As the HIV/AIDS pandemic progresses in Africa, elders are increasingly responsible for the care of orphans. Several reports suggest that elderly Africans do not have the resources to provide care and are at risk of poor health, but few studies have systematically measured health of caregivers. The Kenyan Grandparents Study is a longitudinal study designed to compare elder Luo caregivers to noncaregiving peers. Several measures of health were collected, including body mass index (BMI), blood pressure, glucose, and hemoglobin. In addition, self-perceived health and mental health were measured using the MOS Short-Form 36 (SF-36). It was hypothesized that caregivers would have poorer health than noncaregivers and that the difference in health would widen over the three waves of the study. Caregiving did not affect physical health but did act to decrease mental health and perceived health over time.
Agyarko, R.D., A. Kalache, and P. Kowal.2000. Older People, Children and the HIV/AIDS Nexus. Geneva: UNAIDS.
2.
Agyarko, R.D., N. Madzingira, R. Mupedziswa, N. Mujuru, L. Kanyowa, and J. Matorofa.2002. Impact of AIDS on Older People in Africa. Zimbabwe Case Study. Geneva: World Health Organization.
3.
Ainsworth, M. and D. Filmer.2002. "Poverty, AIDS and Children’s Schooling: A Targeting Dilemma." World Bank Policy Research Working Paper 2885. Retrieved September25, 2009, (http://www.-wds.worldbank.org/external/default/WDSContentServer/IW3P/IB/2002/10/12/000094946_02100204022275/Rendered/PDF/multi0page.pdf ).
4.
Ainsworth, M. and I. Semali.2000. "The Impact of Adult Deaths on Children’s Health in Northwestern Tanzania." World Bank Policy Research Working Paper No. 2266. Available at SSRN: http://ssrn.com/abstract=629117
5.
Aranda, M.P. and B.G. Knight.1997. "The Influence of Ethnicity and Culture on the Caregiver Stress and Coping Process: A Sociocultural Review and Analysis." The Gerontologist37:P342-54.
6.
Bjorntorp, P. and R. Rosmond.1999. "Hypothalamic Origin of the Metabolic Syndrome X." Annals of the New York Academy of Sciences892:297-307.
7.
Bjorntorp, P. and P. Rosmond.2000. "Obesity and Cortisol." Nutrition16:924-36.
8.
Buzzard, S.1982. "Women’s Status and Wage Employment in Kisumu, Kenya ." Washington, DC: American University .
9.
Charlton, K.E. and D. Rose.2001. "Nutrition Among Older Adults in Africa: The Situation at the Beginning of the Millennium" American Society for Nutritional Sciences131:2424S-28S.
10.
Cohen, S., T. Kamarck, and R. Mermelstein.1983. "A Global Measure of Perceived Stress ." Journal of Health Society and Behavior24:385-96.
11.
Cook, K.D.1990. "Determinants of Female Time Allocation in Agricultural Households in Southwestern Kenya." PhD thesis, Cornell University.
12.
Cox, C.B.2000. "Why Grandchildren Are Going to and Staying at Grandmother’s House and What Happens When They Get There" Pp. 3-19 in To Grandmother’s House We Go and Stay. Perspectives on Custodial Grandparents, edited by C. B. Cox.New York: Springer.
13.
Dayton, J., and M. Ainsworth.2002. "The Elderly and AIDS: Coping Strategies and Health Consequences in Rural Tanzania" Population Council Working Paper series, No 160. http://www.popcouncil.org/pdfs/wp/160.pdf
14.
Dayton, J. and M. Ainsworth.2004. "The Elderly and AIDS: Coping With the Impact of Adult Death in Tanzania." Social Science & Medicine59:2161-72.
15.
Donovan, C. and J. Massingue.2007. "Illness, Death and Macronutrients: Adequacy of Rural Mosambican Household Production of Macronutrients in the Face of HIV/AIDS ." Food and Nutrition Bulletin28:S331-38.
16.
Emick, M.A. and B. Hayslip.1999. "Custodial Grandparenting: Stresses, Coping Skills, and Relationships With Grandchildren" International Journal of Aging and Human Development48:35-61.
17.
Frolkis, W.V.1993. "Stress-Age Syndrome" Mechanisms of Aging and Development69:93-107.
18.
Geissler, P.W., K. Nokes, R.J. Price, R. Achieng’ Odhiambo, J. Aagaard-Hansen, and J.H. Ouma.2000. "Children and Medicines: Self-Treatment of Common Illnesses Among Luo Schoolchildren in Western Kenya" Social Science & Medicine50: 1771-83.
19.
Gilborn, L.Z., R. Nyonyintono, R. Kabumbuli, and G. Jagwe-Wadda.2001. Making a Difference for Children Affected by AIDS: Baseline Findings From Operations Research in Uganda. New York: Population Council.
20.
Grinstead, L.N., S. Leder, S. Jensen, and L. Bond.2003. "Review of Research on the Health of Caregiving Grandparents." Journal of Advanced Nursing44:318-26.
21.
Grundy, E. and A. Sloggett.2003. "Health Inequalities in the Older Population: The Role of Personal Capital, Social Resources and Socio-Economic Circumstances ." Social Science & Medicine56:935-47.
22.
HelpAge International.2002. HIV/AIDS and Older People: The African Situation. Nairobi : Author.
23.
Ice, G.H.2004. "Nutritional Status, Gender and Caregiving Among Luo Elders ." American Journal of Human Biology16:209.
24.
Ice, G.H. and G.D. James.2007. "Conducting a Field Study of Stress: General Principles " Pp. 3-24 in Measuring Stress. A Practical Guide to Measuring Stress in the Field , edited by G. H. Ice and G. D. James.Cambridge, UK: Cambridge University Press.
25.
Ice, G.H., K. Jobbins, J. Yogo, and E. Juma.2008. "Gender, Caregiving and Food Intake Among Elder Luo" American Journal of Human Biology20:224.
26.
Ice, G.H. and J. Yogo.2005. "Measuring Stress Among Luo Elders: Development of the Luo Perceived Stress Scale." Field Methods17:394-411.
27.
Ice, G.H., A.M. Zidron, and E. Juma.2008. "Health and Health Perceptions Among Kenyan Grandparents." Journal of Cross Cultural Gerontology23:111-29.
28.
Jackson, K.N., S. Horwitz, J. Yogo, and G.H. Ice.2007. "Nutrition Transition and Health Consequences Among Kenyan Elders." American Journal of Human Biology19:261.
29.
James, G.D. and P.T. Baker.1990. "Human Population Biology and Hypertension" Pp. 115-26 in Hypertension: Pathophysiology, Diagnosis, and Management, edited by J. H. Laragh and B. M. Brenner.New York: Raven Press, Ltd.
30.
Jones, L.1997. "The Health Consequences of Economic Recessions " Pp. 49-64 in Health and Poverty, edited by M. J. Holosko and M. D. Feit.New York: Haworth Press.
31.
Kakooza, J. and S.R. Kiumuna.2005. "HIV/AIDS Orphans’ Education in Uganda: The Changing Role of Older People." Journal of Intergenerational Relationships34:63-81.
32.
Labarthe, D.R., M.D. Blaufox, W.M. Smith, C.R. Lacy, H. Schnaper, F. LaBaw, S. Mascioli, J. Davey, and E. Lakatos.1991. "Systolic Hypertension in the Elderly Program (SHEP). Part 5: Baseline Blood Pressure and Pulse Rate Measurements ." Hypertension17:62-76.
33.
Lawton, M.P., M.H. Kleban, M. Moss, M. Rovine, and A. Glicksman.1989. "Measuring Caregiving Appraisal." Journal of Gerontology44:P61-71.
34.
Lawton, M.P., D. Rajagopal, E. Brody, and M.H. Kleban.1992. "The Dynamics of Caregiving for a Demented Elder Among Black and White Families." Journal of Gerontology47:S156-64.
35.
Lima-Costa, M.F., S.M. Barreto, J.O.A. Firmo, and E. Uchoa.2003. "Socioeconomic Position and Health in a Population of Brazilian Elderly: The Bambí Health and Aging Study (BHAS)" Revista Panamericana de Salud Públuca/Pan American Journal of Public Health13.
36.
Lohman, T.G., A.F. Roche, and R. Martorell.1988. Anthropometric Standardization Reference Manual. Champaign, IL: Human Kinetics Books.
37.
Maruapula, S. and K. Chapman-Novakofski.2007. "Health and Dietary Patterns of the Elderly in Botswana." Journal of Nutrition Education and Behavior39:311-19.
38.
McEwen, B.2001. "From Molecules to Mind. Stress, Individual Differences, and the Social Environment." Annals New York Academy of Sciences935:42-9.
39.
McEwen, B.2002. The End of Stress as We Know it. Washington, DC: Joseph Henry Press.
40.
McEwen, B.S. and J.C. Wingfield.2003. "The Concept of Allostatis in Biology and Biomedicine ." Hormones and Behavior43:2-15.
41.
Minkler, M. and D.E. Fuller-Thomson.1999. "The Health of Grandparents Raising Grandchildren: Results of a National Study." American Journal of Public Health89:1384-89.
42.
Minkler, M. and D.E. Fuller-Thomson.2001. "Physical and Mental Health Status of American Grandparents Providing Extensive Child Care to Their Grandchildren ." Journal of the American Medical Women’s Association56:199-205.
43.
Musil, C.M. and M. Ahmad.2002. "Health of Grandmothers: A Comparison by Caregiver Status ." Journal of Aging and Health14:96-121.
44.
Musil, C.M., S. Schrader, and J. Mutikani.2000. "Social Support, Stress and Special Coping Tasks of Grandmother Caregivers" Pp. 56-70 in To Grandmother’s House We Go and Stay. Perspectives on Custodial Grandparents, edited by C. B. Cox.New York: Springer.
45.
Nalagoda, F., M.J. Wawer, J.K. Konde-Lule, R. Menon, R.H. Gray, D. Serwadda, N.K. Servankambo, and C. Li.1997. "HIV Infection in Rural Households, Rakai District, Uganda" Health Transition Review7:3-17.
46.
National Council for Population and Development.1999. Demographic and Health Survey 1998. Calverton, MD: Macro International Inc.
47.
Nyambedha, E.O., S. Wandibba, and J. Aagaard-Hansen .2001. "Policy Implications of the Inadequate Support Systems for Orphans in Western Kenya." Health Policy58:83-96.
48.
Nyambedha, E.O., S. Wandibba, and J. Aagaard-Hansen .2003a. "Changing Patterns of Orphan Care Due to the HIV Epidemic in Western Kenya." Social Science & Medicine57:301-11.
49.
Nyambedha, E.O., S. Wandibba, and J. Aagaard-Hansen .2003b. "‘Retirement lost’-The New Role of the Elderly as Caretakers for Orphans in Western Kenya" Journal of Cross-Cultural Gerontology18:33-52.
50.
Ochieng’, W.1985. People Round the Lake. London : Evans Brothers Limited.
51.
Ocholla-Ayayo, A.B.C.1999. Traditional Ideology and Ethics Among the Southern Luo . Uppsala, Sweden: Scandinavian Institute of African Studies.
52.
Opiyo, F.A.1996. Rural Kenyan Luo Women’s Lived Experiences: An Interpretation . Greensboro: University of North Carolina at Greensboro.
53.
Pearlin, L.I.1989. "The Sociological Study of Stress." Journal of Health and Social Behavior30:241-56.
54.
Pearlin, L.I.1999. "The Stress Process Revisited. Reflections on Concepts and Their Interrelationships" Pp. 395-416 in Handbook of the Sociology of Mental Health, edited by C. S. Aneshensel and J. C. Phelan.New York: Kluwer Academic/Plenum Publishers.
55.
Pearlin, L.I., J.T. Mullan, S.J. Semple, and M.M. Skaff.1990. "Caregiving and the Stress Process: An Overview of Concepts and Their Measures." The Gerontologist30:P583-94.
56.
Reynar, A.2000. Fertility Decision Making by Couples Amongst the Luo of Kenya. Philadelphia: Demography, University of Pennsylvania.
57.
Russell, S.2004. "The Economic Burden of Illness for Households in Developing Countries: A Review of Studies Focusing on Malaria, Tuberculosis and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome." American Journal of Tropical Medicine and Hygiene71:147-55.
58.
Sapolsky, R.M.1996. "Why Stress Is Bad for Your Brain." Science273:749-50.
59.
Sapolsky, R.M.1999. "Glucocorticoids, Stress, and Their Adverse Neurological Effects: Relevance to Aging." Experimental Gerontology34:721-32.
60.
Sapolsky, R., M. Armanini, D. Packan, and G. Tombaugh.1987. "Stress and Glucocorticoids in Aging ." Endocrinology and Metabolism Clinics of North America16:965-80.
61.
Sauerborn, R., A. Nougtara, M. Hien, and H.J. Diesfeld.1996. "Seasonal Variations of Household Costs of Illness in Burkina Faso." Social Science & Medicine43:281-90.
62.
Taylor, J.Y., O.G.M. Washington, N.T. Artinian, and P. Lichtenberg.2007. "Parental Stress Among African American Parents and Grandparents." Issues in Mental Health Nursing28:373-87.
63.
Unaids.2006. 2006 Report on the Global AIDS Epidemic. Geneva: Joint United Nations Programme on HIV/AIDS.
64.
Unaids/Unicef.2002. Children on the Brink 2002. A Joint Report on Orphan Estimates and Program Strategies. Washington, DC: TvT Associates/The Synergy Project.
65.
Unaids/Unicef.2004. "Children on the Brink 2004. A Joint Report of New Orphan Estimates and a Framework for Action" Retrieved September 25, 2009 (http://data.unaids.org/Publications/External-Documents/unicef_childrenonthebrink2004_en.pdf ).
66.
UNAIDS/UNICEF/WHO2002. Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections: Kenya. Geneva: UNAIDS.
67.
UNICEF2003. "Africa’s Orphaned Generations." New York: UNICEF.
68.
Wagner, A.K., K. Wyss, B. Gandek, P.M. Kilima, S. Lorenz, and D. Whiting.1999. "A Kiswahili Version of the SF-36 Health Survey for Use in Tanzania: Translation and Tests of Scaling Assumptions " Quality of Life Research8:101-10.
69.
United States Census Bureau.2006. International Data Base (IDB): Summary Demographic Data for Kenya . Washington, DC: Author.
70.
Wangui, E.E. in press. "Livelihood Strategies and Nutritional Security of Grandparent Caregivers of AIDS Orphans in Nyando District, Kenya."Qualitative Health Research.
71.
Ware, J.E.2007. SF-36 Health Survey Update. Santa Monica, CA: RAND.
72.
Ware, J.E. and C.D. Sherbourne.1992. "The MOS 36-Item Short-Form Health Survey (SF-36). I. Conceptual Framework and Item Selection."Medical Care30:473-83.
73.
Williams, A. and G. Tumwekwase.2001. "Multiple Impacts of the HIV/AIDS Epidemic on the Aged in Rural Uganda."Journal of Cross-Cultural Gerontology16:221-36.
74.
Wilson, A.O. and D.J. Adamchak.2000. "AIDS in Africa: The Grandmothers’ Disease. Comment ." Journal of Age Related Disorders12:5-6.
75.
Wyss, K., A.K. Wagner, D. Whiting, D.M. Mtasiwa, M. Tanner, B. Gandek, and P.M. Kilima.1999. "Validation of the Kiswahili Version of the SF-36 Health Survey in a Representative Sample of an Urban Population in Tanzania" Quality of Life Research8:111-20.
76.
Yamano, T. and T.S. Jayne.2003. "Measuring the Impacts of Working-age Adult Mortality on Small-scale Farm Households in Kenya" World Development32:91-119.
