The Impact of AIDS, Poverty, and Social Upheaval on the Elderly: The Case of Cambodia
John Knodel, PI
Zachary Zimmer, Co-PI
Kim Sovan Kiry, Key Personnel
Sina Puch, Key Personnel
Abstract:
This project collects and analyzes data from a representative survey of persons aged 60 and over in Cambodia conducted in 2004. The survey is intended to provide information on the current social, economic and health status of older persons; to assess the impact of the political turmoil of the last few decades on their support structures, health, and economic well-being; to examine the impact of the AIDS epidemic on their well-being; and to assess their knowledge and attitudes related to AIDS. (See longer description for more details).
Description:
The Impact of AIDS, Poverty, and Social Upheaval on the Elderly: The Case of Cambodia
Investigators: John E. Knodel, Zachary S. Zimmer, and Kim Sovan Kiry
Background: Cambodia experienced civil strife, political violence, severe food shortages and lack of medical care during the rule of the Khmer Rouge in the 1970s. Many who died as a result were adult children or spouses of today's older-aged population. The post Khmer Rouge period was characterized by severe social dislocation and continuing conflict resulting in further losses of children and spouses. These have eroded the base of core family support in a country where formal channels of assistance are virtually absent. More recently, Cambodia has been experiencing the worst AIDS epidemic in Asia resulting in the infection and death of adult sons and daughters of the current elderly population.
Main Objective: To collect and analyze data from persons aged 60 and over in Cambodia on their current social, economic and health status; to assess the impact of the political turmoil of the last few decades on their support structures, health, and economic well-being; to examine the impact of the AIDS epidemic on their well-being; and to assess their knowledge and attitudes related to AIDS.
Methodology: A representative sample survey of 1273 persons aged 60 and older was conducted during April to October 2004 in an area covering over half of Cambodia's population and including Phnom Penh. The questionnaire was especially designed to cover both the standard issues about elderly economic, social and physical well-being that recent surveys in the region focus as well as aspects of the situation of special relevance for Cambodia. The latter included questions to capture the dramatic political history that caused so much social upheaval in the lives of older Cambodians over the past several decades, the impact of illness and death of adult children, and awareness and knowledge of older persons regarding the AIDS, especially as related to caregiving to HIV-infected persons. Thus, sections of the questionnaire are tailored to examine the impact of the Pol Pot (Khmer Rouge) era and its aftermath on the lives of the current elderly generation including on the availability of support from family members. Another section is directed towards older persons who experience the death of an adult child during the last five years and includes several questions that can serve as a verbal autopsy to determine if the child died of AIDS.
Significance: This is first systematic representative survey of the situation of older persons in Cambodia. Given Cambodia's unusual history of devastating social upheaval and violence and its substantial AIDS epidemic, special attention is given to assessing both the longer term impacts of conflict and violence and the effects of illness and deaths of adult children on the well-being of older adults in the context of an impoverished developing country. To date, there have been virtually no studies of linkages between conflict and violence and elderly well-being a generation later and only a very few studies of the impact of the AIDS epidemic on older parents. There are both practical and theoretical benefits to be had by bringing together these areas of interest. Older adults constitute a key group of persons for whom the legacy of widespread violence and conflict a generation earlier can have dire consequences today. This is particularly so in contexts where physical decline associated with aging is accelerated by poverty and a lack of effective health care systems and where old age translates into increased dependency on adult children and kin for care and material support. Older aged parents in such settings are also particularly vulnerable to adverse consequences from caregiving and loss of adult children due to AIDS or other causes.
Investigators: John E. Knodel, Zachary S. Zimmer, and Kim Sovan Kiry
Background: Cambodia experienced civil strife, political violence, severe food shortages and lack of medical care during the rule of the Khmer Rouge in the 1970s. Many who died as a result were adult children or spouses of today's older-aged population. The post Khmer Rouge period was characterized by severe social dislocation and continuing conflict resulting in further losses of children and spouses. These have eroded the base of core family support in a country where formal channels of assistance are virtually absent. More recently, Cambodia has been experiencing the worst AIDS epidemic in Asia resulting in the infection and death of adult sons and daughters of the current elderly population.
Main Objective: To collect and analyze data from persons aged 60 and over in Cambodia on their current social, economic and health status; to assess the impact of the political turmoil of the last few decades on their support structures, health, and economic well-being; to examine the impact of the AIDS epidemic on their well-being; and to assess their knowledge and attitudes related to AIDS.
Methodology: A representative sample survey of 1273 persons aged 60 and older was conducted during April to October 2004 in an area covering over half of Cambodia's population and including Phnom Penh. The questionnaire was especially designed to cover both the standard issues about elderly economic, social and physical well-being that recent surveys in the region focus as well as aspects of the situation of special relevance for Cambodia. The latter included questions to capture the dramatic political history that caused so much social upheaval in the lives of older Cambodians over the past several decades, the impact of illness and death of adult children, and awareness and knowledge of older persons regarding the AIDS, especially as related to caregiving to HIV-infected persons. Thus, sections of the questionnaire are tailored to examine the impact of the Pol Pot (Khmer Rouge) era and its aftermath on the lives of the current elderly generation including on the availability of support from family members. Another section is directed towards older persons who experience the death of an adult child during the last five years and includes several questions that can serve as a verbal autopsy to determine if the child died of AIDS.
Significance: This is first systematic representative survey of the situation of older persons in Cambodia. Given Cambodia's unusual history of devastating social upheaval and violence and its substantial AIDS epidemic, special attention is given to assessing both the longer term impacts of conflict and violence and the effects of illness and deaths of adult children on the well-being of older adults in the context of an impoverished developing country. To date, there have been virtually no studies of linkages between conflict and violence and elderly well-being a generation later and only a very few studies of the impact of the AIDS epidemic on older parents. There are both practical and theoretical benefits to be had by bringing together these areas of interest. Older adults constitute a key group of persons for whom the legacy of widespread violence and conflict a generation earlier can have dire consequences today. This is particularly so in contexts where physical decline associated with aging is accelerated by poverty and a lack of effective health care systems and where old age translates into increased dependency on adult children and kin for care and material support. Older aged parents in such settings are also particularly vulnerable to adverse consequences from caregiving and loss of adult children due to AIDS or other causes.
More Information: http://www.popcouncil.org/socsci/agingAIDSImpact.html