“My heart is very painful”: Physical, mental and social wellbeing of older women at the times of HIV/AIDS in rural South Africa

The meanings of health and illness as well as people's beliefs about the required response to illness vary widely according to time and place and represents the culture and society in which people live. A double burden of disease in rural South Africa - an emerging epidemic of non-communicable diseases alongside high HIV-prevalence - defines illness as a 'normal' part of older persons' everyday lives. Against this background we analyze qualitative interviews with 30 women over the age of 60 in a rural community to provide an in-depth portrait of older women's physical, mental and social wellbeing and how these women make sense of it all in a changing and challenging social and economic context. These women, while making the connections between the various dimensions, view their own physical, mental and social wellbeing as impaired, and make use of a variety of health and help-seeking behaviors in order to feel better. However, poverty and the unavailability of health resources shape older women's constructions of the meaning of their health and their control, or lack thereof, over how healthy or ill they are. This study demonstrates the usefulness of the broader psycho-socio-environmental model in explaining old-age and wellbeing by providing a context specific and nuanced understanding.