Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-18T16:23:12.614Z Has data issue: false hasContentIssue false

Receipt of emotional support among rural South African adults

Published online by Cambridge University Press:  06 December 2018

Elyse A. Jennings*
Affiliation:
Center for Population and Development Studies, T.H. Chan Harvard School of Public Health, Boston, MA, USA
Nolwazi Mkhwanazi
Affiliation:
Wits Institute for Social and Economic Research, University of the Witwatersrand, Johannesburg, South Africa
Lisa Berkman
Affiliation:
Center for Population and Development Studies, T.H. Chan Harvard School of Public Health, Boston, MA, USA MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
*
*Corresponding author. Email: [email protected]

Abstract

As the world undergoes rapid ageing, informal support from friends and relatives is becoming especially important among older adults in middle- and low-income countries, where formalised social protections may be limited. We use new data from a cohort of adults aged 40 and older in rural South Africa to explore how receipt of emotional support differs by gender and marital status. Our findings suggest that women are more likely to get emotional support than men and have more sources of support. Moreover, women are more likely to get emotional support from relatives, whereas men are more likely to get support from friends. In regard to marital status, married people are more likely to get emotional support and have more sources of support than people who are not married. However, separated/divorced and widowed people are more likely to get emotional support from relatives and have more sources of non-spousal support than married people. These findings point towards gaps in informal systems of support, and the particular importance of considering men and unmarried (especially never-married) people when designing policies to offer social protections to older populations.

Type
Article
Copyright
Copyright © Cambridge University Press 2018

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Acharya, B, Maru, D, Schwarz, R, Citrin, D, Tenpa, J, Hirachan, S, Basnet, M, Thapa, P, Swar, S, Halliday, S, Kohrt, B, Luitel, NP, Hung, E, Gauchan, B, Pokharel, R and Ekstrand, M (2017) Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal. Globalization and Health 13, 2, 17.CrossRefGoogle ScholarPubMed
Amoateng, AY, Heaton, TB and Kalule-Sabiti, I (2007) Families and Households in Post-Apartheid South Africa: Socio-demographic Perspectives. Cape Town: HSRC Press.Google Scholar
Amoateng, AY, Richter, L, Makiwane, M and Rama, S (2004) Describing the Structure and Needs of Families in South Africa: Towards the Development of a National Policy Framework for Families (Report commissioned by the Department of Social Development). Pretoria, South Africa: Child Youth and Family Development, Human Sciences Research Council.Google Scholar
Antonucci, TC and Akiyama, H (1987 a) An examination of sex differences in social support among older men and women. Sex Roles 17, 737749.CrossRefGoogle Scholar
Antonucci, TC and Akiyama, H (1987 b) Social networks in adult life and a preliminary examination of the convoy model. Journal of Gerontology 42, 519527.CrossRefGoogle Scholar
Arling, G (1987) Strain, social support, and distress in old age. Journal of Gerontology 42, 107113.CrossRefGoogle ScholarPubMed
Aseltine, RH and Kessler, RC (1993) Marital disruption and depression in a community sample. Journal of Health and Social Behavior 34, 237251.CrossRefGoogle Scholar
Berkman, LF, Melchior, M, Chastang, J-F, Niedhammer, I, Leclerc, A and Goldberg, M (2004) Social integration and mortality: a prospective study of French employees of Electricity of France–Gas of France, The GAZEL Cohort. American Journal of Epidemiology 159, 167174.CrossRefGoogle ScholarPubMed
Berkman, LF and Syme, SL (1979) Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. American Journal of Epidemiology 109, 186204.CrossRefGoogle ScholarPubMed
Budlender, D, Chobokoane, N and Simelane, S (2004) Marriage patterns in South Africa: methodological and substantive issues. Southern African Journal of Demography 9, 125.Google Scholar
Cacioppo, JT, Hughes, ME, Waite, LJ, Hawkley, LC and Thisted, RA (2006) Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychology and Aging 21, 140151.CrossRefGoogle ScholarPubMed
Carr, D and Bodnar-Deren, S (2009) Gender, aging and widowhood. In Uhlenberg, P (ed.), International Handbook of Population Aging. Dordrecht, The Netherlands: Springer, pp. 705728.CrossRefGoogle Scholar
Carstensen, LL (1992) Social and emotional patterns in adulthood: support for socioemotional selectivity theory. Psychology and Aging 7, 331338.CrossRefGoogle ScholarPubMed
Clark, S and Brauner-Otto, S (2015) Divorce in sub-Saharan Africa: are unions becoming less stable? Population and Development Review 41, 583605.CrossRefGoogle Scholar
Collinson, MA (2010) Striving against adversity: the dynamics of migration, health and poverty in rural South Africa. Global Health Action 3, 5080.CrossRefGoogle ScholarPubMed
Collinson, MA, Tollman, SM and Kahn, K (2007) Migration, settlement change and health in post-apartheid South Africa: triangulating health and demographic surveillance with national census data. Scandinavian Journal of Public Health 35, 7784.CrossRefGoogle Scholar
Cornwell, B (2012) Spousal network overlap as a basis for spousal support. Journal of Marriage and Family 74, 229238.CrossRefGoogle ScholarPubMed
Cornwell, EY and Waite, LJ (2009) Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior 50, 3148.CrossRefGoogle ScholarPubMed
Cotten, SR (1999) Marital status and mental health revisited: examining the importance of risk factors and resources. Family Relations 48, 225233.CrossRefGoogle Scholar
Duflo, E (2003) Grandmothers and granddaughters: old-age pensions and intrahousehold allocation in South Africa. The World Bank Economic Review 17, 125.CrossRefGoogle Scholar
Eaton, J, McCay, L, Semrau, M, Chatterjee, S, Baingana, F, Araya, R, Ntulo, C, Thornicroft, G and Saxena, S (2011) Scale up of services for mental health in low-income and middle-income countries. The Lancet 378, 15921603.CrossRefGoogle ScholarPubMed
Filmer, D and Pritchett, LH (2001) Estimating wealth effects without expenditure data – or tears: an application to educational enrollments in states of India. Demography 38, 115132.Google ScholarPubMed
Garenne, ML, Tollman, SM, Collinson, MA and Kahn, K (2007) Fertility trends and net reproduction in Agincourt, rural South Africa, 1992–2004. Scandinavian Journal of Public Health 35, 6876.CrossRefGoogle Scholar
Geldsetzer, P, Vaikath, M, Wagner, R, Rohr, JK, Montana, L, Gómez-Olivé, FX, Rosenberg, MS, Manne-Goehler, J, Mateen, FJ, Payne, CF, Kahn, K, Tollman, SM, Salomon, JA, Gaziano, TA, Bärnighausen, T and Berkman, LF (2019) Depressive symptoms and their relation to age and chronic diseases among middle-aged and older adults in rural South Africa. Journals of Gerontology: Biological Sciences and Medical Sciences 74, 957963. https://doi-org.ezp-prod1.hul.harvard.edu/10.1093/gerona/gly145Google Scholar
Gerstel, N, Riessman, CK and Rosenfield, S (1985) Explaining the symptomatology of separated and divorced women and men: the role of material conditions and social networks. Social Forces 64, 84101.CrossRefGoogle Scholar
Gómez-Olivé, FX, Montana, L, Wagner, RG, Kabudula, CW, Rohr, JK, Kahn, K, Bärnighausen, T, Collinson, M, Canning, D, Gaziano, T, Salomon, JA, Payne, CF, Wade, A, Tollman, SM and Berkman, L (2018) Cohort profile: Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI). International Journal of Epidemiology 47, 689690j.CrossRefGoogle Scholar
Gomez-Olive, FX, Thorogood, M, Bocquier, P, Mee, P, Kahn, K, Berkman, L and Tollman, S (2014) Social conditions and disability related to the mortality of older people in rural South Africa. International Journal of Epidemiology 43, 15311541.CrossRefGoogle ScholarPubMed
Grimes, CE, Bowman, KG, Dodgion, CM and Lavy, CBD (2011) Systematic review of barriers to surgical care in low-income and middle-income countries. World Journal of Surgery 35, 941950.CrossRefGoogle ScholarPubMed
Gupta, S, Pattillo, CA and Wagh, S (2009) Effect of remittances on poverty and financial development in sub-Saharan Africa. World Development 37, 104115.CrossRefGoogle Scholar
Hamoudi, A and Thomas, D (2014) Endogenous coresidence and program incidence: South Africa's old age pension. Journal of Development Economics 109, 3037.CrossRefGoogle ScholarPubMed
Harling, G, Perkins, JM, Gómez-Olivé, FX, Morris, K, Wagner, RG, Montana, L, Kabudula, CW, Bärnighausen, T, Kahn, K and Berkman, L (2018) Interviewer-driven variability in social network reporting: results from Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community (HAALSI) in South Africa. Field Methods 30, 140154.CrossRefGoogle ScholarPubMed
Hawkley, LC and Cacioppo, JT (2010) Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine 40, 218227.CrossRefGoogle ScholarPubMed
Hawkley, LC, Thisted, RA, Masi, CM and Cacioppo, JT (2010) Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults. Psychology and Aging 25, 132141.CrossRefGoogle ScholarPubMed
Herm, A, Anson, J and Poulain, M (2016) Living arrangements and marital status: a register-based study of survival of older adults in Belgium at the beginning of the 21st century. Ageing & Society 36, 21412162.CrossRefGoogle Scholar
Holt-Lunstad, J, Smith, TB and Layton, JB (2010) Social relationships and mortality risk: a meta-analytic review. PLOS Medicine 7. https://doi.org/10.1371/journal.pmed.1000316CrossRefGoogle ScholarPubMed
House, JS (1987) Social support and social structure. Sociological Forum 2, 135146.CrossRefGoogle Scholar
Isherwood, LM, King, DS and Luszcz, MA (2017) Widowhood in the fourth age: support exchange, relationships and social participation. Ageing & Society 37, 188212.CrossRefGoogle Scholar
Iwelunmor, J, Airhihenbuwa, CO, Okoror, TA, Brown, DC and Belue, R (2006) Family systems and HIV/AIDS in South Africa. International Quarterly of Community Health Education 27, 321335.CrossRefGoogle ScholarPubMed
Jahan, S (2016) Human Development Report 2016: Human Development for Everyone. New York, NY: United Nations.Google Scholar
Kabudula, CW, Tollman, S, Mee, P, Ngobeni, S, Silaule, B, Gómez-Olivé, FX, Collinson, M, Kahn, K and Byass, P (2014) Two decades of mortality change in rural northeast South Africa. Global Health Action 7, 25596.CrossRefGoogle ScholarPubMed
Kahn, K, Garenne, ML, Collinson, MA and Tollman, SM (2007) Mortality trends in a new South Africa: hard to make a fresh start. Scandinavian Journal of Public Health 35, 2634.CrossRefGoogle Scholar
Kalmijn, M (2003) Shared friendship networks and the life course: an analysis of survey data on married and cohabiting couples. Social Networks 25, 231249.CrossRefGoogle Scholar
Kim, B, Park, S and Antonucci, TC (2016) Longitudinal changes in social networks, health and wellbeing among older Koreans. Ageing & Society 36, 19151936.CrossRefGoogle Scholar
Kinsella, K and Phillips, DR (2005) Global Aging: The Challenge of Success. Population Bulletin. Washington, DC: Population Reference Bureau.Google Scholar
Kiral, K, Yetim, Ü, Özge, A and Aydin, A (2017) The relationships between coping strategies, social support and depression: an investigation among Turkish care-givers of patients with dementia. Ageing & Society 37, 167187.CrossRefGoogle Scholar
Knodel, J and Ofstedal, MB (2003) Gender and aging in the developing world: where are the men? Population and Development Review 29, 677698.CrossRefGoogle Scholar
Kon, ZR and Lackan, N (2008) Ethnic disparities in access to care in post-apartheid South Africa. American Journal of Public Health 98, 22722277.CrossRefGoogle ScholarPubMed
Lachman, ME and Agrigoroaei, S (2010) Promoting functional health in midlife and old age: long-term protective effects of control beliefs, social support, and physical exercise. PLOS ONE 5, e13297.CrossRefGoogle ScholarPubMed
Lehohla, PJ (2011) Marriages and Divorces. Statistical Release P0307. Pretoria: Statistics South Africa.Google Scholar
Levitt, MJ, Guacci-Franco, N and Levitt, JL (1993) Convoys of social support in childhood and early adolescence: structure and function. Developmental Psychology 29, 811818.CrossRefGoogle Scholar
Lloyd-Sherlock, P (2000) Old age and poverty in developing countries: new policy challenges. World Development 28, 21572168.CrossRefGoogle Scholar
Madhavan, S and Gross, M (2013) Kin in daily routines: time use and childrearing in rural South Africa. Journal of Comparative Family Studies 44, 175191.CrossRefGoogle ScholarPubMed
Madhavan, S, Schatz, E and Clark, B (2009) Effect of HIV/AIDS-related mortality on household dependency ratios in rural South Africa, 2000–2005. Population Studies 63, 3751.CrossRefGoogle ScholarPubMed
Manderson, L and Block, E (2016) Relatedness and care in Southern Africa and beyond. Social Dynamics 42, 205217.CrossRefGoogle Scholar
Matt, GE and Dean, A (1993) Social support from friends and psychological distress among elderly persons: moderator effects of age. Journal of Health and Social Behavior 34, 187200.CrossRefGoogle ScholarPubMed
McIntyre, D and Gilson, L (2002) Putting equity in health back onto the social policy agenda: experience from South Africa. Social Science & Medicine 54, 16371656.CrossRefGoogle ScholarPubMed
Ng, N, Kowal, P, Kahn, K, Naidoo, N, Abdullah, S, Bawah, A, Binka, F, Chuc, NTK, Debpuur, C, Egondi, T, Gómez-Olivé, FX, Hakimi, M, Hirve, S, Hodgson, A, Juvekar, S, Kyobutungi, C, Van Minh, H, Mwanyangala, MA, Nathan, R, Razzaque, A, Sankoh, O, Streatfield, PK, Thorogood, M, Wall, S, Wilopo, S, Byass, P, Tollman, SM and Chatterji, S (2010) 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. Global Health Action 3, 5420.CrossRefGoogle ScholarPubMed
Population Reference Bureau (2017) World Population Data Sheet. Washington, DC: Population Reference Bureau.Google Scholar
Prince, MJ, Harwood, RH, Blizard, RA, Thomas, A and Mann, AH (1997) Social support deficits, loneliness and life events as risk factors for depression in old age. The Gospel Oak Project VI. Psychological Medicine 27, 323332.CrossRefGoogle ScholarPubMed
Ross, CE (1995) Reconceptualizing marital status as a continuum of social attachment. Journal of Marriage and the Family 57, 129140.CrossRefGoogle Scholar
Ross, CE and Mirowsky, J (2002) Family relationships, social support and subjective life expectancy. Journal of Health and Social Behavior 43, 469489.CrossRefGoogle ScholarPubMed
Schatz, E and Ogunmefun, C (2007) Caring and contributing: the role of older women in rural South African multi-generational households in the HIV/AIDS era. World Development 35, 13901403.CrossRefGoogle Scholar
Schatz, E and Seeley, J (2015) Gender, ageing and carework in East and Southern Africa: a review. Global Public Health 10, 11851200.CrossRefGoogle Scholar
Schnittker, J (2005) Chronic illness and depressive symptoms in late life. Social Science & Medicine 60, 1323.CrossRefGoogle ScholarPubMed
Schnittker, J (2007) Look (closely) at all the lonely people. Journal of Aging and Health 19, 659682.CrossRefGoogle ScholarPubMed
Schnittker, J (2008) Happiness and success: genes, families, and the psychological effects of socioeconomic position and social support. American Journal of Sociology 114, S233S259.CrossRefGoogle ScholarPubMed
Seeman, TE and Berkman, LF (1988) Structural characteristics of social networks and their relationship with social support in the elderly: who provides support. Social Science & Medicine 26, 737749.CrossRefGoogle ScholarPubMed
Thoits, PA (2011) Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior 52, 145161.CrossRefGoogle ScholarPubMed
Turvey, CL, Wallace, RB and Herzog, R (2005) A revised CES-D measure of depressive symptoms and a DSM-based measure of major depressive episodes in the elderly. International Psychogeriatrics 11, 139148.CrossRefGoogle Scholar
van Tilburg, T (1998) Losing and gaining in old age: changes in personal network size and social support in a four-year longitudinal study. Journals of Gerontology: Psychological Sciences and Social Sciences 53B, S313S323.CrossRefGoogle Scholar
Waite, L and Gallagher, M (2001) The Case for Marriage: Why Married People are Happier, Healthier and Better Off Financially. New York, NY: Doubleday.Google Scholar
Walen, HR and Lachman, ME (2000) Social support and strain from partner, family, and friends: costs and benefits for men and women in adulthood. Journal of Social and Personal Relationships 17, 530.CrossRefGoogle Scholar
Weiss, RS (2005) Retirement, marriage, and social isolation. Illness, Crisis & Loss 13, 7584.CrossRefGoogle Scholar
Wenger, GC, Davies, R, Shahtahmasebi, S and Scott, A (2008) Social isolation and loneliness in old age: review and model refinement. Ageing & Society 16, 333358.CrossRefGoogle Scholar