This article examines the meaning of health among middle-aged and older adults in a rural South African setting, where 72 percent of adults aged 40 and over are living with a major chronic condition, and 81 percent report good or very good health. We draw on a unique mixed-methods dataset that includes a population-based survey with disease biomarkers (hypertension, diabetes, HIV), self-assessments of health including self-rated health, functional ability and medication use, as well as nested qualitative life history interviews with survey participants including questions about lived experiences of health. We conduct survey trend analysis and ordinal logistic regression, as well as inductive and deductive coding of qualitative interviews, and triangulate findings across data sources. Overall, we find that self-rated health and functional ability are not associated with biometric disease indicators; however, we find that gendered familial expectations, life course stage, and the socioepidemiological context work together to regulate the salience of illness as people age. The study highlights the utility of research with multiple measures of health in illuminating the challenges of aging amidst the complex epidemiological transitions that increasingly characterize low- and middle-income countries.

中文翻译：

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南非农村健康的意义：性别、生命历程和社会流行病学背景

本文研究了南非农村环境中中年和老年人健康的意义，其中 72% 的 40 岁及以上成年人患有严重的慢性病，​​81% 的人报告健康状况良好或非常好。我们利用了一个独特的混合方法数据集，其中包括基于人群的疾病生物标志物调查（高血压、糖尿病、艾滋病毒）、自我健康评估，包括自评健康、功能能力和药物使用，以及嵌套定性生活与调查参与者的历史访谈，包括有关健康生活经历的问题。我们进行调查趋势分析和顺序逻辑回归，以及定性访谈的归纳和演绎编码，并对跨数据源的调查结果进行三角测量。全面的，我们发现自评健康和功能能力与生物特征疾病指标无关；然而，我们发现性别化的家庭期望、生命历程阶段和社会流行病学背景共同作用，随着人们年龄的增长而调节疾病的显着性。该研究强调了采用多种健康措施的研究在阐明复杂的流行病学转变中的老龄化挑战方面的效用，而复杂的流行病学转变日益成为低收入和中等收入国家的特征。