The impact of adult mortality on household dissolution and
migration in rural South Africa.
Hosegood V, McGrath N, Herbst K, Timaeus IM.
Africa Centre for Health and Population Studies, Mtubatuba, South Africa.
Vicky.Hosegood@lshtm.ac.uk
OBJECTIVE: To investigate the effect of adult death on household dissolution and
migration. DESIGN: Demographic surveillance of the population in a rural area of
northern KwaZulu Natal, South Africa. METHODS: Data on households resident in
the surveillance area on 1 January 2000 were used to examine the effect of adult
mortality and household risk factors on household dissolution and mobility
between January 2000 and October 2002. Cox regression models were used to assess
the risk of household dissolution and migration, controlling for multiple risk
factors including causes of death, household composition and household assets.
RESULTS: By October 2002, 238 households (2%) had dissolved and 874 (8%)
migrated out of the area; 21% (2179) of all households had at least one adult
death (18 years and older). Households where one or more adult members died
during the follow-up period were four times more likely to dissolve, after
controlling for household and community level risk factors [4.3; 95% confidence
interval, (CI), 3.3-5.7]. The risk of dissolution was significantly higher in
households with multiple deaths (2.3; 95% CI, 1.3-4.3). There were no
significant differential risks associated with cause of death, age or sex of the
deceased. Adult mortality in the household was not associated with migration.
CONCLUSIONS: Poorer households, as measured by asset ownership, and households
trying to cope with adult deaths are vulnerable to dissolution. The dramatic
increase in adult mortality attributable to AIDS will increase the number of
households that do not survive as a functional and cohesive social group.