Equity and elderly health in India: reflections from 75th round National Sample Survey, 2017–18, amidst the COVID-19 pandemic

Abstract Background Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak, called coronavirus disease - 2019 (COVID-19), has affected more than 200 countries across the globe with a higher fatality rate among the elderly population. Aim of the study is to highlight the vulnerability of the aged amidst the current COVID-19 pandemic, and in the light of the recent international evidence, suggests what government could do to mitigate their vulnerability. Methods Data from the recently released (November 2019) 75th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used for this study. Data collected from 555,115 individuals (rural: 325,232; urban: 229,232) included 42,762 elderly individuals (60 years or above). Bivariate and multivariate analyses were used for the calculation. Results Of the total sample of elderly individuals, 27.7% reported suffering from an ailment in the last 15 days, whereas 8.5% had been hospitalized during the last 365 days. Among the elderly, hospitalization rate was higher in the urban areas (OR: 1.23), general social category (OR: 1.18), richest economic quintile (OR: 1.69), and among those living alone (OR: 2.40). Also, among the elderly, 64% of those in the scheduled tribe (social group) and 51% in the poorest economic quintile utilized public facilities for hospitalization. Cardiovascular ailments were the major cause for hospitalization (18.1%) and outpatient visit (32%) among the elderly. Ailments related to diabetes and hypertension constituted 55% of outpatient visit for the elderly. Only 18.9% of the elderly had health insurance though chances of facing catastrophic health expenditures were high among the elderly. 6.6% of elderly female and 1.6% male live alone, and 27.5% of age 80 years and above are immobile. 50% of male and 90% of female are financially dependent on others and more so in poorer economic quintiles. Conclusions The vulnerability of India’s elderly increases across economic levels, and other dimensions such as the place of residence, gender, social group (caste), marital status, living arrangements, surviving children, and economic dependence. The current COVID-19 pandemic poses a greater risk of social isolation among the elderly, which may cause detrimental health impact. Trial registration Not applicable since the study is based on secondary data.

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Equity and Elderly Health in India: Reflections from 75th Round National Sample Survey, 2017-18, amidst the COVID-19 Pandemic

10.21203/rs.3.rs-41285/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Alok Ranjan ◽

Muraleedharan V R

Keyword(s):

Living Arrangements ◽

Urban Areas ◽

Outpatient Visit ◽

Secondary Data ◽

The Elderly ◽

National Sample ◽

Sample Survey ◽

Income Quintile ◽

General Category ◽

National Sample Survey

Abstract Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak, called coronavirus disease - 2019 (COVID-19), has affected more than 200 countries across the globe with a higher fatality rate in the elderly population. Historical experience shows that the pandemic disproportionately afflicts the socioeconomically disadvantaged population. Aim of the study is to highlight the vulnerability of the aged amidst the current pandemic, in the light of the recent international evidence, and what government could do to mitigate their vulnerability.Methods: Data from the recently released (November 2019) 75 th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used for this study. Data collected from 555115 individuals (rural: 325232; urban: 229232) included that of 42762 elderly individuals (60 years or above). Bivariate and multivariate analysis was used for the calculation.Results: 27.7 % of elderly reported suffering from any ailment in the last 15 days, whereas 8.5% had hospitalization during the last 365 days. Hospitalization rate was higher in the urban areas (OR: 1.21), general category (OR: 1.18), richest economic quintile (OR: 1.68), and among elderly living alone (OR: 2.05), which was statistically significant. 64% of the scheduled tribe and 51.0% of the poorest income quintile elderly utilized public facilities during hospitalization. Cardiovascular ailments were major cause for hospitalization (18.1%) and outpatient visit (32.0%) in the elderly. Diabetes and hypertension together constituted 55% of outpatient visit for the elderly. 18.9% of the elderly has health insurance though chances of facing catastrophic health expenditure was high in the elderly. 6.6% of elderly female and 1.6% male live alone, and 27.5% of elderly of age 80 years or above are immobile. 50% of male and 90% of female are financially dependent on others and more so in poorer economic quintiles.Conclusions: The vulnerability of India’s elderly increases across various equity dimensions which include the place of residence, gender, caste, marital status, economic quintile, living arrangements, surviving children, and economic dependence. The current COVID-19 pandemic poses a greater risk of social isolation among the elderly, which may lead to detrimental health impact.Trial Registration: No applicable since the study is based on secondary data.

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Equity and Elderly Health in India: Reflections from 75th Round National Sample Survey, 2017-18, amidst the COVID-19 Pandemic

10.21203/rs.3.rs-41285/v3 ◽

2020 ◽

Author(s):

Alok Ranjan ◽

Muraleedharan V R

Keyword(s):

Living Arrangements ◽

Urban Areas ◽

Outpatient Visit ◽

The Elderly ◽

Health Impact ◽

National Sample ◽

Catastrophic Health Expenditure ◽

Sample Survey ◽

Income Quintile ◽

National Sample Survey

Abstract Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak, called coronavirus disease - 2019 (COVID-19), has affected more than 200 countries across the globe with a higher fatality rate among the elderly population. Aim of the study is to highlight the vulnerability of the aged amidst the current COVID-19 pandemic, and in the light of the recent international evidence, suggests what government could do to mitigate their vulnerability. Methods: Data from the recently released (November 2019) 75 th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used for this study. Data collected from 555115 individuals (rural: 325232; urban: 229232) included that of 42762 elderly individuals (60 years or above). Bivariate and multivariate analysis was used for the calculation. Results: 27.7 % of elderly reported suffering from any ailment in the last 15 days, whereas 8.5% had hospitalization during the last 365 days. Among the elderly, hospitalization rate was higher in the urban areas (OR: 1.23), general social category (OR: 1.18), richest economic quintile (OR: 1.69), and among those living alone (OR: 2.40). Also, among the elderly, 64% of those in the scheduled tribe (social class) and 51.0% in the poorest income quintile utilized public facilities for hospitalization. “Cardiovascular ailments” was a major cause for hospitalization (18.1%) and outpatient visit (32.0%) among the elderly. Diabetes and hypertension together constituted 55% of outpatient visit for the elderly. 18.9% of the elderly had health insurance though chances of facing catastrophic health expenditure was high among the elderly. 6.6% of elderly female and 1.6% male live alone, and 27.5% of age 80 years and above are immobile. 50% of male and 90% of female are financially dependent on others and more so in poorer economic quintiles. Conclusions: The vulnerability of India’s elderly increases across economic levels, and other dimensions such as the place of residence, gender, caste, marital status, living arrangements, surviving children, and economic dependence. The current COVID-19 pandemic poses a greater risk of social isolation among the elderly, which may cause detrimental health impact.

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Equity and Elderly Health in India: Reflections from 75th Round National Sample Survey, 2017-18, amidst the COVID-19 Pandemic

10.21203/rs.3.rs-41285/v2 ◽

2020 ◽

Author(s):

Alok Ranjan ◽

Muraleedharan V R

Keyword(s):

Living Arrangements ◽

Urban Areas ◽

Outpatient Visit ◽

The Elderly ◽

National Sample ◽

Catastrophic Health Expenditure ◽

Sample Survey ◽

Income Quintile ◽

General Category ◽

National Sample Survey

Abstract Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak, called coronavirus disease - 2019 (COVID-19), has affected more than 200 countries across the globe with a higher fatality rate in the elderly population. Historical experience shows that the pandemic disproportionately afflicts the socioeconomically disadvantaged population. Aim of the study is to highlight the vulnerability of the aged amidst the current pandemic, in the light of the recent international evidence, and what government could do to mitigate their vulnerability. Methods: Data from the recently released (November 2019) 75 th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used for this study. Data collected from 555115 individuals (rural: 325232; urban: 229232) included that of 42762 elderly individuals (60 years or above). Bivariate and multivariate analysis was used for the calculation. Results: 27.7 % of elderly reported suffering from any ailment in the last 15 days, whereas 8.5% had hospitalization during the last 365 days. Hospitalization rate was higher in the urban areas (OR: 1.21), general category (OR: 1.18), richest economic quintile (OR: 1.68), and among elderly living alone (OR: 2.05), which was statistically significant. 64% of the scheduled tribe and 51.0% of the poorest income quintile elderly utilized public facilities during hospitalization. Cardiovascular ailments were major cause for hospitalization (18.1%) and outpatient visit (32.0%) in the elderly. Diabetes and hypertension together constituted 55% of outpatient visit for the elderly. 18.9% of the elderly has health insurance though chances of facing catastrophic health expenditure was high in the elderly. 6.6% of elderly female and 1.6% male live alone, and 27.5% of elderly of age 80 years or above are immobile. 50% of male and 90% of female are financially dependent on others and more so in poorer economic quintiles. Conclusions: The vulnerability of India’s elderly increases across various equity dimensions which include the place of residence, gender, caste, marital status, economic quintile, living arrangements, surviving children, and economic dependence. The current COVID-19 pandemic poses a greater risk of social isolation among the elderly, which may lead to detrimental health impact.

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IS HEALTH STATUS OF ELDERLY WORSENING IN INDIA? A COMPARISON OF SUCCESSIVE ROUNDS OF NATIONAL SAMPLE SURVEY DATA

Journal of Biosocial Science ◽

10.1017/s0021932010000623 ◽

2010 ◽

Vol 43 (2) ◽

pp. 211-231 ◽

Cited By ~ 12

Author(s):

ZAKIR HUSAIN ◽

SASWATA GHOSH

Keyword(s):

Health Status ◽

Living Arrangements ◽

Economic Status ◽

Health Care Expenditure ◽

The Elderly ◽

National Sample ◽

Sample Survey ◽

National Sample Survey ◽

Level Data ◽

Reported Health

SummaryThe increasing greying of India's population raises concerns about the welfare and health status of the aged. One important source of information of health status of the elderly is the National Sample Survey Rounds on Morbidity and Health Care Expenditure. Using unit-level data for 1995–96 and 2004, this paper examines changes in reported health status of the elderly in India and analyses their relationship with living arrangements and extent of economic dependency. It appears that even after controlling for factors like caste, education, age, economic status and place of residence, there has been a deterioration in self-perceived current health status of the elderly. The paper argues that, although there have been changes in the economic condition and traditional living arrangements – with a decline in co-residential arrangements – this is not enough to explain the decline in reported health status and calls for a closer look at narratives of neglect being voiced in developing countries.

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Differentials and predictors of hospitalization among the elderly people in India: Evidence from 75th round of National Sample Survey (2017-18)

10.1101/2021.08.25.21262606 ◽

2021 ◽

Author(s):

Saddaf Naaz Akhtar ◽

Nandita Saikia

Keyword(s):

The Elderly ◽

National Sample ◽

Communicable Diseases ◽

Public Hospitals ◽

Sample Survey ◽

Binary Logistic Regression Analysis ◽

Eastern Region ◽

Early Screening ◽

National Sample Survey ◽

Hospitalization Rates

AbstractIntroductionThere are limited evidences on the determinants of hospitalization and its causes in India. We examined the differential in the hospitalization rates and its socio-economic determinants. We also examined the causes of diseases in hospitalization among the elderly (≥60 years) in India.MethodsWe used data from 75th round of the National Sample Survey Organizations (NSSO), collected from July 2017 to June 2018. The elderly samples in this survey are 42759, where 11070 were hospitalized, and 31,689 were not hospitalized in the last year or 365 days. We estimated hospitalization rates and carried out binary logistic regression analysis to examine the associations of hospitalization with the background variables. The cause of diseases in hospitalizations were also calculated.ResultsHospitalization rate was lower among female elderly compared to male elderly. Elderly who belongs to middle-old aged groups, non-married, North-Eastern region, Southern region, general caste, health insurance, partially & fully economically dependent elderly have a higher chance of being hospitalized. About 38% elderly were hospitalized due to communicable diseases (CDs), 52% due to non-communicable diseases (NCDs) and 10% due to Injuries & others. Nearly 40% elderly were hospitalized in public hospitals due to CDs, while 52% were hospitalized in private hospitals due to NCDs and 11% due to Injuries & others.ConclusionsRaising awareness, promoting a healthy lifestyle, and improving the quality of good healthcare provisions at the primary level is necessary. Early screening and early treatment for NCDs are needed, which is non-existent in almost all parts of India.

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MORBIDITY PATTERN OF HOSPITALIZATION AND ASSOCIATED OUT OF POCKET EXPENDITURE: EVIDENCE FROM NSSO (2017-2018)

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v9.i11.2021.4401 ◽

2021 ◽

Vol 9 (11) ◽

pp. 138-155

Author(s):

Amiya Saha ◽

Dipti Govil

Keyword(s):

Urban Areas ◽

Sudden Change ◽

National Sample ◽

Medical Expenditure ◽

Sample Survey ◽

Care Utilization ◽

National Sample Survey ◽

Survey Report ◽

Nationally Representative ◽

Log Linear

In 2018, according to the National Sample Survey Report, the number of cases of hospitalization per 1000 persons in 365 days was 29 in India (26 per 1000 in rural and 34 per 1000 in urban areas). Between 2004 and 2014, for example, the average medical expenditure per hospitalization for urban patients increased by about 176%, and for rural patients, it jumped by a little over 160%. Most of these hospitalizations are for infections, but a significant number also for treatment for cancer and blood-related diseases. The increase in access to healthcare has also brought with it a massive spike in costs. India is rapidly undergoing an epidemiological transition with a sudden change in the disease profile of its population. This study aimed to analyze hospitalization due to different factors like age and morbidity and its effect on health care utilization from nationally representative data from 2018 among the total population of India. 75th round of National Sample Survey Organisation (NSSO) conducted in July 2017- June 2018 has been used to examine what are the determinant factors that affect the hospitalization and mean monthly disease-specific expenditure in the different age group populations in India. We have used cross-tabulation to understand the association between morbidity patterns and healthcare utilization with other socio-demographic variables. A set of logistic regression analyses was carried out to understand the role of age patterns on hospitalization. A log-linear regression model was used to understand the significant predictors of out-of-pocket expenditure (OOPE).

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Prenatal malnutrition and adult cognitive impairment: a natural experiment from the 1959–1961 Chinese famine

British Journal Of Nutrition ◽

10.1017/s0007114518000958 ◽

2018 ◽

Vol 120 (2) ◽

pp. 198-203 ◽

Cited By ~ 8

Author(s):

Ping He ◽

Li Liu ◽

J. M. Ian Salas ◽

Chao Guo ◽

Yunfei Cheng ◽

...

Keyword(s):

Cognitive Impairment ◽

Prenatal Exposure ◽

Urban Areas ◽

Total Sample ◽

National Sample ◽

Potential Effect ◽

Sample Survey ◽

Birth Cohorts ◽

Adult Intelligence Scale ◽

Wechsler Adult Intelligence Scale

AbstractThe current measures of cognitive functioning in adulthood do not indicate a long-term association with prenatal exposure to the Dutch famine. However, whether such association emerges in China is poorly understood. We aimed to investigate the potential effect of prenatal exposure to the 1959–1961 Chinese famine on adult cognitive impairment. We obtained data from the Second National Sample Survey on Disability implemented in thirty-one provinces in 2006, and restricted our analysis to 387 093 individuals born in 1956–1965. Cognitive impairment was defined as intelligence quotient (IQ) score under 70 and IQ of adults was evaluated by the Wechsler Adult Intelligence Scale – China Revision. Famine severity was defined as excess death rate. The famine impact on adult cognitive impairment was estimated by difference-in-difference models, established by examining the variations of famine exposure across birth cohorts. Results show that compared with adults born in 1956–1958, those who were exposed to Chinese famine during gestation (born in 1959–1961) were at greater risk of cognitive impairment in the total sample. Stratified analyses showed that this effect was evident in males and females, but only in rural, not in urban areas. In conclusion, prenatal exposure to famine had an enduring deleterious effect on risk of cognitive impairment in rural adults.

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Family structure and its impacts on the restrictions of self-perception of elderly health levels in Brazil

Ciência & Saúde Coletiva ◽

10.1590/1413-81232018238.18102016 ◽

2018 ◽

Vol 23 (8) ◽

pp. 2751-2762

Author(s):

Mércia Santos da Cruz ◽

Jair Andrade Araujo ◽

Adriano Nascimento da Paixão

Keyword(s):

Urban Areas ◽

Family Health ◽

The Elderly ◽

National Sample ◽

Self Report ◽

Sample Survey ◽

Physical Mobility ◽

Elderly Health ◽

Home Living ◽

The Impact

Abstract The aim of the article is to investigate the impacts of co-residence over spouce and\or children on self-perceived health among Brazilian elderly. The database used was the health supplement of the National Sample Survey of Households (PNAD) conducted by the Brazilian Institute of Geography and Statistics (IBGE) in 2008. The sample consists of 36 551 people from all regions of the country such as urban areas and rurals. The results indicate that seniors with better socioeconomic status, who don’t have physical mobility problems are more propenspos to a better self report among their health, regardless of the gender of the elderly. Regarding the impact of co-residence family health of respondents, living with daughters increases the probability that perception is better (specifically good or very good). Moreover,the results are consistent with the hypothesis that elderly brazilians realize better their health with home living with daughters and/or spouse.

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