clines in deaths from infections and parasitic diseases, have resulted in increases in life expectancy throughout the world, leading to increasing numbers and proportions of elderly people. This demo-epidemiological transition has been attributed to public health measures, advances in medical science, and health care. Irrespective of reasons, people are living longer and many of them are having more years of healthy, active, and independent life, especially in developed countries.
In contrast, there is a dearth of information and research on the health status and functional limitations of the older populations of many developing countries in general (Gorman, 2002; National Research Council, 2001; Palloni, Pinto-Aguirre, and Pelaez, 2002; Restrepo and Rozental, 1994) and notably in African countries. In this region of the world, population aging coincides with increasing social inequalities, poverty, unemployment, violence, malnutrition, and the devastating and differentiated effects of the rampant HIV/AIDS epidemic on individuals, families, communities, and nations.
The causes and consequences of aging in this region within and between countries are complex, multifactorial, and intertwined. Their study is difficult and demands an interdisciplinary approach, given the complexity of the interactions among social, economic, and environmental variables and their effect on health status and functional limitations. The projected increase in the number of older people poses new challenges to researchers, policy makers, and planners. This paper addresses the following questions: Is the population in Africa living healthier, longer lives or are added years accompanied by disabilities and generally poor health? How do changing family structures and socioeconomic conditions affect the prevalence of poor health and limited activity among the elderly?
Since current and prospective policy responses are likely to differ among countries in Africa, a number of natural experiments are needed to enable countries to learn from each other’s experiences. This study examines self-reported health and physical functional status among older people in a transitional environment—the rural and semirural societies of Cameroon—and compares their determinants in men and women. Such an investigation is important as a contrast to the general tendency to focus on urban areas of less developed countries and sub-Saharan Africa. Although differences in health between the richest and the poorest segments of the populations in many societies are clearly identifiable, differences among the rural, semirural, and urban areas of Africa may not be so obvious. In addition to variations in life expectancy, population health, and adult mortality, self-ratings of poor health and disability are likely to be lower in semirural areas than in most urban settings, and the average rate of self-reporting of good health and functional status is usually lower in rural than in urban areas. Furthermore, some differences in social influences (e.g., education, social