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2017 ; 176
(ä): 149-157
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Offspring schooling associated with increased parental survival in rural
KwaZulu-Natal, South Africa
#MMPMID28153751
De Neve JW
; Harling G
Soc Sci Med
2017[Mar]; 176
(ä): 149-157
PMID28153751
show ga
BACKGROUND: Investing in offspring's human capital has been suggested as an
effective strategy for parents to improve their living conditions at older ages.
A few studies have assessed the role of children's schooling in parental survival
in high-income countries, but none have considered lower-resource settings with
limited public wealth transfers and high adult mortality. METHODS: We followed
17,789 parents between January 2003 and August 2015 in a large population-based
open cohort in rural KwaZulu-Natal, South Africa. We used Cox proportional
hazards models to investigate the association between offspring's schooling and
time to parental death. We assessed the association separately by parental sex
and for four cause of death groups. RESULTS: A one year increase in offspring's
schooling attainment was associated with a 5% decline in the hazard of maternal
death (adjusted Hazard Ratio [aHR]: 0.95, 95%CI: 0.94-0.97) and a 6% decline in
the hazard of paternal death (aHR: 0.94, 95%CI: 0.92-0.96), adjusting for a wide
range of demographic and socio-economic variables of the parent and their
children. Among mothers, the association was strongest for communicable,
maternal, perinatal and nutritional conditions (aHR: 0.87, 95%CI: 0.82-0.92) and
AIDS and tuberculosis (aHR: 0.92, 95%CI: 0.89-0.96), and weakest for injuries.
Among fathers, the association was strongest for injuries (aHR: 0.87, 95%CI:
0.79-0.95) and AIDS and tuberculosis (aHR: 0.92, 95%CI: 0.89-0.96), and weakest
for non-communicable diseases. CONCLUSION: Higher levels of schooling in
offspring are associated with increased parental survival in rural South Africa,
particularly for mothers at risk of communicable disease mortality and fathers at
risk of injury mortality. Offspring's human capital may be an important factor
for health disparities, particularly in lower-resource settings.
|*Parents
[MESH]
|Adolescent
[MESH]
|Cause of Death/trends
[MESH]
|Child
[MESH]
|Cohort Studies
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Income/statistics & numerical data
[MESH]
|Male
[MESH]
|Mortality/*trends
[MESH]
|Proportional Hazards Models
[MESH]
|Rural Population/statistics & numerical data
[MESH]
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