Adults in Malawi are living longer, but with disabilities

The number of adults living beyond age 45 in the sub-Saharan African country of Malawi is growing rapidly, but according to a study by Penn and Malawian researchers, many of these older men and women experience physical illnesses or disabilities that limit their capacity to function normally.

The research, conducted by Collin F. Payne, a doctoral candidate in demography in the School of Arts & Sciences; Hans-Peter Kohler, the Frederick J. Warren Professor of Demography in the Department of Sociology; and James Mkandawire, a research manager at the Malawian firm Invest in Knowledge, shows that the physical limitations of a 45-year-old in Malawi living with severe functional deficiencies are comparable to those of an 80-year-old in the United States.  

The study, “Disability Transitions and Health Expectancies among Adults 45 Years and Older in Malawi: A Cohort-Based Model,” was published in the May issue of the journal PLOS Medicine.

Using information from surveys conducted between 2006 and 2010, the researchers analyzed different levels of disability and health expectancies among adults in Malawi older than 45.

They found among those surveyed that the likelihood of having a physical disability increased considerably with age, with 45-year-old women in Malawi expected to spend 58 percent of their estimated remaining 28 years with functional limitations, and 45-year-old men expected to live 41 percent of their remaining 25.4 years of life with functional limitations.

“Given the strong association of disabilities with work efforts and subjective well-being, this research suggests that current national health policies and international donor-funded health programs in sub-Saharan Africa inadequately target the physical health of mature and older adults,” Payne says.

Malawians surveyed in the study experienced a lengthy struggle with disabling conditions during adulthood, with high probabilities of “relapsing between states of functional limitation.”

The researchers say their findings stress the importance of investing in the health of older people with functional limitations in Malawi in order to improve their ability to perform physical work in the country’s rural agricultural settings, and ultimately boost the economy.