Socio-economic inequality in the prevalence of violence against older adults – Findings from India

Abstract Background Violence against older adults is a well-recognised socio-psychological and public health problem worldwide. It is uncared-for, undiagnosed, and untreated problem that is widespread across both developed and developing countries. Therefore, this paper aims to understand the extent of socio-economic status related inequality in violence against older adults. Methods Data for this study came from Building a Knowledge Base on Population Aging in India (BKPAI). Violence against older adults was the outcome variable for this study and defined as older adults who faced any abuse or violence or neglect or disrespect by any person. Bivariate analysis and regression-based decomposition technique is used to understand the relative contribution of various socioeconomic factors to violence among (N = 9541) older adults. Results The most dominant form of violence is verbal (10%) followed by disrespect (5.8%) and economic violence (5.2%). Older adults aged 80 + years [OR: 1.49; CI: 1.14–1.93] and working [OR: 1.26; CI: 1.02–1.56] had higher likelihood to suffer from violence than their counterparts. On the other hand older adults who were currently in union [OR: 0.79; CI: 0.65–0.95], living with children [OR: 0.53; CI: 0.40–0.72] and belonging to richer wealth quintile [OR: 0.35; CI: 0.24–0.51] had lower likelihood to suffer from violence than their counterparts. The decomposition results revealed that poor older adults are more prone to violence (Concentration index: -0.20). Household’s wealth status was responsible for 93.7% of the SES-related inequality whereas living arrangement of older adults explained 13.7% SES-related inequality. Education and working status of older adults made a substantial contribution to the inequalities in reported violence, explaining 3.7% and 3.3% of the total inequality, respectively. Conclusion With no or meagre income of their own, older adults belonging to the poorest wealth quintile have little or no bargaining power to secure a violent free environment for themselves. Therefore, special attention in terms of social and economic support should be given to the economically vulnerable older population.

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Socio-economic inequality in the prevalence of violence against older adults – findings from India

BMC Geriatrics ◽

10.1186/s12877-021-02234-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Debashree Sinha ◽

Prem Shankar Mishra ◽

Shobhit Srivastava ◽

Pradeep Kumar

Keyword(s):

Older Adults ◽

Economic Status ◽

Living Arrangement ◽

Public Health Problem ◽

Wealth Quintile ◽

Substantial Contribution ◽

Outcome Variable ◽

Bivariate Analysis ◽

Socio Economic Status ◽

Related Inequality

Abstract Background Violence against older adults is a well-recognised socio-psychological and public health problem. It is uncared-for, undiagnosed, and an untreated problem that is widespread across both developed and developing countries. The present paper aims to understand the extent of the socio-economic status related inequality in violence against older adults in India. Methods The study uses data from Building a Knowledge Base on Population Aging in India (BKPAI). Violence against older adults is the outcome variable for the study and is defined as older adults who faced any abuse or violence or neglect or disrespect by any person. Bivariate analysis and regression-based decomposition technique is used to understand the relative contribution of various socio-economic factors to violence against older adults (N = 9541). Results The prevalence of violence faced by older adults was 11.2%. Older adults aged 80+ years [OR: 1.49; CI: 1.14–1.93] and working [OR: 1.26; CI: 1.02–1.56] had higher likelihood to face violence than their counterparts. On the other hand, older adults who were currently in union [OR: 0.79; CI: 0.65–0.95], lived with children [OR: 0.53; CI: 0.40–0.72] and who belonged to richer wealth quintile [OR: 0.35; CI:0.24–0.51] had lower likelihood to suffer from violence than their counterparts. The decomposition results revealed that poor older adults were more prone to violence (Concentration index: − 0.20). Household’s wealth status was responsible for explaining 93.7% of the socio-economic status related inequality whereas living arrangement of older adults explained 13.7% of the socio-economic related inequality. Education and working status of older adults made a substantial contribution to the inequalities in reported violence, explaining 3.7% and 3.3% of the total inequality, respectively. Conclusion Though interpretation of the results requires a cautious understanding of the data used, the present study highlights some of the relevant issues faced by the country’s older adults. With no or meagre income of their own, older adults belonging to the poorest wealth quintile have little or no bargaining power to secure a violent free environment for themselves. Therefore, special attention in terms of social and economic support should be given to the economically vulnerable older population.

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Wealth and unintended pregnancy in Ghana: Analysis of 2014 Ghana Demographic and Health Survey

10.21203/rs.2.18741/v1 ◽

2019 ◽

Author(s):

Jones Arkoh Paintsil ◽

Edward Kwabena Ameyaw

Keyword(s):

Unintended Pregnancy ◽

Descriptive Analysis ◽

Critical Factor ◽

Wealth Quintile ◽

Control Measures ◽

Reproductive Age ◽

Outcome Variable ◽

Wealth Status ◽

Unintended Pregnancies ◽

Binary Logistic Model

Abstract Background: Pregnancy intention is a critical factor for both short and long term maternal and 27 child health outcomes. Some evidence show that wealth status has varying implications on 28 unintended pregnancy. In this study, we investigated wealth and unintended pregnancy among 29 women of reproductive age in Ghana. 30Methods: Our descriptive analysis comprised calculation of wealth status and unintended 31 pregnancy. The same calculation was done for socio-demographic characteristics and 32 unintended pregnancy. Due to the binary nature of the outcome variable (unintended 33 pregnancy), Binary Logistic Model was used for the inferential analysis. The first model 34 (Model I), constituted wealth quintile and unintended pregnancy. The second model (Model II) 35 was developed by adjusting for five key socio-demographic variables. 36Results: Women in the richest wealth quintile had less likelihood of experiencing unintended 37 pregnancy (OR=0.740, CI=0.42-1.28). Considering women aged 15-19 as the reference 38 category, women in all other age categories had less likelihood of unintended pregnancy 39 especially those aged 45-49 (AOR=0.26, CI=0.04-1.58). The findings revealed that those who 40 listened to radio at least once a week (AOR=0.56, CI=0.36-0.89) were less probable to report 41 unintended pregnancy, having those not listening to radio at all as the reference category. 42 Women in urban settings were less likely to have unintended pregnancies (AOR=0.74, 43 CI=0.46-1.19). 44Conclusions: This study has indicated that unintended pregnancy to larger extent is poverty 45 driven. The study suggests that the mass media, particularly radio, is valuable in 46 communicating birth control measures and messages on unintended pregnancies. Efforts to 47 halt unintended pregnancies must target poor women, especially those in the rural locations.

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Abortion care seeking in India: patterns and predictors

Journal of Biosocial Science ◽

10.1017/s002193201900049x ◽

2019 ◽

Vol 52 (3) ◽

pp. 353-365

Author(s):

Palak Sharma ◽

Manas Ranjan Pradhan

Keyword(s):

Health Care ◽

Multinomial Logistic Regression ◽

Care Facility ◽

Health Care Facility ◽

Public Health Problem ◽

Wealth Quintile ◽

Bivariate Analysis ◽

Care Seeking ◽

Abortion Care ◽

Facility Type

AbstractUnsafe abortions remain a considerable public health problem and continue to be a leading cause of maternal morbidity and mortality throughout the world. This study assessed whether women’s choice of type of health care facility for abortion in India varied by their socio-demographic and economic characteristics, and aimed to determine the significant predictors of choice of health care facility. Data were taken from the 2015–16 Indian National Family and Health Survey (NFHS-4). The study sample included women aged 15–49 years, irrespective of their marital status, who had terminated their last pregnancy by induced abortion in the five years before the survey (N = 6876). A bivariate analysis was carried out to assess the pattern in the choice of health care facility type for an abortion, and a multinomial logistic regression model was fitted to assess the predictors affecting the choice of health care facility type for an abortion. The results showed that, at the time of the 2015–16 survey, women in India went to private facilities more than public facilities for abortion care, irrespective of their age, distance to facility and financial constraints. The probability of visiting a private facility increased with women’s age, gestational age and the wealth quintile. A wide variation in choice of health facility for abortion care by socioeconomic characteristics was observed.

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Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

Brain Sciences ◽

10.3390/brainsci10010049 ◽

2020 ◽

Vol 10 (1) ◽

pp. 49 ◽

Cited By ~ 1

Author(s):

Shervin Assari ◽

Cheryl Wisseh ◽

Mohammed Saqib ◽

Mohsen Bazargan

Keyword(s):

Older Adults ◽

African American ◽

Cognitive Function ◽

Los Angeles ◽

Living Arrangement ◽

Memory Function ◽

Continuous Variable ◽

Financial Strain ◽

Outcome Variable ◽

Future Research

Although previous research has linked polypharmacy to lower cognitive function in the general population, we know little about this association among economically challenged African American (AA) older adults. This study explored the link between polypharmacy and memory function among AA older adults. This community-based study recruited 399 AA older adults who were 65+ years old and living in economically disadvantaged areas of South Los Angeles. Polypharmacy (taking 5+ medications) was the independent variable, memory function was the outcome variable (continuous variable), and gender, age, living arrangement, socioeconomic status (educational attainment and financial strain), health behaviors (current smoking and any binge drinking), and multimorbidity (number of chronic diseases) were the covariates. Linear regression was used for data analyses. Polypharmacy was associated with lower scores on memory function, above and beyond covariates. Among AA older adults, polypharmacy may be linked to worse cognitive function. Future research should test the mechanisms by which polypharmacy is associated with lower levels of cognitive decline. There is a need for screening for memory problems in AA older adults who are exposed to polypharmacy.

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Urban-Rural and Gender Differential in Depressive Symptoms Among Elderly in India

10.21203/rs.3.rs-608443/v1 ◽

2021 ◽

Author(s):

Shubham Kumar ◽

Shekhar Chauhan ◽

Ratna Patel ◽

Manish Kumar

Keyword(s):

Depressive Symptoms ◽

Urban Areas ◽

Health Care Services ◽

Decomposition Analysis ◽

The Elderly ◽

Outcome Variable ◽

Bivariate Analysis ◽

Related Inequality ◽

Prevalence Of Depression ◽

Urban Rural

Abstract Background To date, evidence remained inconclusive explaining rural-urban and male-female differential in depression. Unlike other previous research on the association of several risk factors with depressive symptoms among the elderly, this study focussed on the socio-economic status-related inequality in the prevalence of depression among the elderly along with focussing urban-rural and male-female gradients of depression among the elderly. Methods This study used data from Longitudinal Ageing Study in India (LASI) wave-I, 2017-18, survey. The outcome variable for this study was self-reported depression. Bivariate analysis was used to understand the prevalence by sociodemographic clusters. Fairlie decomposition analysis has been done to measures rural-urban inequalities for depression among older men and women. Results Results found that around 22 percent of urban elderly and 17 percent of rural elderly reported depression. A higher proportion of female elderly (22.6% vs. 18.4%) reported depression than male elderly. Almost one in every five elderly (20.6%) reported depression in India. The results found that a higher percentage of women in rural and urban areas reported depression than their male counterparts. While examining SES-related inequality in the prevalence of depression, education was a significant factor explaining the SES-related inequality in the prevalence of depression among female elderly and not in male elderly. Conclusion Given the large proportion of elderly reporting depression, this study highlights the need for improving health care services among the elderly. The increasing burden of depression in specific sub-populations also highlights the importance of understanding the broader consequences of depression among rural and female elderly.

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Decomposing socio-economic inequality for routine medical check-ups among older adults in India

10.21203/rs.3.rs-72308/v1 ◽

2020 ◽

Author(s):

Shobhit Srivast ◽

Ratna Patel ◽

Shekhar Chauhan ◽

Pradeep Kumar ◽

Samriddhi S Gupte ◽

...

Keyword(s):

Older Adults ◽

Rural Areas ◽

Concentration Index ◽

Early Stage ◽

Economic Inequality ◽

Decomposition Analysis ◽

Policy Formulation ◽

Health Check ◽

Substantial Contribution ◽

Outcome Variable

Abstract BackgroundRoutine medical check-ups not only reduce the health-care costs over time by detecting potentially life-threatening health conditions at an early stage but also reduces the risk of getting sick and thereby increasing the life span and improving overall health. Therefore, this study examined the prevalence and factors associated with medical check-ups among older adults in India.MethodsThe study utilized data from Building a Knowledge Base on Population Aging in India(BKPAI). The routine medical check-up is the outcome variable of this study. Multivariate analysis has been implemented to fulfil the objectives of the study. Concentration index and decomposition analysis were carried out to examine observed socio-economic inequality in the routine medical check-ups.ResultsNearly one-fourth (23.1%) of the older adults were undergoing the routine medical check-up. Older adults with below five years (OR, 1.31; CI: 1.13-1.51), 6 to 10 years (OR, 1.36; CI: 1.16-1.60), and 11+ years of schooling (OR, 2.02; CI: 1.6-2.54) were significantly more likely to go for routine medical check-ups than illiterate older adults. The concentration Index value of 0.19 depicts the pro-rich inequality in health check-ups among older adults. Furthermore, the results from the decomposition analysis revealed that the wealth quintile of the household contributed nearly 57 percent to the observed socio-economic inequality in the prevalence of routine medical check-up. Education and working status of older adults made a substantial contribution to the inequalities in routine medical check-ups and explained 16.9 percent, and 4.2 percent of the total inequality, respectively.ConclusionsFrom a policy perspective, at first, there is a dire need to spread awareness about the usefulness of routine medical check-ups among older adults. Further, this study reflects the association between education and routine medical check-up, and therefore there is a need to promote literacy at the grass-root level; also, it is recommended to promote health literacy among the older adults. A low level of medical check-up among older adults in rural areas could be reduced by offering free health check-ups regularly. Furthermore, the care of the elderly needs to be prioritized while policy formulation.

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Association of family structure with gain and loss of household headship among older adults in India: Analysis of panel data

PLoS ONE ◽

10.1371/journal.pone.0252722 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252722

Author(s):

Shobhit Srivastava ◽

Muhammad Thalil ◽

Rashmi Rashmi ◽

Ronak Paul

Keyword(s):

Older Adults ◽

Family Structure ◽

Independent Living ◽

Regression Models ◽

Psychosocial Support ◽

Outcome Variable ◽

Bivariate Analysis ◽

Public Intervention ◽

Single Generation ◽

Household Headship

Background Despite huge changes in demographic behaviors, the family continues to be the major source of psychosocial support for older adults in India. The loss of household headship can be a cause of disregard for the aged and is associated in a very fundamental way with other status losses. Our study used the two rounds of the India Human Development Survey to understand the association of family structure on the gain or loss status of household headship among 10,527 older adults. Method Bivariate analysis was done using the chi-square test for association. Equivalently, the multivariate analysis involved estimating multivariable logistic regression models. Multicollinearity did not affect the estimates from the regression models. For examining headship transition, we performed two complete sets of analysis, by taking gain in headship and loss in headship as the outcome variable respectively. Results Across two rounds, a major shift in family structure was noticed as 6.8% of households moved from extended to a single generation. Results indicate that family structure was significantly associated with gaining and losing headship among older adults. Headship loss was more common among nuclear [OR: 2.16; CI: 1.28, 3.65] and extended [OR: 2.76; CI: 1.64, 4.66] family structures. Moreover, gaining headship was found to be significantly associated with married, educated, and working older adults. Conclusion Since living in single generation household may preferably be encouraged among older adults than their living in a complex household without headship and value they deserve, the public intervention may support the independent living within the older population through housing policies that create additional choices presented to older adults making residential decisions.

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The association of widowhood and living alone with depression among older adults in India

Scientific Reports ◽

10.1038/s41598-021-01238-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shobhit Srivastava ◽

Paramita Debnath ◽

Neha Shri ◽

T. Muhammad

Keyword(s):

Older Adults ◽

Marital Status ◽

Living Arrangement ◽

Binary Logistic Regression ◽

Well Being ◽

Living Alone ◽

Bivariate Analysis ◽

Binary Logistic Regression Analysis ◽

Effective Sample Size ◽

Nationally Representative

AbstractWidowhood is a catastrophic event at any stage of life for the surviving partner particularly in old age, with serious repercussions on their physical, economic, and emotional well-being. This study investigates the association of marital status and living arrangement with depression among older adults. Additionally, the study aims to evaluate the effects of factors such as socio-economic conditions and other health problems contributing to the risk of depression among older adults in India. This study utilizes data from the nationally representative Longitudinal Ageing Study in India (LASI-2017–18). The effective sample size was 30,639 older adults aged 60 years and above. Descriptive statistics and bivariate analysis have been performed to determine the prevalence of depression. Further, binary logistic regression analysis was conducted to study the association between marital status and living arrangement on depression among older adults in India. Overall, around nine percent of the older adults suffered from depression. 10.3% of the widowed (currently married: 7.8%) and 13.6% of the older adults who were living alone suffered from depression. Further, 8.4% of the respondents who were co-residing with someone were suffering from depression. Widowed older adults were 34% more likely to be depressed than currently married counterparts [AOR: 1.34, CI 1.2–1.49]. Similarly, respondents who lived alone were 16% more likely to be depressed compared to their counterparts [AOR: 1.16; CI 1.02, 1.40]. Older adults who were widowed and living alone were 56% more likely to suffer from depression [AOR: 1.56; CI 1.28, 1.91] in reference to older adults who were currently married and co-residing. The study shows vulnerability of widowed older adults who are living alone and among those who had lack of socio-economic resources and face poor health status. The study can be used to target outreach programs and service delivery for the older adults who are living alone or widowed and suffering from depression.

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The Role of Socio-Economic Inequality in Physical Immobility Among Older Adults: Did the Scenario Changed from 2004-05 to 2017-18?

10.21203/rs.3.rs-54744/v1 ◽

2020 ◽

Author(s):

Shobhit Srivast ◽

Ratna Patel ◽

Shekhar Chauhan ◽

Pradeep Kumar ◽

Preeti Dhillon

Keyword(s):

Risk Factors ◽

Older Adults ◽

Living Arrangement ◽

Economic Inequality ◽

National Sample ◽

Sample Survey ◽

Wealth Status ◽

Relative Contribution ◽

Socio Economic Factors

Abstract Background: Despite declining overall growth rate of the population across the world, the number of older adults is rising. To understand the needs and problems faced by older adults, it is imperative to understand the demographic and socio-economic conditions of the individuals. On these lines, physical immobility among older adults is attributed to various risk factors. The living arrangement is found to be one of the critical risk factors along with economic dependency in explaining physical immobility among older adults in India. Therefore, this study is an attempt to explore the role of socio-economic inequality in physical immobility among older adults in India. Methods: This study utilized 60th and 75th rounds of data from the National Sample Survey conducted in 2004-05 and 2017-18, with a sample size of 34,831 and 42,762 older adults aged 60 and above, respectively. Further, the study decomposes the concentration index using regression-based decomposition technique to understand the relative contribution of various socio-economic factors to the physical immobility of older adults.Results: Result found a decline of 0.6 points in the prevalence of physical immobility from 2004-05 to 2017-18. The sharpest increase was observed in Puducherry (9.9%) followed by Chandigarh (7.6%), and decline was witnessed in Nagaland (9.2%) followed by Lakshadweep (6.4%) and Delhi (5.3%). Physical immobility was more concentrated among well-off older adults in 2017-18 as compared to in 2004-05. Living alone, chronic diseases, and rich wealth status contributed significantly to explaining the observed socio-economic inequality in physical immobility.Conclusions: Based on the observations made on the socio-economic inequality in physical immobility among older adults in India, some health interventions are required to cater to the needs of older adults.

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Geospatial Inequality of Anemia Among Children in Ethiopia

10.21203/rs.3.rs-54237/v1 ◽

2020 ◽

Author(s):

bilal Endris ◽

Geert-Jan Dinant ◽

Seifu Hagos Gebreyesus ◽

Mark Spigt

Keyword(s):

Risk Factors ◽

Multivariable Analysis ◽

Spatial Association ◽

Public Health Problem ◽

Wealth Quintile ◽

Scan Statistics ◽

Outcome Variable ◽

High Fertility ◽

Control Programs ◽

Prevalence Of Anemia

Abstract Background: Anemia remains a severe public health problem among children in Ethiopia. The lack of progress in the trend of anemia infers the failure of national anemia prevention and control programs. If there are considerable geospatial differences in the prevalence of anemia in Ethiopia, targeted approaches, based on the distribution and specific risk factors for that setting are needed to efficiently target health interventions. This study aimed to identify and locate anemia hotspots among children in Ethiopia. Methods: Data analysis was performed using Ethiopia Demographic and Health Survey (EDHS) 2016 Data. Blood specimens for anemia testing were collected from children age 6-59 months. Hemoglobin analyses were placed in a HemoCue photometer and the results were recorded onsite for 9,268 children. The outcome variable anemia was categorized into a dichotomous variable (anemic and not anemic); a child was considered as anemic if the blood-hemoglobin count was less than 11.0 g/dl. We applied Kulldorf’s spatial scan statistics and used SaTScanTM to identify locations and estimate cluster sizes. In addition, we ran LISA (local indicator of spatial association) and the Getis-Ord Gi(d) local statistics to detect and locate hotspots of anemia. We ran multilevel multivariable analysis to identify risk factors for anemia clustering.Result: More than half (57%) of children aged 6-59 months were anemic in Ethiopia. Higher prevalence of anemia was found among children who live in Somali region (83%), in rural area (58%), in the lowest wealth quintile (68%), and among children of mothers’ with no education (59%). We found significant geospatial inequality of anemia among children in Ethiopia. We identified one anemia cluster (hotspot) in the eastern part of Ethiopia. Women anemia, stunting and high fertility were associated with anemia clustering.Conclusion: Anemia clustering was found in the eastern part of Ethiopia. We recommend that policy makers and programmers should especially target this area for accelerated reduction of anemia.

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