Public Policies to Improve Healthy Aging

课题四：研究计划-摘要

Project 4: Research Plan—Abstract The goal of this project is to understand how public policies affect the health of older men and women in the Agincourt Community, a Health and Socio-Demographic Surveillance System (HDSS), South Africa. Our baseline wave of 5,059 men and women ≥40 for the Health and Aging in Africa: Longitudinal Studies of an INDEPTH Community (HAALSI) study found a strong socioeconomic gradient in a number of health outcomes from specific chronic conditions to measures of physical and cognitive function. Our key hypothesis is that public policies can improve population health and reduce health disparities, especially among older men and women. South Africa has several active and proposed new public policies in the form of social grants and public health measures that make it an interesting testbed for study. These policies have direct relevance for US public policy. Initial findings from the HAALSI baseline found that health of the elderly was strongly increasing with family size, leading us to the hypothesis that older peoples' health is a public good within the family rather than a private good, and which may explain disproportionally large effects on health from social grants. We will investigate how changes in eligibility for grants based on age affect health. The baseline study also found low take up of some grants by the elderly and we will examine the reasons for this. In addition to social grants, South Africa is introducing new policies on sugar- sweetened drinks and salt in processed foods. Evaluation of salt legislation is evaluated in Project 2 in relation to biomarkers and health with input from Project 5. In Project 5, we aim to investigate how these policies affect behaviors related to food and drink consumption and with regard to sugar-sweetened drink consumption, how the policy impacts obesity. This project has four specific aims: AIM 1: To measure and describe the relationship between socioeconomic conditions and the health and wellbeing of older people in Agincourt, South Africa. AIM 2: To explore the concept of heath as a family public good. We will study the effect of changes in individual health on the wellbeing of other family members and the household health production function. AIM 3: To determine how social grants affect the health of the elderly in Agincourt, South Africa, and ascertain the reasons for non-take-up of grants among older people who appear to meet eligibility criteria. AIM 4: To assess the effect of the introduction of new taxes on sugar-sweetened drinks and limits on salt in processed foods on consumption and health risk factors.