Sub-Saharan Africa’s older population is projected to nearly double in size by 2030. At the same time, demographic changes have caused major shifts in the units primarily responsible for the care of older adults: the family and household. The purpose of this paper is to examine the relationship between household composition and health at older ages in rural Malawi. We use data from the Malawi Longitudinal Study of Families and Health (MLSFH), which contains detailed information on household and family structure, along with measures of mental and physical health (from the Short Form-12). We focus on several measures of living arrangements that are expected to be associated with health: overall household size, sex composition, and kin structure (based on co-residence with offspring and grandchildren). Results show that: (1) older women who co-reside with offspring have better mental and physical health compared to those living only with grandchildren; (2) older men who live in larger households or in households with a higher proportion of females have better physical health.

The connection between migration and health has long been established, but relatively little is known about this relationship for older persons, particularly in sub-Saharan Africa (SSA). In this paper we examine migration selection with regards to health status among older individuals in Malawi, by testing whether older migrants differ from non-migrants in health status before migration. To do so, we use data from the Malawi Longitudinal Study of Families and Health (MLSFH), a longitudinal panel dataset that includes a relatively large number of individuals at older ages. We focus on three measures: mental health, physical health, and HIV status. We find that the relationship between migration and health selection differs by gender. Older women who are HIV-positive are nearly ten times more likely to migrate compared to their HIV-negative counterparts. For men, those with better mental health are less likely to migrate in the future. These results suggest that, although research in some settings shows that migrants have better health before moving, some older migrants have worse health than their non-migrant peers, and may therefore add to the already-heavy burden on rural health centers in Africa.

The older population in sub-Saharan Africa is growing rapidly, but little is known about the migration patterns of older individuals in this setting. In this article, we identify the determinants of migration for older individuals in a rural African setting. To do so, we use rare longitudinal data with information for older individuals both before and after migration. We first identify premigration factors associated with moving in the future and then identify differences in characteristics between migrants and nonmigrants after migration. In addition to basic sociodemographic information, we examine differences between migrants and nonmigrants in land ownership, number of lifetime marriages, number of living offspring, previous migration experience, household size, social and religious participation, and religious affiliation. Results show that (a) migration in older age is related to marriage, health and HIV status, household size, and religion; (b) older women who are HIV-positive are more likely to move, and older men with better physical health are more likely to move; (c) older female migrants have worse postmigration physical health; and (d) the relationship between health and migration for older men disappears after migration.

No abstract