| Urban–rural disparities in adult mortality in sub-Saharan Africa |
| Authors: |
Ashira Menashe-Oren, and Guy Stecklov |
| Source: |
Demographic Research, 39(5): 136-176; DOI: 10.4054/DemRes.2018.39.5 |
| Topic(s): |
Adult mortality
Rural-urban differentials
|
| Country: |
Africa
Multiple African Countries
|
| Published: |
JUL 2018 |
| Abstract: |
BACKGROUND
Empirical evidence showing higher survivorship in urban areas of sub-Saharan Africa
(SSA) supports a theory of rural disadvantage. Yet this evidence mostly builds on infant
or child mortality. There is practically no empirical evidence comparing adult mortality
levels across urban and rural sectors.
OBJECTIVE
This study explores adult mortality differences by urban–rural residence across SSA for
men and women. It considers whether existing differences across sectors vary over the
course of development.
METHODS
The indirect orphanhood method is applied to 90 Demographic and Health Survey
(DHS) datasets from 30 countries between 1991 and 2014. Conditional probabilities of
dying between ages 15 and 60 (45q15) are separately estimated for rural and urban
populations.
RESULTS
Based on country averages over all time periods, the mean 45q15 is 0.274 and 0.265
among adult women and 0.307 and 0.292 among adult men in urban and rural
populations, respectively. The average urban to rural probability of dying ratio from the
most recent data between 2000 and 2010 is 1.08 for females and 1.11 for males in SSA
as a whole, indicating an urban penalty. Multiple checks highlight the robustness of our
findings to methodological limitations inherent in the method. Multivariate regression
models suggest that as countries develop, excess adult mortality is likely to shift from
the urban to the rural sector.
CONTRIBUTION
We provide evidence that, unlike child mortality, adult mortality remains higher in the
urban sector for many countries and for SSA as a whole. This finding has policy
implications regarding the spatial provision of health services. Urban poor should be
given more attention. |
| Web: |
https://www.jstor.org/stable/pdf/26585326.pdf?ab_segments=0%2Fbasic_expensive%2Fcontrol |