The in incidence of prime-age adult death is increasing as a result of HIV/AIDS and opportunistic infections. Because of these increases, the ability of smallholders to increase food security and maintain current on and off-farm activities is more constrained than ever. Using panel data, this paper empirically examines the effects of disease-related adult death on small farm households in Kenya. With increasing pressure on land and resources, the strategies employed by these households are currently centered around maintaining household composition consistent with their needs for household and farm labor. The demographic crisis being faced in some areas of Kenya is not repeated across all districts at this time. Government and non-government entities must shape policy and programs to stop adult death from becoming an extensive crisis, and to off-set the food insecurity created by loss of productive labor and increased dependency ratios.