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Selvamani Y, Arokiasamy P, Chaudhary M. Association between food insecurity and quality of life among older adults (60+) in six low and middle-income countries. Arch Gerontol Geriatr 2023; 114:105079. [PMID: 37247515 DOI: 10.1016/j.archger.2023.105079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 05/31/2023]
Abstract
Food insecurity is a key social determinant of health and nutrition. However, very few studies have examined the association of food insecurity and quality of life outcomes among older adults in low and middle-income settings. In this study, we examine the association of food insecurity with self-rated poor quality of life, low life satisfaction, and WHO quality of life (WHOQol). Nationally representative data from WHO's Study on global AGEing and adult health (SAGE) consisting of 20,026 older adults were analyzed. The association of food insecurity with self-rated poor quality of life and low life satisfaction was assessed using bivariate and multivariate logistic regression analysis. Multivariate linear regression models examine the association between food insecurity and WHOQol score. Pooled data analysis of six countries showed older adults with severe food insecurity were two times more likely to report poor quality of life (OR = 2.49, CI 2.10, 2.96; p < 0.001) and low life satisfaction (OR = 2.36, CI 1.94, 2.87; p < 0.001), respectively. Similarly, older adults with severe food insecurity had 3.60 (CI-4.25, -2.95; p < 0.001) points lower WHO-QoL score than those who are food secure. These results show that the association of food insecurity is statistically significant with all three outcomes of quality of life in all six countries adjusting for sociodemographic and health measures. Public health and social security interventions are important to prevent food insecurity to promote overall wellbeing of the growing older population in low and middle-income countries.
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Affiliation(s)
- Y Selvamani
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Chennai, 603203, India.
| | - P Arokiasamy
- Policy Department, SESRI, Qatar University, Qatar
| | - Mamta Chaudhary
- School of Health System Studies, Tata Institute of Social Sciences, Mumbai, 400088, India
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Abstract
OBJECTIVES In this study, we assess the relationship between food insecurity andperceived stress among older adults (50+) in six low- and middle-income countries of China, Ghana, India, Mexico, Russia and, South Africa. METHODS Cross-sectional comparative analysis was conducted using nationally representative data from the WHO's Study on global AGEing and adult health survey. Bivariate and multivariate regression analyses examine if food insecurity was associated with perceived stress. We also examined the mediating role of health conditions on the association between food insecurity and perceived stress. RESULTS Across countries, the mean perceived stress score was higher among the older population with food insecurity. Regression analysis showed significant and positive association between food insecurity and perceived stress. Findings from the pooled data of six countries showed, older adults who experienced severe food insecurity (β = 4.05, p < .001) had higher perceived stress scores. The association was statistically significant in India, Russia, South Africa, and Ghana. CONCLUSION Food insecurity showed significant adverse impact on perceived stress among the older population in low- and middle-income countries. Policy measures to reduce household food insecurity are important for improving both mental and physical health conditions of the growing older population in low- and middle-income countries.
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Affiliation(s)
- Y Selvamani
- Department of Development Studies, Longitudinal Aging Study in India (LASI), International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, India
| | - P Arokiasamy
- Department of Development Studies, International Institute for Population Sciences (IIPS), Longitudinal Aging Study in India (LASI), Mumbai, Maharashtra, India
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Arokiasamy P, Selvamani Y, Jotheeswaran AT, Sadana R. Socioeconomic differences in handgrip strength and its association with measures of intrinsic capacity among older adults in six middle-income countries. Sci Rep 2021; 11:19494. [PMID: 34593926 PMCID: PMC8484588 DOI: 10.1038/s41598-021-99047-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 09/20/2021] [Indexed: 12/18/2022] Open
Abstract
Handgrip strength, a measure of muscular strength is a powerful predictor of declines in intrinsic capacity, functional abilities, the onset of morbidity and mortality among older adults. This study documents socioeconomic (SES) differences in handgrip strength among older adults aged 50 years and over in six middle-income countries and investigates the association of handgrip strength with measures of intrinsic capacity-a composite of all the physical and mental capacities of an individual. Secondary data analysis of cross-sectional population-based data from six countries from the WHO's Study on global AGEing and adult health (SAGE) Wave 1 were conducted. Three-level linear hierarchical models examine the association of demographic, socioeconomic status and multimorbidity variables with handgrip strength. Regression-based Relative Index of Inequality (RII) examines socioeconomic inequalities in handgrip strength; and multilevel linear and logistic hierarchical regression models document the association between handgrip strength and five domains of intrinsic capacity: locomotion, psychological, cognitive capacity, vitality and sensory. Wealth quintiles are positively associated with handgrip strength among men across all countries except South Africa while the differences by education were notable for China and India. Work and nutritional status are positively associated with handgrip strength. Our findings provide new evidence of robust association between handgrip strength and other measures of intrinsic capacity and confirms that handgrip strength is a single most important measure of capacity among older persons.
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Affiliation(s)
- P Arokiasamy
- International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, 400088, India
| | - Y Selvamani
- International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, 400088, India.
| | - A T Jotheeswaran
- Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Ritu Sadana
- Head, Ageing and Health, Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
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Himanshu, Arokiasamy P. Association between multimorbidity and disability among older adults of Uttar Pradesh, India. Aging and Health Research 2021. [DOI: 10.1016/j.ahr.2021.100033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Selvamani Y, Arokiasamy P. Association of life course socioeconomic status and adult height with cognitive functioning of older adults in India and China. BMC Geriatr 2021; 21:354. [PMID: 34107877 PMCID: PMC8191062 DOI: 10.1186/s12877-021-02303-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 05/26/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cognitive functioning is an important measure of intrinsic capacity. In this study, we examine the association of life course socioeconomic status (SES) and height with cognitive functioning among older adults (50+) in India and China. The age pattern of cognitive functioning with measures of life course socioeconomic status has also been examined. METHODS Cross-sectional comparative analysis was conducted using the WHO's Study on global AGEing and adult health (SAGE) data for India and China. Multilevel mixed-effect linear regression analysis was used to examine the association of life course socioeconomic status and adult height with cognitive functioning. RESULTS In both India and China, parental education as a measure of childhood socioeconomic status was positively associated with cognitive functioning. The association between adult socioeconomic status and cognitive functioning was positive and significant. Height was significantly and positively associated with improved cognitive functioning of older adults in India and China. Furthermore, the age-related decline in cognitive functioning score was higher among older adults whose parents had no schooling, particularly in China. The cognitive functioning score with age was much lower among less-educated older adults than those with higher levels of education in China. Wealthier older adults in India had higher cognitive functioning in middle ages, however, wealth differences narrowed with age. CONCLUSIONS The results of this study suggest a significant association of lifetime socioeconomic status and cumulative net nutrition on later-life cognitive functioning in middle-income settings.
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Affiliation(s)
- Y Selvamani
- International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, 400088, India.
| | - P Arokiasamy
- Department of Development Studies, International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, 400088, India
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Selvamani Y, Arokiasamy P. Height and quality of life among older adults (50+) in India: a cross-sectional study. J Biosoc Sci 2021; 54:1-26. [PMID: 33849678 DOI: 10.1017/s0021932021000146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Adult height is a summary measure of health and net nutrition in early childhood. This study examines the association between height and quality-of-life outcomes in older adults (50+) in India. Cross-sectional data from Wave 1 of the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) conducted in 2007 were analysed. The association between height and quality of life was assessed using bivariate and multivariate logistic and linear regression models. The mean WHO quality-of-life score (WHO-QoL) increased from 45.2 among the older adults in the lowest height quintile to 53.2 for those in the highest height quintile. However, the prevalence of self-rated poor quality of life declined from 16.4% in the lowest height quintile to 6.1% in the highest height quintile. In the fully adjusted regression model, height was found to be positively associated with quality-of-life outcomes among both men and women, independent of socioeconomic and physical health confounders. The association was particularly strong for women. Women in the highest height quintile had a 2.65 point higher WHO-QoL score than those in the lowest height quintile. Similarly, the likelihood of reporting a poor quality of life was lower among women in the highest height quintile. Furthermore, measures of economic status, handgrip strength, cognitive ability and poor self-rated health were significantly associated with WHO-QoL and self-rated poor quality of life. Overall, this study revealed a significant association between height and quality of life among older adults in India, suggesting a significant role of childhood circumstances in quality of life in later life.
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Affiliation(s)
- Y Selvamani
- International Institute for Population Sciences (IIPS), Mumbai, India
| | - P Arokiasamy
- International Institute for Population Sciences (IIPS), Mumbai, India
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Kumar H, Arokiasamy P, Selvamani Y. Socioeconomic Disadvantage, Chronic Diseases and their Association with Cognitive Functioning of Adults in India: A Multilevel Analysis. Population Ageing 2019. [DOI: 10.1007/s12062-019-09243-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Dave M, Ahankari AS, Myles PR, Arokiasamy P, Khobragade P, Mortimer K, Fogarty AW. Household air pollution and lung function in Indian adults: a cross-sectional study. Int J Tuberc Lung Dis 2018; 21:702-704. [PMID: 28482966 DOI: 10.5588/ijtld.16.0615] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Exposure to air pollution produced by cooking is common in developing countries, and represents a potentially avoidable cause of lung disease. Cross-sectional data were collected by the World Health Organization's Study on Global AGEing and Adult Health conducted in India between 2007 and 2010. Exposure to biomass cooking was also associated with a decrease in forced expiratory volume in 1 s (FEV1) (-70 ml, 95%CI -111 to -30) and FEV1/FVC (forced vital capacity) ratio (-0.025, 95%CI -0.035 to -0.015) compared to those who were not exposed. These associations were predominantly observed in males (P < 0.05 for interaction analyses). Intervention studies using non-biomass fuels in India are required to ascertain potential respiratory health benefits.
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Affiliation(s)
- M Dave
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - A S Ahankari
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK, Halo Medical Foundation, Andur
| | - P R Myles
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - P Arokiasamy
- International Institute for Population Sciences, Mumbai, India
| | - P Khobragade
- International Institute for Population Sciences, Mumbai, India
| | - K Mortimer
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - A W Fogarty
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
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Biritwum RB, Minicuci N, Yawson AE, Theou O, Mensah GP, Naidoo N, Wu F, Guo Y, Zheng Y, Jiang Y, Maximova T, Kalula S, Arokiasamy P, Salinas-Rodríguez A, Manrique-Espinoza B, Snodgrass JJ, Sterner KN, Eick G, Liebert MA, Schrock J, Afshar S, Thiele E, Vollmer S, Harttgen K, Strulik H, Byles JE, Rockwood K, Mitnitski A, Chatterji S, Kowal P. Prevalence of and factors associated with frailty and disability in older adults from China, Ghana, India, Mexico, Russia and South Africa. Maturitas 2016; 91:8-18. [PMID: 27451316 DOI: 10.1016/j.maturitas.2016.05.012] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/18/2016] [Accepted: 05/23/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND The severe burden imposed by frailty and disability in old age is a major challenge for healthcare systems in low- and middle-income countries alike. The current study aimed to provide estimates of the prevalence of frailty and disability in older adult populations and to examine their relationship with socioeconomic factors in six countries. METHODS Focusing on adults aged 50+ years, a frailty index was constructed as the proportion of deficits in 40 variables, and disability was assessed using the World Health Organization Disability Assessment Schedule (WHODAS 2.0), as part of the Study on global AGEing and adult health (SAGE) Wave 1 in China, Ghana, India, Mexico, Russia and South Africa. RESULTS This study included a total of 34,123 respondents. China had the lowest percentages of older adults with frailty (13.1%) and with disability (69.6%), whereas India had the highest percentages (55.5% and 93.3%, respectively). Both frailty and disability increased with age for all countries, and were more frequent in women, although the sex gap varied across countries. Lower levels of both frailty and disability were observed at higher levels of education and wealth. Both education and income were protective factors for frailty and disability in China, India and Russia, whereas only income was protective in Mexico, and only education in South Africa. CONCLUSIONS Age-related frailty and disability are increasing concerns for older adult populations in low- and middle-income countries. The results indicate that lower levels of frailty and disability can be achieved for older people, and the study highlights the need for targeted preventive approaches and support programs.
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Affiliation(s)
- R B Biritwum
- University of Ghana, Department of Community Health, Accra, Ghana.
| | - N Minicuci
- University of Ghana, Department of Community Health, Accra, Ghana; National Research Council, Neuroscience Institute, Padova, Italy.
| | - A E Yawson
- University of Ghana, Department of Community Health, Accra, Ghana.
| | - O Theou
- Dalhousie University, Geriatric Medicine, Halifax, Canada.
| | - G P Mensah
- University of Ghana, Department of Community Health, Accra, Ghana.
| | - N Naidoo
- World Health Organization, SAGE team, Geneva, Switzerland.
| | - F Wu
- Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC), Shanghai, PR China.
| | - Y Guo
- Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC), Shanghai, PR China.
| | - Y Zheng
- Shanghai Municipal Center for Disease Control and Prevention (Shanghai CDC), Shanghai, PR China.
| | - Y Jiang
- Capital Medical University, Clinical Trial and Research Center for Stroke, Beijing Tiantan Hospital, Beijing, PR China.
| | - T Maximova
- National Research Institute of Public Health (FSBI, RAMS), Moscow, Russian Federation.
| | - S Kalula
- University of Cape Town, Division of Geriatric Medicine, The Albertina and Walter Sisulu Institute of Ageing in Africa, South Africa; Groote Schuur Hospital, International Longevity Centre, Cape Town, South Africa.
| | - P Arokiasamy
- International Institute of Population Studies, Mumbai, India.
| | - A Salinas-Rodríguez
- National Institute of Public Health, Center for Evaluation Research and Surveys, Cuernavaca, Morelos, Mexico.
| | - B Manrique-Espinoza
- National Institute of Public Health, Center for Evaluation Research and Surveys, Cuernavaca, Morelos, Mexico.
| | - J J Snodgrass
- University of Oregon, Department of Anthropology, Eugene, USA.
| | - K N Sterner
- University of Oregon, Department of Anthropology, Eugene, USA.
| | - G Eick
- University of Oregon, Department of Anthropology, Eugene, USA.
| | - M A Liebert
- University of Oregon, Department of Anthropology, Eugene, USA.
| | - J Schrock
- University of Oregon, Department of Anthropology, Eugene, USA.
| | - S Afshar
- University of Southampton, Faculty of Medicine, United Kingdom
| | - E Thiele
- Vassar College, Department of Biology, Poughkeepsie, NY, USA.
| | - S Vollmer
- University of Göttingen, Department of Economics, Germany; Harvard T.H. Chan School of Public Health, Boston, USA.
| | | | - H Strulik
- University of Gottingen, Department of Economics, Gottingen, Germany.
| | - J E Byles
- University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, Australia.
| | - K Rockwood
- Dalhousie University, Geriatric Medicine, Halifax, Canada.
| | - A Mitnitski
- Dalhousie University, Geriatric Medicine, Halifax, Canada.
| | - S Chatterji
- World Health Organization, SAGE team, Geneva, Switzerland.
| | - P Kowal
- World Health Organization, SAGE team, Geneva, Switzerland; University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, Australia.
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Lee J, McGovern ME, Bloom DE, Arokiasamy P, Risbud A, O'Brien J, Kale V, Hu P. Education, gender, and state-level disparities in the health of older Indians: Evidence from biomarker data. Econ Hum Biol 2015; 19:145-156. [PMID: 26398850 PMCID: PMC4658270 DOI: 10.1016/j.ehb.2015.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Revised: 08/07/2015] [Accepted: 09/03/2015] [Indexed: 06/05/2023]
Abstract
Using new biomarker data from the 2010 pilot round of the Longitudinal Aging Study in India (LASI), we investigate education, gender, and state-level disparities in health. We find that hemoglobin level, a marker for anemia, is lower for respondents with no schooling (0.7g/dL less in the adjusted model) compared to those with some formal education and is also lower for females than for males (2.0g/dL less in the adjusted model). In addition, we find that about one third of respondents in our sample aged 45 or older have high C-reaction protein (CRP) levels (>3mg/L), an indicator of inflammation and a risk factor for cardiovascular disease. We find no evidence of educational or gender differences in CRP, but there are significant state-level disparities, with Kerala residents exhibiting the lowest CRP levels (a mean of 1.96mg/L compared to 3.28mg/L in Rajasthan, the state with the highest CRP). We use the Blinder-Oaxaca decomposition approach to explain group-level differences, and find that state-level disparities in CRP are mainly due to heterogeneity in the association of the observed characteristics of respondents with CRP, rather than differences in the distribution of endowments across the sampled state populations.
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Affiliation(s)
- Jinkook Lee
- Dornsife Center for Economic and Social Research, University of Southern California, 638 Downey Way, Los Angeles, CA 90089, USA; RAND Corporation, Santa Monica, CA, USA.
| | - Mark E McGovern
- Queen's University Belfast, Belfast, United Kingdom; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Harvard Center for Population and Development Studies, Cambridge, MA, USA
| | - David E Bloom
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - P Arokiasamy
- International Institute for Population Sciences, Mumbai, India
| | - Arun Risbud
- National AIDS Research Institute, Pune, Maharashtra, India
| | - Jennifer O'Brien
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Varsha Kale
- National AIDS Research Institute, Pune, Maharashtra, India
| | - Peifeng Hu
- University of California, Los Angeles, CA, USA
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Jain K, Goli S, Arokiasamy P. Are self reported morbidities deceptive in measuring socio-economic inequalities. Indian J Med Res 2012; 136:750-7. [PMID: 23287121 PMCID: PMC3573595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND & OBJECTIVES The ambiguity and variability in existing literature on the magnitude of socio-economic inequality in self-reported morbidities makes it difficult to set priorities in health policy. This study examined three critical research questions: first, how far self-reporting affects measuring socio-economic inequalities in case of obstetric morbidities. Second, does using simple bivariate variations mislead in estimating socio-economic differentials in prevalence of obstetric morbidities? Finally, whether use of sophisticated regression based decomposition results can overcome such problems. METHODS The data from National Family Health Survey (NFHS-3; 2005-06) were used, and analyzed by statistical tools such as bivariate estimates and regression based decomposition analysis. RESULTS Bivariate results revealed that self-reported obstetric morbidity data were misleading in measurement of socio-economic differentials, as these failed to show existing socio-economic variations in obstetric morbidities by socio-economic standing of women. However, decomposition analysis showed that the prevalence of obstetric complications was greater among socioeconomically disadvantaged groups. INTERPRETATION & CONCLUSIONS Based on our findings on measurement of socio-economic inequality in self-reported obstetric morbidity, we conclude that the use of regression based inequality decomposition estimates not only overcomes the problems of measuring socio-economic inequality based on self-reported morbidities, but also increases the validity of such measures.
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Affiliation(s)
- Kshipra Jain
- International Institute for Population Sciences, Mumbai, India,Reprint requests: Ms. Kshipra Jain, Ph. D. Research Scholar, International Institute for Population Sciences, Mumbai 400 088, India e-mail:
| | - Srinivas Goli
- International Institute for Population Sciences, Mumbai, India
| | - P. Arokiasamy
- International Institute for Population Sciences, Mumbai, India
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Arokiasamy P, Pradhan J. Measuring wealth-based health inequality among Indian children: the importance of equity vs efficiency. Health Policy Plan 2010; 26:429-40. [PMID: 21112926 DOI: 10.1093/heapol/czq075] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The concentration index is the most commonly used measure of socio-economic-related health inequality. However, a critical constraint has been that it is just a measure of inequality. Equity is an important goal of health policy but the average level of health also matters. In this paper, we explore evidence of both these crucial dimensions-equity (inequality) and efficiency (average health)-in child health indicators by adopting the recently developed measure of the extended concentration index on the National Family Health Survey (NFHS-3) data from India. An increasing degree of inequality aversion is used to measure health inequalities as well as achievement in the following child health indicators: under-2 child mortality, full immunization coverage, and prevalence of underweight, wasting and stunting among children. State-wise adjusted under-2 child mortality scores reveal an increasing trend with increasing values of inequality aversion, implying that under-2 child deaths have been significantly concentrated among the poor households. The level of adjusted under-2 child mortality scores increases significantly with the increasing value of aversion even in states advanced in the health transition, such as Kerala and Goa. The higher values of adjusted scores for lower values of aversion for child immunization coverage are evidence that richer households benefited most from the rise in full immunization coverage. However, the lack of radical changes in the adjusted scores for underweight among children with increasing degrees of aversion implies that household economic status was not the only determinant of poor nutritional status in India.
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Affiliation(s)
- P Arokiasamy
- Department of Development Studies, International Institute for Population Sciences, Deonar, Mumbai, India.
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Abstract
This paper presents evidence on the levels, patterns and determinants of morbidity prevalence and hospitalisation in the state of West Bengal in India using data from the 60th round (2004) of the National Sample Survey Organisation on 'morbidity and health care'. The reported morbidity and hospitalisation rates were considerably higher in urban than in rural populations. Age indicated substantial effects on morbidity and hospitalisation in both rural and urban areas, with females reporting higher morbidity than males in urban areas. Caste, region and seasonal differences in morbidity prevalence were found significant only in rural areas, but socio-economic inequalities in the prevalence of morbidity and hospitalisation were lower in urban areas. Morbidity and hospitalisation rates were more strongly related with household monthly per capita expenditure than to educational attainment. The distribution of ailments suggest that West Bengal is passing through the advanced phase of epidemiologic transition in which communicable diseases are being swiftly replaced with rising levels of non-communicable diseases.
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Affiliation(s)
- S Ghosh
- Centre for Health Policy, Planning and Management, Tata Institute of Social Sciences, School of Health Systems Studies, Mumbai, Maharashtra, India.
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Abstract
India is experiencing accelerated demographic transition. The country will face the challenge of dealing with problem of population aging in the coming decades. Amidst socioeconomic consequences, health risks among older adults are rising rapidly especially on account of noncommunicable diseases. Given such background, this study assesses the pattern of disease burden, health care utilization, and their covariates for older adults in two selected states based on the 60th round of National Sample Survey (NSSO) data. The states in focus are Maharashtra, the state ahead in demographic transition, and Uttar Pradesh, the state lagging in this process. Correspondingly, the overall prevalence of noncommunicable diseases is higher in Maharashtra compared with Uttar Pradesh. Multivariate logistic regression estimates further show that both the morbidity and health care utilization rates are increasing among older adults. At the same time, substantial disparities are demonstrated in the pattern of morbidity prevalence and health care utilization among older persons by demographic and socioeconomic factors and between Maharashtra and Uttar Pradesh.
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Affiliation(s)
- Gopal Agrawal
- International Institute for Population Sciences, Mumbai,
India
| | - P. Arokiasamy
- International Institute for Population Sciences, Mumbai,
India,
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Arokiasamy P, Karthick K, Pradhan J. Environmental risk factors and prevalence of asthma, tuberculosis and jaundice in India. ACTA ACUST UNITED AC 2007. [DOI: 10.1504/ijenvh.2007.014633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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