Iliana V. Kohler, PhD

Scholar

  •   Burkina Faso | Eastern Europe | Malawi | Sub-Saharan Africa | United States
  •   Aging | Cognition | Health Systems Strengthening | Mental health | Non-communicable disease

Languages: English (proficient), German (proficient), Bulgarian (proficient)

BIO STATEMENT

I am social demographer interested in the demographic, health and social aspects of aging in low and middle income contexts. My approach to study global health, aging and mortality is based on the life-course perspective and in several projects and publications in collaboration with other researchers we have shown the long legacy of early childhood factors on health outcomes in late life in different contexts. I am leading a portfolio of research projects that critically evaluates social, demographic and epidemiological theories of aging outside the realm of the transitional aging studies that are focused on upper-middle-income and high-income contexts.

RECENT GLOBAL HEALTH PROJECTS

MLSFH-MAC: Recently, I established the MLSFH Mature Adults Cohort (MLSFH-MAC) that builds on the Malawi Longitudinal Study of Families and Health (MLSFH), a prominent cohort study at Penn that previously focused on the demographic, social and economic consequences of the HIV epidemic. My MLSFH-MAC work and research is part of a consortium on Inclusive Social Protection for Chronic Health Problems, with sister-studies in India, Philippines, and Sri Lanka. In addition and related to this project, I collaborate with the Heidelberg Institute of Global Health on the CRSN Heidelberg Aging Study (CHAS) in Burkina Faso to create comparable data sources that allow comparative analyses of aging. Initial analyses of the MLSFH Mature Adults project have been published in Demography and the European Journal of Population.

Mental and cognitive health in low income sub-Saharan African Context building on the MLSFH-MAC cohort: While a nascent body of research investigates the shift in sub-Saharan Africa's (SSA's) disease burden towards non-communicable diseases (NCDs), very few studies have investigated mental health, specifically depression and anxiety, in SSA. Using the 2012--13 Malawi Longitudinal Study of Families and Health (MLSFH), I have investigated the demography of mental health and the burden of poor mental health among individuals aged 45+. Depression and anxiety in Malawi are associated with adverse outcomes such as less nutritional intake and reduced productivity, they sharply increase with age and women are experience higher levels of poor mental health compared to men. My research shows that there is a strong relationship between physical and mental health and underscores the need to further investigate the life-course determinants of this relationship. My research also shows that cognitive health is an important dimension of well-being at older ages in sub-Saharan Africa and we find that the age patterns of decline in cognitive health are similar with those observed in the U.S. We also find that women have substantially worse cognitive health than men, and experience a steeper decline of cognitive ability with age. Lower levels of cognitive health are also strongly associated with increased levels of depression and anxiety, and are associated with worse physical health measured through both self-reports and physical performance.

UN aging studies of aging in sub-Saharan Africa: Building on my experience with the MLSFH Mature Adults Cohort, I have also worked as lead consultant with the United Nations Department of Economic and Social Affairs (UN DESA) to develop a study design and aging questionnaire for comparative UN aging studies in sub-Saharan Africa. The study was piloted and implemented in Malawi in collaboration with the National Statistical Office.

“Synthesized Evidence and Knowledge from R4d Public Health Projects to Make a Difference in One Place”: The overall aim is to synthesize key policy and health-systems-related findings of the multi-country R4D projects in the public health module, initiate a partnership for effective R4d-research-to-policy translation in sub-Saharan African countries, and engage with stakeholders in one country--Malawi--to develop and disseminate specific and actionable policy and health-systems recommendations based on R4D research.

SELECTED PUBLICATIONS

Payne, C. F., I.V. Kohler, C. Bandawe and H.-P. Kohler Kohler (2018). Cognition, Health, and Well-Being in a Rural Sub-Saharan African Population. 34 (4): 637-662. 10.1007/s10680-017-9445-1.

Kohler, H.-P., S.C. Watkins, J.R. Behrman, P. Anglewicz, I.V. Kohler, R.L. Thornton, J. Mkandawire, H. Honde, A. Hawara, B. Chilima, C. Bandawe, V. Mwapasa, P. Fleming, and L. Kalilani-Phiri. 2015. "Cohort Profile: The Malawi Longitudinal Study of Families and Health (MLSFH)." International Journal of Epidemiology. PMCID: PMC Journal – In Process.

Kohler, I.V., P. Anglewicz, H.-P. Kohler, J.F. McCabe, B. Chilima, and B.J. Soldo. 2012. "Evaluating Health and Disease in Sub-Saharan Africa: Minimally Invasive Collection of Plasma in the Malawi Longitudinal Study of Families and Health (MLSFH)." Genus 68(2):1-27. PMCID: PMC3780399.

Kohler, I.V., B.J. Soldo, P. Anglewicz, B. Chilima, and H.-P. Kohler. 2013. "Association of Blood Lipids, Creatinine, Albumin, and CRP with Socioeconomic Status in Malawi." Population Health Metrics 11(1):4. PMCID: PMC3701600.

Kohler, I.V., H.-P. Kohler, P. Anglewicz, and J.R. Behrman. 2012. "Intergenerational Transfers in the Era of HIV/AIDS: Evidence from Rural Malawi." Demographic Research 27(27):775-834. PMCID: PMC3628805.