By THE INDEPENDENT UG
ANALYSIS | AGENCIES | Nearly half of South Africa’s 60 million people receive social grants, ranging from child support to pensions. The grants are designed to provide financial assistance to people living in poverty.
The largest components of the South African social grant system were introduced or expanded to include the full population in the 1990s. Since then, the system has evolved into one of the most comprehensive in the global south.
In addition to their direct financial benefits, the grants have been found to have a wide range of positive effects, including improvements in child nutrition and education, and increased participation of women in the labor force.
However, the effects of social grants on the health of older adults have not been extensively explored until now.
Across a series of recent studies conducted as part of an extensive research project in a rural part of South Africa, we have established that social grants can help older South Africans protect their cognitive health and live longer. Cognitive health is the ability to think clearly, learn, and remember.
Using our collective expertise in cognitive and population health, we studied the health effects of three different cash transfer programs in a sample of 5,059 adults 40 years and older in rural Mpumalanga province.
Our results consistently found strong and positive effects thanks to these programs.
As older people will make up a much bigger portion of South Africa’s population over the next 20 years, our results provide good news about a social intervention program the country already has in place to promote health and well-being among older adults.
How we did the studies and what we learnt
The Agincourt Health and Demographic Surveillance System has been collecting data on more than 120,000 people living in 31 villages in northeast South Africa since 1992.
Established as a rural campus of the University of the Witwatersrand, this initiative aims to track and understand health and well-being in these rural environments. Additionally, the Agincourt project serves as a platform for other studies to gather more detailed information on specific community members.
Data from an experimental cash transfer trial within the broader Agincourt research platform, which provided monthly cash transfers to households from 2011 through 2015, was utilized. This trial involved over 2,500 households, with monthly payments of R300 split between a school-age female and her caregiver.
Furthermore, data from the Health and Aging in Africa: Longitudinal Studies in South Africa, a smaller Agincourt cohort of 5,059 men and women aged 40 and older, were employed. This cohort provided detailed information on memory function and dementia probability every three years from 2014/2015 through 2021/2022.
The research aimed to determine whether being part of the group that received cash transfers led to better cognitive health later in life, up to seven years after the trial concluded.
Results indicated that individuals who received the cash transfers experienced better cognitive health outcomes. They demonstrated slower aging-related memory decline and lower dementia probability in the most recent data collection wave in 2021/2022.
For certain groups, the impact extended to mortality. Among those who were relatively better off at baseline in terms of education and wealth, the addition of cash transfers led to a significantly reduced risk of mortality.
In a separate study, the impact of the older person’s grant, a public pension, on men’s later-life cognitive health was examined. The grant expanded its age eligibility for men from 65 to 60 years from 2008 to 2010. Men aged 60 through 64 at the time of expansion, receiving one to five extra years of pension income prior to turning 65, exhibited significantly better cognitive function. A “stair-step” pattern was observed, where cognitive function improved progressively for each additional year of pension eligibility.
Finally, the impact of the child support grant on women’s later-life cognitive health was explored. Similar to the findings for the older person’s grant expansion, higher access to child support grant income was associated with higher later-life cognitive function for maternal beneficiaries of the grant.
Looking forward
Our findings thus far unequivocally highlight the advantages of South Africa’s current structure of social grant programs for older adults. The data suggests that as South Africa undergoes demographic shifts in the coming decades, continued and substantial investments in these programs will yield positive outcomes, contributing to the enhanced health and well-being of the nation’s most vulnerable older adults.
Contributors:
– Molly Rosenberg, Associate Professor of Epidemiology, Indiana University
– Chodziwadziwa Whiteson Kabudula, Senior Researcher Rural Health in Transition and Agincourt Research Unit, University of the Witwatersrand
– Kathleen Kahn, Professor Health and Population Division, School of Public Health, University of the Witwatersrand
– Lindsay Kobayashi, Assistant Professor, Department of Epidemiology, University of Michigan, University of Michigan
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