Surviving an Epidemic: Families and Well-Being, Malawi 1998-2020

流行病生存：家庭与福祉，马拉维 1998-2020

基本信息

批准号：
9239153
负责人：
Philip Anthony Anglewicz
金额：
$ 62.94万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-15 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9239153
关键词：
Acquired Immunodeficiency Syndrome Address Adult Affect Age Ally Americas Behavior Capital Censuses Cessation of life Characteristics Child Complement Consumption Country Data Data Collection Data Quality Data Set Data Sources Demographic Transitions Disease Eastern Africa Economic Conditions Economic Development Epidemic Epidemiology Equation Ethnography Family Family health status Family member Famines Fertility Future HIV Health Health system Healthcare Healthcare Systems Household Household and Family Husband Income Individual Intergenerational Relations Investments Journals Learning Life Life Cycle Stages Life Table Models Longitudinal Studies Malawi Mental Health Methodology Modeling Morbidity - disease rate Motivation Nomads Outcome Pathway Analysis Pattern Perception Persons Policies Population Poverty Production Proxy Recording of previous events Recovery Remittance Research Research Personnel Respondent Risk Behaviors Shapes Shock Site Social Conditions Social Environment Social Network Societies Southern Africa Surveys Survivors Time Uncertainty Update Vision Vital Status Wife Zika Virus antiretroviral therapy behavior influence cohort coping ethnographic method experience follow-up global health health data human capital imprint improved lens low income country man migration mortality physical conditioning programs public health relevance resilience risk perception safety net social social capital social engagement social implication socioeconomics survival prediction

项目摘要

Surviving the Epidemic: Families and Well-Being, Malawi 1998–2020 Project Summary: Across Eastern and Southern Africa (ESA), a remarkable cohort is reaching middle and older ages: those who have survived the AIDS epidemic. Some were infected with HIV, but everybody in this co- hort was affected by HIV. Nobody could escape an epidemic that was devastating for both its health and social implications, and one that struck hard in a region also dealing with poverty, famines, and basic uncertainties of life. Were the survivors of this cohort just lucky? What promoted survival and resilience in such a terrible context, and what inﬂuenced health and well-being among the survivors and their families? How is present demographic change, health, well-being and economic development in ESA shaped by the experience of the epi- demic and by the strategies used to survive the epidemic? These and related questions about “Surviving the Epidemic” (STE) will be studied by exploiting an unusually rich data source: the Malawi Longitudinal Study of Families and Health (MLSFH) cohort, 1998–2020. The motivation to expand, publicly-release and analyze the MLSFH until 2020 is multifold: (a) The MLSFH 1998–2020 will provide a unique opportunity to investigate questions about STE, an opportunity not available from other ESA data. (b) The MLSFH 1998–2020 will also be exceptional in allowing researchers to understand how the epidemic and the strategies for STE employed by individuals and families continue to shape the epidemiological and demographic transitions in ESA. (c) The end of the epidemic will almost certainly not mark the end of global health crises (an example at the time of this submission is the considerable concern about Zika in the Americas), and we need to better understand the mech- anisms of how low-income country citizens cope with such crises. The Speciﬁc Aims for the MLSFH 1998-2020 therefore include: Aim 1: Collect and publicly-release new MLSFH data from 2016–20 for (a) surviving MLSFH respondents and their families, (b) children of surviving and deceased respondents, and (c) migrants, with an expected N(surveyed) 6,300 plus data on 1,200 deceased respondents. The topics to be covered include well- being, mortality & morbidity, family & household dynamics, social capital & networks, physical & mental health, household production & consumption, and intergenerational relations. Aim 2: Using the MLSFH 1998–2020 and diverse methodological approaches for longitudinal data ranging from ethnographic methods to econometric structural equation modeling, analyze the determinants of STE by identifying the factors, social contexts and individual/household behaviors inﬂuencing survival, resilience, and well-being among MLSFH respondents, their children, and other family members. Aim 3: Analyze the consequences and lasting imprints of STE on (a) physical/mental health and non-communicable diseases among surviving adults and children of survivors and non-survivors, (b) fertility, investments in children and human capital in families differentially affected by the epidemic and STE, (c) migration and remittances, and (d) coping capabilities for new shocks and crises.

生存流行病：家庭与福祉，马拉维1998 - 2020年项目摘要：在东部和南部非洲（ESA），一个非凡的队列正在中间及以上年龄：那些在艾滋病流行病中幸存下来的人。有些人感染了艾滋病毒，但这个共同的每个人霍特受艾滋病毒的影响。没有人能逃脱对其健康和社会造成毁灭性的流行病含义，以及一个在一个也涉及贫困，饥荒和基本不确定性的地区震惊的含义生活。这个队列的生存是幸运的吗？是什么促进了如此可怕的生存和韧性背景，什么影响了冲浪者及其家人的健康和福祉？如何出现 ESA的人口变化，健康，福祉和经济发展，这是由Epi的经验所塑造的 DEMIC以及用于生存流行的策略？这些关于“幸存的问题流行病”（Ste）将通过利用异常丰富的数据来源来研究：马拉维纵向研究家庭与卫生（MLSFH）队列，1998 - 2020年。扩展，公开释放和分析的动机直到2020年的MLSFH是多重的：（a）MLSFH 1998–2020将为调查提供独特的机会有关Ste的问题，其他ESA数据中没有机会。（b）MLSFH 1998–2020也将在允许研究人员了解流行病和Ste的策略如何雇用的过程中要出色个人和家庭继续塑造ESA中的流行病学和人口过渡。（c）结束流行病几乎可以肯定不会标志着全球健康危机的终结（这是一个例子提交是对美洲Zika的相当关注的），我们需要更好地了解机甲低收入国家公民应对这种罪行的障碍。特定目标是MLSFH 1998-2020 因此包括：AIM 1：收集和公开发行的新MLSFH数据2016 - 20年（a）幸存的MLSFH 受访者及其家人，（b）生存和已故受访者的孩子，以及（c）移民，预期n（被调查）6,300张加上1,200名已故受访者的数据。要涵盖的主题包括存在，死亡率和发病率，家庭和家庭动态，社会资本和网络，身心健康，家庭生产和消费以及代际关系。目标2：使用MLSFH 1998-2020和潜水员的方法论方法，用于纵向数据，从人种学方法到经济结构方程建模，通过识别因素，社会环境和在MLSFH受访者中，个人/家庭行为影响了生存，韧性和福祉，他们的孩子和其他家庭成员。 AIM 3：分析Ste上的后果和持久烙印（a）幸存的成年人和幸存者的孩子的身心健康和非通讯疾病（b）生育能力，对儿童和人力资本的投资对受不同影响的家庭的投资流行病和Ste，（c）移民和汇款，以及（d）应对新的冲击和危机的能力。