Determinants of Poor Health Outcome Among Older Adults in India
Abstract
Self-rated health (SRH) is a crucial indicator of overall health status, functionality, and mortality among older adults. This study examines the socio-economic correlates of health outcomes among older adults aged 45-59 in India using data from the Longitudinal Ageing Study of India Wave-I. Descriptive analysis, bi-variate analysis, and multivariate logistic regression were performed to investigate the factors that best explain and predict SRH. The results show that age, gender, place of residence, education, marital status, religion, social category, living arrangements, work status, income, multimorbidity, functional limitations, nutritional status, and health behaviours are significant determinants of poor SRH. Multimorbidity and functional limitations were found to be the principal determinants of poor SRH. The likelihood of reporting poor SRH increases with age, being female, living in rural areas, having lower education, being unmarried, divorced, or widowed, belonging to disadvantaged social categories, living with a spouse or others, not currently working, having lower income, being underweight, and engaging in risky health behaviours. The findings highlight the need to strengthen healthcare services for older adults in India, considering the ongoing demographic transition and the substantial proportion of poor SRH in this age group. Addressing the needs of older adults aged 45-59 can help the nation benefit from the demographic dividend.
References
2. Brown, R. T., Diaz-Ramirez, L. G., Boscardin, W. J., Lee, S. J., & Steinman, M. A. (2017). Functional Impairment and Decline in Middle Age. Annals of Internal Medicine, 167(11), 761–768. https://doi.org/10.7326/M17-0496
3. Brown, V., Cataldo, J., Shaw, T., & Collins, S. (2019). Review of strategies to address social determinants of health and health disparities to improve health outcomes. Social Determinants of Health, 5(3), Article 3. https://doi.org/10.22037/sdh.v5i3.25413
4. Harrington, J., Perry, I. J., Lutomski, J., Fitzgerald, A. P., Shiely, F., McGee, H., Barry, M. M., Van Lente, E., Morgan, K., & Shelley, E. (2010). Living longer and feeling better: Healthy lifestyle, self-rated health, obesity and depression in Ireland. European Journal of Public Health, 20(1), 91–95. https://doi.org/10.1093/eurpub/ckp102
5. International Institute for Population Sciences (IIPS), National Programme for Health Care of Elderly (NPHCE), MoHFW, Harvard T. H. Chan School of Public Health (HSPH), & the University of Southern California (USC) 2020. (n.d.). Longitudinal Ageing Study in India (LASI) Wave 1, 2017-18, India Report. International Institute for Population Sciences, Mumbai. https:// www.iipsindia.ac.in/sites/default/files/LASI_India_ Report_2020_compressed.pdf
6. Kumar, S., & Pradhan, M. R. (2019). Self-rated health status and its correlates among the elderly in India. Journal of Public Health, 27(3), 291–299. https://doi.org/10.1007/s10389-018-0960-2
7. Machón, M., Vergara, I., Dorronsoro, M., Vrotsou, K., & Larrañaga, I. (2016). Self-perceived health in functionally independent older people: Associated factors. BMC Geriatrics, 16(1), 66. https://doi.org/10.1186/s12877-016-0239-9
8. Mishra, R., Sharma, S. K., & Talukdar, B. (2018). Self-reported Health of Aged Population in India. Social Science Spectrum, 3(4), Article 4. https://www.socialspectrum.in/index.php/sp/article/view/113
9. Omran, A. R. (2005). The Epidemiologic Transition: A Theory of the Epidemiology of Population Change. The Milbank Quarterly, 83(4), 731. https://doi.org/10.1111/j.1468-0009.2005.00398.x
10. Pandey, A., & Ladusingh, L. (2015). Socioeconomic Correlates of Gender Differential in Poor Health Status Among Older Adults in India. Journal of Applied Gerontology, 34(7), 879–905. https://doi.org/10.1177/0733464813481850
11. Rajan, S. I., Mishra, U. S., & Sarma, P. S. (2001). Health concerns among India’s elderly. International Journal of Aging & Human Development, 53(3), 181–194. https://doi.org/10.2190/19WH-50YR-QAKG-C8VR
12. Sen, A. (1993). Positional Objectivity. Philosophy & Public Affairs, 22(2), 126–145. https://www.jstor.org/stable/2265443
13. Sen, A. (1999). The Possibility of Social Choice. The American Economic Review, 89(3), 349–378. https://www.jstor.org/stable/117024
14. Sen, A. (2002). Health: Perception versus observation. BMJ : British Medical Journal, 324(7342), 860–861. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122815/
15. Shields, M., & Shooshtari, S. (2001). Determinants of self-perceived health. Health Reports, 13(1), 35–52.
16. Sibthorpe, B., Anderson, I., & Cunningham, J. (2001). Self-Assessed Health Among Indigenous Australians: How Valid Is a Global Question? American Journal of Public Health, 91(10), 1660. https://doi.org/10.2105/ajph.91.10.1660
17. Singh, L., Arokiasamy, P., Singh, P. K., & Rai, R. K. (2013). Determinants of Gender Differences in Self-Rated Health Among Older Population: Evidence From India. Sage Open, 3(2), 2158244013487914. https://doi.org/10.1177/2158244013487914
18. Srivastava, S., Debnath, P., Shri, N., & Muhammad, T. (2021). The association of widowhood and living alone with depression among older adults in India. Scientific Reports, 11(1), 21641. https://doi.org/10.1038/s41598-021-01238-x
19. Tissue, T. (1972). Another look at self-rated health among the elderly. Journal of Gerontology, 27(1), 91–94. https://doi.org/10.1093/geronj/27.1.91
20. United Nations & Department of Economic and Social Affairs, Population Division (2019). (n.d.). Wolrd Population Prospect 2019. United Nations.
Authors
This work is licensed under a Creative Commons Attribution 4.0 International License.