The Demography of Mental Health among Mature Adults: Puzzling Patterns in a Low Income High HIV-Prevalence

Iliana V. Kohler, University of Pennsylvania
Collin F. Payne, University of Pennsylvania
Chiwoza Bandawe, College of Medicine, Malawi

While a nascent body of research investigates the shift in sub-Saharan Africa's disease burden towards non-communicable diseases (NCDs), very few studies have investigated mental health, specifically depression and anxiety, as a particularly important subset of NCDs in SSA low-income countries. Using exceptionally-detailed data on mental health in the 2012--13 rounds of the Malawi Longitudinal Study of Families and Health (MLSFH), this paper provides a first picture of the demography of mental health among mature adults (= persons aged 45+) in a low-income high HIV-prevalence area. Our study shows striking gender-differences in both the level and age-pattern of depression and anxiety, and in contrast to findings from high-income contexts, we show sharp increases in mental health disorders with age. Our analyses of the 2006--12 MLSFH mental health transitions also show that mature adults in rural Malawi will spend a substantial fraction (often >50%) of their remaining life with poor mental health.