveillance data
BACKGROUND: Research training for public health professionals is key to the future of public health and policy in Africa. A growing number of schools of public health are connected to health and socio-demographic surveillance system field sites in developing countries, in Africa and Asia in particular. Linking training programs with these sites provides important opportunities to improve training, build local research capacity, foreground local h…
Ageing and adult health status in eight lower-income countries: The INDEPTH WHO-Sage collaboration
BACKGROUND: Globally, ageing impacts all countries, with a majority of older persons residing in lower- and middle-income countries now and into the future. An understanding of the health and well-being of these ageing populations is important for policy and planning; however, research on ageing and adult health that informs policy predominantly comes from higher-income countries. A collaboration between the WHO Study on global AGEing and adult h…
Young and vulnerable: Spatial-temporal trends and risk factors for infant mortality in rural South Africa (Agincourt), 1992-2007
This study demonstrates the use of Bayesian geostatistical models in assessing risk factors and producing smooth maps of infant mortality risk in a health and socio-demographic surveillance system. Results showed marked geographical differences in mortality risk across a relatively small area. Prevention of vertical transmission of HIV and survival of mothers during the infants' first year in high prevalence villages needs to be urgently addresse…
The prevalence of stunting, overweight and obesity, and metabolic disease risk in rural South African children
The study highlights that in transitional societies, early stunting and adolescent obesity may co-exist in the same socio-geographic population. It is likely that this profile relates to changes in nutrition and diet, but variation in factors such as infectious disease burden and physical activity patterns, as well as social influences, need to be investigated. As obesity and adult short stature are risk factors for metabolic syndrome and Type 2 …
Medicine (108 works) · Environmental health (78 works) · Demography (65 works) · Population (61 works) · Public health (48 works) · Gerontology (46 works) · Geography (42 works) · Global Maternal and Child Health (35 works) · Sociology (34 works) · Economic growth (29 works)