The Economic Consequences of Death in South Africa

We quantify the impact of adult deaths from AIDS, and from other causes on household economic wellbeing, using a large longitudinal dataset spanning more than a decade. Verbal autopsies allow us to distinguish AIDS mortality from that of other causes. We find that households in which members die of AIDS are systematically poorer than other households, measured using members’ educations, household assets, and self-assessed poverty. The timing of the lower SES observed for these households and their AIDS deaths suggests that the socioeconomic gradient in AIDS mortality is being driven primarily by poor households being at higher risk for AIDS, rather than AIDS impoverishing the households. Moreover, we find, using reports on asset holdings and households’ self-reports of poverty, that households that experience a death from any cause are systematically poorer following a death. Funeral expenses born by the deceased’s household can explain some of the impoverishing effects of death in the household. The scale-up of antiretroviral therapy (ART), late in our study period, has begun to change the age profile of mortality in the study area. However, to date, ART has not changed the socioeconomic status gradient observed in AIDS deaths.