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

从流行病中幸存下来：家庭和福祉，马拉维1998-2020 项目摘要：在整个东部和南部非洲(ESA)，一个显著的队列正在接触到中老年人 年龄：那些在艾滋病流行中幸存下来的人。一些人感染了艾滋病毒，但这里的每个人- 霍特感染了艾滋病毒。没有人能逃脱一场对其健康和社会都具有毁灭性的流行病 影响，在一个同样面临贫困、饥荒和基本不确定性的地区造成了沉重打击 生活的一部分。这群人中的幸存者只是幸运吗？是什么在如此可怕的情况下促进了生存和韧性 在此背景下，fl是什么促进了幸存者及其家人的健康和福祉？是如何呈现的 欧空局的人口变化、健康、福祉和经济发展受到环卫经验的影响-- Demic和用来在疫情中生存的策略？关于“幸存”的这些问题和相关问题 “流行病”(STE)将通过利用异常丰富的数据来源进行研究：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年前的《多边林业法》是多方面的：(A)1998-2020年《多边林林法》将提供一个独特的调查机会 关于STE的问题，这是欧空局其他数据中没有的机会。(B)1998-2020年MLSFH还将 让研究人员了解STE的流行和战略是如何采用的 个人和家庭继续影响着欧空局的流行病学和人口结构转变。(C)结尾 这种流行病的蔓延几乎肯定不会标志着全球卫生危机的结束(这是当时的一个例子 提交是对寨卡病毒在美洲的相当大的关注)，我们需要更好地了解机制- 对于低收入国家公民如何应对这样的危机，人们不屑一顾。规范fic的目标是1998年至2020年。 因此包括：目标1：收集并公开发布2016-2020年新的MLSFH数据，用于(A)幸存的MLSFH 答复者及其家人，(B)在世和已故答复者的子女，以及(C)有 预计N(调查)1,200多名已故受访者的6,300多份数据。将涵盖的主题包括： 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1998-2020年《多边金融框架公约》和 纵向数据的不同方法，从人种志方法到计量经济学方法 结构方程模型，通过识别因素、社会背景和 在MLSFH受访者中，fl中的个人/家庭行为影响了生存、弹性和幸福感， 他们的孩子和其他家庭成员。目标3：分析STE的后果和持久影响 (A)在世成年人和幸存者子女的身心健康和非传染性疾病 和非幸存者，(B)生育率、对儿童的投资以及受到不同影响的家庭的人力资本 (C)移民和汇款，以及(D)应对新冲击和危机的能力。

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.