Aging in Asia Findings from New and Emerging Data Initiatives (2012) / Chapter Skim
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3 Longitudinal Aging Study in India: Vision, Design, Implementation, and Preliminary Findings--P. Arokiasamy, David Bloom, Jinkook Lee, Kevin Feeney, and Marija Ozolins
3 Longitudinal Aging Study in India: Vision, Design, Implementation, and Preliminary Findings--P. Arokiasamy, David Bloom, Jinkook Lee, Kevin Feeney, and Marija Ozolins
Pages 36-74
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From page 36... ...
. Countries are at various stages of the process: The share of the 60+ population ranges from under 5% in a number of African and Gulf countries to more than 20% in several European and East Asian countries.2 However, there is much less heterogeneity with respect to time trends; population aging will take place in all regions and countries going forward.
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The elderly dependency ratio (the number of people aged 60 and older per person aged 15 to 59) will rise dramati cally from 0.12 to 0.31.
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Older Indians also face economic insecurity; 90% of them have no pension. According to official statistics, labor force participation remains high (39%)
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; and a biomarker module, collected for each consenting age-eligible respondent and spouse. The household interview consists of five sections: a roster detailing basic demographic information about each household member; a ques 5 These include the Health and Retirement Study (HRS)
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allow researchers to assess the health of LASI's sample population. The dried blood spot collection, for example, allows for up to 35 different assays, including four that the LASI team initially plans to test: C-reactive protein (CRP, a marker of inflammation)
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From page 41... ...
Eligible households were defined as those with at least one member 45 years of age and older, and eligible individuals were those who were 45 years of age and older or married to an individual who was.8 8Eligible age for response rates was determined from the coverscreen household roster, which was reported by the household respondent, who was not always an individual respondent. The respondent who consented to the individual interview did self-report age in the demographics component of the module, effectively creating two possible age variables.
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86.8 92.6 97.9 89.9 86.4 91.1 90.9 Biomarker Module Total eligible 567 1359 419 485 559 463 1,926 Consented to start biomarker module 474 1241 398 436 480 401 1,715 Biomarker Response Rate (%)
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Thus the dried blood spot collection response rate captures the share of respondents who specifically agreed to participate. Response rates for income and consumption are among households and are the share of households that did not require imputation and had no missing income components queried about during the household module.
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From page 44... ...
Profile of LASI Respondents The LASI design and implementation was successful in creating a sample comparable to other nationally representative surveys conducted in India. In Table 3-4, we present the initial results of the fieldwork through a comparison of the basic demographic indicators of LASI respondents to those of respondents from other surveys conducted in India: the National Sample Survey (NSS)
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215.2 137.3 205.2 137.4 174.7 Household Module Total 41.9 29.1 37.6 24.6 33.4 Housing and environment 9.2 7.6 7.0 5.3 7.2 Consumption 12.3 7.6 13.1 7.3 10.1 Income 7.9 5.0 7.4 5.2 6.4 Agricultural income and assets 3.9 4.0 1.7 2.1 2.9 Financial assets and real estate 8.6 5.0 8.5 4.8 6.8 Number of interviews 222 230 261 237 950 Individual Module Total 93.9 57.8 92.5 66.5 78.1 Demographics 9.5 5.7 6.7 5.6 6.9 Family and social network 15.0 11.2 13.1 8.9 12.1 Health 27.4 17.2 30.5 15.9 23.0 Healthcare utilization 4.7 2.7 4.8 3.0 3.8 Employment 7.2 2.5 7.3 4.8 5.5 Pension 4.2 1.1 2.7 2.0 2.5 Experimental: social 11.3 4.9 10.0 7.6 8.4 connectedness Experimental: expectations 5.9 3.5 6.2 3.0 4.7 Experimental: vignettes 4.8 1.5 4.1 1.7 3.1 Biomarker 18.9 14.2 21.0 22.3 19.1 Number of interviews 402 417 462 402 1,683 Number of individual interviews 1.8 1.8 1.8 1.7 1.8 per HH Duration of Interviews One day (n) 298 338 390 380 1,406 Multiple days (n)
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From page 46... ...
Among Respondents 45 Years and Older Urban 27.1 26.3 26.9 11.1 26.8 19.2 20.5 35.7 32.3 Rural 72.9 73.8 73.1 88.9 73.2 80.8 79.5 64.3 67.7 Marital Status (%) Among Respondents 45 Years and Older Married 78.0 75.8 78.2 80.7 81.5 81.0 81.5 75.3 82.4 Never married 1.8 1.1 0.7 1.3 0.6 0.9 0.3 2.2 0.4 Divorced 1.2 0.6 0.5 0.7 0.6 1.4 0.7 0.6 0.5 Widowed 19.1 22.5 20.6 17.3 17.3 16.8 17.5 21.9 16.7
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From page 47... ...
LASI is the Longitudinal Study of Aging in India, NSS is the National Sample Survey, IHDS is the Indian Human Development Survey, WHS is the World Health Survey, and SAGE is the Study on Global AGEing and Adult Health. SAGE states include Assam, Karnataka, Maharashtra, Rajasthan, Uttar Pradesh, and West Bengal.
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From page 48... ...
Even the most basic demographic indicators -- such as education, marital status, and self-rated health -- differ not only by gender and socioeconomic status within regions, but also across regions. Table 3-5 displays demographic differences in the representative LASI sample of those aged 45 years and older as self-reported in the demographics mod ule.
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[0.23] NOTES: This table only considers respondents who self-reported an age of at least 45 years in the individual interview and provided an answer for each of the variables listed in the table.
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It includes self-employment, employment by another, or agricultural work both paid and unpaid as reported in the household income module by a household financial respondent or as self-reported in the individual interview. Self-rated health asks respondents whether they feel their health in general is excellent (scored 5)
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Respondents from Kerala are older and report relatively low labor force participation and worse health than respondents from the other states. The higher prevalence of poor or fair self-rated health may indeed reflect high morbidity in the population, but high literacy rates and better access to healthcare services than in other Indian states also contribute to a more health-literate population (Bloom, 2005)
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The sample is restricted to respondents who reported they were at least 45 years old in the individual interview and provided a nonmissing answer for each of the variables listed in the table, with the exception of hypertension vari ables. Hypertension prevalence was calculated only among respondents in the biomarker module.
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. The surprisingly high figures for Kerala for lack of access to improved water sources and for not having running water in the home are consistent with other relevant reports about Kerala, e.g., International Institute for Population Sciences and Macro International (2007)
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While there is some doubt about the validity of self-reported health measures (Sen, 2002) , other literature has shown that ADLs and measures of disability in particular can be useful in understanding health burdens in this population along with other research that shows self-reported measures are reasonable to use in the developing country context (Subramanian et al., 2009)
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84.2 7.0 2.9 2.1 1.0 1.2 NOTES: Among respondents with only one difficult ADL, the most common was getting in and out of bed; among respondents with two difficult ADLs, the most frequent were getting in and out bed and using a toilet; among respondents with three difficult ADLs, the most commonly reported were difficulty walking across a room, bathing, and using a toilet; among respondents who reported difficulty with four ADLs, the most frequent were walking across a room, bathing, using the toilet, and getting in and out of bed; and among those respondents with five difficult ADLs, the most common were walking across a room, bathing, getting in and out of bed, and the same number of respondents reported difficulty with the remaining ADLs. The sample for this table is restricted to respondents who selfreported an age of at least 45 years in the individual interview.
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. LASI includes measures of verbal and numerical fluency, as well as episodic memory recall that have been used among low-literacy aging populations in India (Ganguli et al., 1996; Mathuranath et al., 2009)
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Delayed word recall asks respondents to name as many words as they can after completion of a cognitive functioning questionnaire. Both delayed and immediate word recall are scored with a maximum of 10 words.
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(–2.59) Episodic memory 3 –0.451 (–1.73)
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LASI used a stratified sampling design that sampled respondents independently by state, rural-urban area, and district. All multivariate models are unweighted, and the standard errors have been corrected for design effects of strati fication.
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questions about water quality, sanitation, and safety in the neighborhood; and (4) questions about a broad range of psychological, social, and behavioral risk factors (e.g., measuring social connectedness in addition to traditional social network questions)
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Anchoring vignettes allow researchers to correct for cross-person heterogeneity in the subjective nature of responses to some health questions by asking respondents to characterize a set of short hypothetical stories (vignettes) that describe fictional individuals with varying health problems.
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17 For social activities, LASI asks about going to the cinema, eating outside the house, go ing to a park or beach, playing cards or games, visiting relatives/friends, attending cultural performances/shows, and attending religious functions/events.
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, we explored the association between the demographic and socioeconomic characteristics, and civic and social participation. Because civic participation was relatively low in the LASI sample, we estimate a probit model and regress a binary indicator for any civic participation on the list of covariates.
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in the LASI sample among respondents who are aged 45 and older. Table 3-10 presents five models of labor force participation.
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Regional differences in availability of pension schemes, old age support, and labor markets account for the association between education and labor force participation in our sample. Given the lack of social security, pension, and health insurance available to most Indians, continued workforce participation is vital.
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(1.67) ADL disability count –0.150*
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It includes self-employment, employment by another, or agricultural work both paid and unpaid as reported in the household income module by a household financial respondent or selfreported in the individual interview. The sample is restricted to respondents who self-reported an age of at least 45 years old; LASI used a stratified sampling design, which sampled respondents independently by state, rural-urban area, and district.
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SOURCE: Data from Longitudinal Aging Study in India (LASI) Pilot Wave.
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LASI used a stratified sampling design that sampled respondents indepen dently by state, rural-urban area, and district. All multivariate models are unweighted and the standard errors have been corrected for design effects of stratification.
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The fact that the LASI pilot achieved high response rates and that respondent demographics are similar to those of other nationally representative surveys within India lends credibility to the survey's results concerning the well-being of aging Indians. This chapter highlights the wide geographic variability in health, social, and economic markers across India.
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. Measuring the health of the Indian elderly: Evidence from National Sample Survey data.
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. Neighborhood deprivation, individual socioeconomic status, and cognitive functioning in older people: Analyses from the English Longitudinal Study of Aging.
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Longitudinal Aging Study in India, Pilot Wave.
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. Study on Global AGEing and Adult Health, Wave 1.
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