Cohort Profile: Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI)

Abstract

Population ageing is a global phenomenon. The United Nations estimates that the world population aged over 60 will have increased 3-fold from 1950 to 2050, to reach 21% of the population. 1 This compositional shift is happening fastest in low-and middle-income countries (LMIC). 2 South Africa in particular is undergoing a dramatic demographic and epidemiological transition, and little is known about the socioeconomic determinants or consequences of transition. This study, following important findings in previous studies in Agincourt 3-6 and South Africa in general, 7-9 is set up to inform us about morbidity, mortality and aetiological factors shaping these trends. Various ageing studies, including the Studies on Global Ageing and Adult Health (SAGE) and the 2015 Global Burden of Disease, found that noncommunicable diseases, driven mainly by population growth and ageing, have become leading causes of death and disability globally, including in LMIC such as South Africa. 10-14 At the same time, the share of the population 60 and above in South Africa is estimated to increase from 7.8% in 2012 to 14.8% in 2050, 15 and the population aged 50 and over living with HIV will triple by 2040. 16 We established the cohort 'Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community' in South Africa (HAALSI) in the INDEPTH Health and Demographic Surveillance System (HDSS) site of Agincourt, as a harmonized sister study to the Health and Retirement Study (HRS) in the USA 17 and other similar studies worldwide, including ELSA in the UK, 18

Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for Phase 1 of the AWI-Gen population cross-sectional study

“…At the outset, the variables were harmonized with the HAALSI study [33], but they have now also been transformed for equivalence with the Cardiovascular H3Africa Innovation Resource (CHAIR) which includes approximately 53,000 individuals [73]. …”

“…This paper questionnaire was then administered to participants at five of the centres. At the sixth centre, Agincourt, the questionnaires were administered in an electronic format using a tablet to facilitate harmonization of the data with another ongoing study – ‘Health and Ageing in Africa: A Longitudinal Study in an INDEPTH Community’ (HAALSI) [33]. …”

Sociodemographic, socioeconomic, clinical and behavioural predictors of body mass index vary by sex in rural South African adults-findings from the AWI-Gen study

“…The sample was stratified by sex to achieve equal numbers of males and females. Participants were a subset of those who had been enrolled in Health and Ageing in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) [19]. Of the 2000 individuals selected for recruitment, 1465 agreed to participate.…”

Socioeconomic gradients in chronic disease risk behaviors in a population-based study of older adults in rural South Africa

“…Data were from baseline assessments collected in 2015 in “Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa” (HAALSI), a population-based study of 5,059 men and women aged ≥40 years in the Agincourt Health and Socio-Demographic Surveillance System (HDSS) area covering approximately 116,000 people residing in 31 villages in Mpumalanga province, South Africa (response rate = 85.9%) (Gómez-Olivé et al 2018). HAALSI is harmonized with the US Health and Retirement Study and other international cohort studies of aging (see: https://g2aging.org/).…”

“…HAALSI is harmonized with the US Health and Retirement Study and other international cohort studies of aging (see: https://g2aging.org/). The demographic profile of the Agincourt region population is typical of rural South Africa (Gómez-Olivé et al 2018). Although the social and economic situation of the region has improved since the end of Apartheid in 1994, the region has a history of systematic racism, poor infrastructure development, and low access to education, employment, and other economic opportunities (United Nations 1963; Christie and Collins 1982).…”