The impact of adult mortality on household dissolution and migration in rural South Africa

OBJECTIVE: To investigate the effect of adult death on household dissolution and migration.DESIGN: Demographic surveillance of the population in a rural area of northern KwaZulu Natal, South Africa.METHODS: Data on households resident in the surveillance area on 1 January 2000 were used to examine the effect of adult mortality and household risk factors on household dissolution and mobility between January 2000 and October 2002. Cox regression models were used to assess the risk of household dissolution and migration, controlling for multiple risk factors including causes of death, household composition and household assets.RESULTS: By October 2002, 238 households (2%) had dissolved and 874 (8%) migrated out of the area; 21% (2179) of all households had at least one adult death (18 years and older). Households where one or more adult members died during the follow-up period were four times more likely to dissolve, after controlling for household and community level risk factors [4.3; 95% confidence interval, (CI), 3.3-5.7]. The risk of dissolution was significantly higher in households with multiple deaths (2.3; 95% CI, 1.3-4.3). There were no significant differential risks associated with cause of death, age or sex of the deceased. Adult mortality in the household was not associated with migration.CONCLUSIONS: Poorer households, as measured by asset ownership, and households trying to cope with adult deaths are vulnerable to dissolution. The dramatic increase in adult mortality attributable to AIDS will increase the number of households that do not survive as a functional and cohesive social group

How do epidemics induce behavioral changes?

Presented at GLOBELICS 2009, 7th International Conference, 6-8 October, Dakar, Senegal.Parallel session 2: Population, health and growthThis paper develops a theory of optimal fertility behavior under mortality shocks. In an OLG model, young adults determine their optimal fertility, labor supply and life-cycle consumption with both exogenous child and adult mortality risks. We show that a rise in adult mortality exerts an ambiguous effect on both net and total fertility in a general equilibrium framework, while child mortality shocks unambiguously lead to a rise in total fertility, leaving net fertility unchanged. We complement our theory with an empirical analysis using a sample of 39 Sub-Saharan African (SSA) countries over the 1980-2004 period, examining the overall effects of the child and adult mortality channels on both total and net fertility. We find child mortality to exert a robust, positive impact on total fertility but no impact on net fertility, whereas a rise in adult mortality is found to negatively influence both total and net fertility. Given the particular demographic profile of the HIV/AIDS epidemic (killing essentially young, active adults), we then conclude in favor of an unambiguous negative effect of the HIV/AIDS epidemic on net fertility in SS