Poverty Transitions, Health, and Socio-Economic Disparities in India

SDGs offer an inclusive and just vision for 2030, in which the interrelationships between (near) elimination of poverty, health reforms and elimination of socio-economic disparities play an important role. The present study focuses on the associations between poverty transitions over a period, and health indicators such as NCDs, disabilities, socio-economic disparities, state affluence and inequality in income distribution. These health indicators reflect their growing importance in recent years. We have used a Multinomial Probit specification which is an improvement on the methodologies used in earlier research. The analysis is based on panel data from the India Human Development Survey 2015. What our analysis emphasises is that changes in the prevalence of poverty/headcount ratio over time do not throw light on how poverty has evolved: whether there were escapes from poverty, whether there were descents into poverty, whether segments persisted in poverty, and whether (the relatively) affluent remained largely unaffected. A significant contribution of this study is to explore the relationships between such poverty transitions and NCDs and disabilities, socio-economic disparities and other covariates. The analysis confirms these linkages. Drawing upon this analysis and other relevant research, policy challenges in achieving the SDG vision of an inclusive and fair economy are delineated

Persistence of Non-Communicable Diseases, Affluence and Inequality in India

This study builds on the extant literature by highlighting the persistence of non-communicable diseases (NCDs), their cross-associations, and how these diseases are linked to different forms of inequality-socio-economic, gaps in affluence measured by asset quartile, and in the overall economic environment, based on a nation-wide panel survey, India Human Development Survey 2015. A multinomial probit specification is used to analyse NCD outcomes. Those at the bottom of the caste hierarchy and least wealthy exhibit lowest vulnerability to NCDs despite their deprivation and limited access to healthcare facilities while those at the higher end of the caste hierarchy and the wealthiest are most vulnerable. However, overall economic inequality, using Piketty’s (2013) measure, is insidious as it corrodes social cohesion and support, and the capability to live a healthy and productive life. New light is thrown on whether social networks are associated with better NCD outcomes. So policy interventions have to be not just medical but much broader in scope

Trust in Hospitals-Evidence from India

Various explanations have been offered for outbursts of violence against doctors and other staff in India, drawing attention to growing supply-demand imbalance in healthcare, quality deterioration, overburdened doctors, weak security for medical staff, high expectations of patients who come in advanced stages of chronic and other illnesses, overcrowding of public hospitals with limited sanitary facilities. But underlying all these explanations is lack of trust in doctors and hospitals-especially public. Our focus here is on trust and its covariates over the period 2005-2012. The motivation stems from the fact that the existing evidence is patchy and scattered. Our aim, therefore, is to build on the empirical evidence through a systematic state-of-art analysis of trust in public and private hospitals and doctors. Combining our analysis with other evidence, we identify specific challenges to build patient-hospital trust and how these could be overcome

Aging, Disability and Disease in India

Obtaining detailed evidence on disabilities and their covariates is important as India’s elderly population (60 years or more) is growing three times faster than the population as a whole. This study is the first of its kind to provide an analysis of disability and its covariates among the elderly in 2012, based on the India Human Development Survey 2015, a nationally representative panel survey. Our analysis throws light on factors associated with (reported) disabilities in 2012.Given better reporting of disabilities in 2012, we examine the role of their covariates in 2005. Variations in both disabilities by count and type are analysed. Based on probit and ordered probit specifications, we find that vulnerability of the elderly people to (reported) disabilities in 2012 is associated with important covariates in 2005: a largely rural population, low assets, non-communicable diseases (NCDs), disabilities, lack of school education, widowhood, aging, and lack of participation in social networks. Similar associations are found for variations in disabilities by type in 2012, using the covariates in 2005..Thus disabilities are not just a medical or social problem but an outcome of their interplay. While the Rights of Persons with Disabilities Act 2016 is laudable in its intent and procedural detail, it is largely silent on disabilities among the elderly. A major overhaul of the health system is proposed to address better the disabilities of India’s aging population

Employment, Aging and Disease in India

The literature on the associations between NCDs and disabilities, and loss of employment in India is patchy and sparse. Although insightful, these studies are long on economic losses through high out of pocket expenditure (OOP) and cutbacks in non-medical expenditure, but they are short on employment losses. Besides, most are based on not-so-recent data. The present study seeks to fill these gaps using a nation-wide panel survey, the India Human Development Survey 2015, that covers the period between 2005-2012. A state-of-art econometric analysis confirms that substantial employment losses are associated with non-communicable diseases such as diabetes, heart disease and high blood pressure (NCDs) and disabilities (or limitations in carrying out ADL) with appropriate controls. The economic burden of NCDs is already enormous and is set to grow rapidly. Scaling-up the prevention and control of NCDs is very low cost compared to this burden, and would provide substantial returns to health and productivity. Prevention of NCDs should be thus a major priority for India. Health and labour market policies have considerable potential for mitigating the detrimental labour market impacts of ill-health, and thus enable better lives and a more inclusive economy

Changes in Subjective versus Objective Well-Being in India

Although there is abundant literature on subjective well-being (SWB), there is virtually none for India. Growing recognition of the validity and accuracy of measures of SWB of well-being underlies the rapid growth of literature on SWB in recent decades but it has mainly focused on developed countries. Ours is, to our knowledge, the first study of SWB at the all-India level, and one of the few on developing countries, with a rigorous validation of the results. Applying robust OLS and ordered probit models to the India Human Development Survey (IHDS) panel data in 2005 and 2012, we assess SWB changes in 2005-2012, based on a self-reported measure of changes in economic well-being, as a function of household and state covariates in 2005. This is in sharp contrast with earlier studies’ focus on the levels of SWB. Another point of departure of our study and an innovative extension is to compare the covariates of SWB changes with those of objective well-being (OWB) changes, proxied by the relative growth in real per capita household consumption between 2005 and 2012. Households with an older and educated head in a larger household, located in urban areas or affluent states in 2005 tend to experience further improvement in both SWB and OWB between 2005 and 2012. On the contrary, households with a female household head, with more male members in the labour market, with regular access to mass media, without members suffering from non-communicable diseases or disability are more likely to be better off subjectively without experiencing corresponding improvement in OWB. The policy challenges raise serious concerns

Comparison of neonatal outcome parameters between thick and thin meconium stained liquor: a prospective study

Background: Meconium stained liquor is a commonly observed phenomenon in the day-to-day obstetric practice, the incidence being 12-22%. Meconium stained liquor can be considered as a normal physiological event in a term fetus in the absence of fetal heart rate abnormalities. It has greater significance as one of the parameters of fetal distress, when associated with abnormal fetal heart rate pattern. The aim of the present study was to study the association of, fetal heart rate abnormalities, mode of delivery and neonatal outcome with different grades of meconium stained liquor.Methods: A prospective study was conducted in one hundred and fifty cases of meconium stained liquor beyond 37 weeks gestation admitted to the labor room in a tertiary care Centre. Depending on the consistency of meconium, the patients were divided into two groups namely, Thick meconium stained liquor (group K) and Thin meconium stained liquor (group N). Maternal conditions, Intrapartum fetal heart rate pattern, Apgar scores and neonatal morbidities were studied in relation to the grade of meconium. The proportions between the two groups were compared using chi-square test and Fisher’s exact t-test.Results: The incidence of post term pregnancy (p=0.004), unbooked (p=0.007) status and oligohydramnios (p=0.01) were significantly higher among group K when compared to group N. Non-reassuring fetal heart rate pattern (p=0.002) and Apgar score ≤7 (p=0.02) were significantly higher in group K. In group K, non-reassuring fetal heart rate pattern and reduced beat to beat variability were significantly associated with low Apgar score (p=0.01).Conclusions: Neonatal outcomes like low Apgar score, meconium aspiration syndrome are strongly associated with thick meconium stained liquor. Visual grading of liquor into thick and thin meconium stained may help in timely obstetric intervention leading to a better neonatal outcome

HLA-DQA1*05 carriage associated with development of anti-drug antibodies to infliximab and adalimumab in patients with Crohn's Disease

Anti-tumor necrosis factor (anti-TNF) therapies are the most widely used biologic drugs for treating immune-mediated diseases, but repeated administration can induce the formation of anti-drug antibodies. The ability to identify patients at increased risk for development of anti-drug antibodies would facilitate selection of therapy and use of preventative strategies.This article is freely available via Open Access. Click on Publisher URL to access the full-text

What moves Indian stock markets: A Study on the linkage with real economy in post-reform era

This paper is a fresh attempt to unravel the relationship between the real economic variables and the capital market in Indian context. The paper considers the monthly data of several economic variables like the national output, fiscal deficit, interest rate, inflation, exchange rate, money supply, foreign institutional investment in Indian markets between 1994 and 2003, and tries to reveal the relative influence of these variables on the sensitive index of the Bombay stock exchange. Compared to the earlier similar attempts, this paper applies the modern non-linear technique like VAR and Artificial Neural Network and compares the results. The finding shows that certain variables like the interest rate, output, money supply, inflation rate and the exchange rate has considerable influence in the stock market movement in the considered period, while the other variables have very negligible impact on the stock market. Keywords: Indian Stock Market, Economic Variables, Artificial Neural Network, VA