Historical change in the health of Ghanaian middle-aged and older adults

OBJECTIVES: Over the last 70 years, Ghana has undergone significant political and socioeconomic transformations that have dramatically reshaped adult life, with implications for development across birth cohorts. To date, studies on birth cohort differences have primarily emerged from high-income nations. Little research has examined these trends in low- and middle-income countries (LMICs), particularly in Africa. We aim to fill this gap by using data from Ghana's WHO Study on Global Ageing and Adult Health to examine birth cohort differences in self-rated health. METHODS: Growth curve models were fitted to three waves of longitudinal data collected between 2002 and 2015, predicting self-reported health and systematically tested for gender and educational differences across cohorts. RESULTS: Later-born participants reported poorer self-reported health, indicative of historical declines. No significant cohort (birthyear) effects or modifying effects of gender and education were found. DISCUSSION: These findings shed light on Ghana's unique historical trajectory of health, with later-born participants experiencing declines, mirroring trends observed in the United States but differing from the historical improvements typically seen in Europe. Factors such as changing dynamics in healthcare access and disruptions in traditional family and social life may contribute to these patterns.