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.

度过流行病：家庭与福祉，马拉维 1998-2020 项目摘要：在东部和南部非洲 (ESA)，有一个引人注目的群体正在进入中老年年龄：那些在艾滋病流行中幸存下来的人，有些人感染了艾滋病毒，但这个群体中的每个人都感染了艾滋病毒。没有人能够逃脱这种对其健康和社会都具有毁灭性影响的流行病。影响，并且在一个同样面临贫困、饥荒和基本不确定性的地区受到严重打击是什么让这群幸存者在如此可怕的灾难中得以生存和恢复？背景是什么，以及是什么影响了幸存者及其家人的健康和福祉？欧空局的人口变化、健康、福祉和经济发展受到了欧洲航天局经验的影响流行病以及用于生存流行病的策略？这些以及有关“生存”的相关问题？流行病”（STE）将通过利用异常丰富的数据源进行研究：马拉维纵向研究家庭与健康 (MLSFH) 队列，1998-2020 年扩展、公开发布和分析的动机。 2020 年之前的 MLSFH 具有多重意义： (a) 1998-2020 年 MLSFH 将提供一个独特的机会进行调查 (b) 1998-2020 年 MLSFH 还将在让研究人员了解流行病以及 STE 策略的情况方面表现出色个人和家庭继续影响欧空局的流行病学和人口转变 (c) 结束。这种流行病的爆发几乎肯定不会标志着全球健康危机的结束（本次会议时的一个例子）提交是美洲对寨卡病毒的相当大的关注），我们需要更好地了解其机制低收入国家公民如何应对此类危机的观点。 1998-2020 年 MLSFH 的具体目标。因此包括：目标 1：收集并公开发布 2016-20 年 (a) 幸存 MLSFH 的新 MLSFH 数据受访者及其家人，(b) 幸存证人和已故证人的子女，以及 (c) 移民，预计 N（调查）6,300 多名已故受访者的数据涵盖的主题包括：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：利用 MLSFH 1998-2020 和纵向数据的多种方法论，从民族志方法到计量经济学结构方程模型，通过识别因素、社会背景和影响因素来分析 STE 的决定因素 MLSFH 受访者中影响生存、复原力和福祉的个人/家庭行为，目标 3：分析 STE 对他们的影响和持久影响。 (a) 幸存成人和幸存者儿童的身心健康和非传染性疾病和非幸存者，(b) 受不同程度影响的家庭的生育率、对儿童的投资和人力资本流行病和 STE，(c) 移民和汇款，以及 (d) 应对新冲击和危机的能力。