Mortality Compression and Variability in Age at Death in India

The global rise of life expectancy at birth has attracted worldwide interest, especially in understanding the pace of mortality transition in developing countries. In this study, we assess the progress of mortality transition in India during four decades between 1970 and 2013. We estimate measures of mortality compression and variability in age at death to assess the trends and patterns in mortality compression for India as a whole and its twelve biggest states. The results reveal an unequivocal convergence pattern in mortality compression across the states underpinned by the reduction in premature mortality and emerging homogeneity in mortality. Results by gender show that women are more homogenous in their mortality across the country because of an explicit reduction in the Gini coefficients at age 10 by the age group of 15-29 years. Mortality compression has changed in recent decades because of the increased survival of women in their reproductive ages, which marked a distinct phase of mortality transition in India. The pace of mortality transition, however, varies; adult mortality decline was greater than senescent mortality decline. These results show that India has passed the middle stage of mortality transition and has entered an early phase of low mortality

Health insurance and health care in India: a supply-demand perspective

India’s health care and health financing provision is characterized by too little Government spending on health, meager health insurance coverage, declining public health care use contrasted by highest levels of private out-of-pocket health spending in the world. To understand the interconnectedness of these disturbing outcomes, this paper envisions a theoretical framework of health insurance and health care revisits the existing health insurance schemes and assesses the health insurance cover in relation to the pattern of health care use using data from myriad official statistics and the recent NFHS, 2005-06. Theoretical exploration of the axis of supply-demand determinants unfolds that a complex of factors such as sparse health financing options, self-obstructing heavily risk protected insurance market and weak consumer demand contribute to the measly level of health insurance penetration in India. Health insurance cover is found to be a strong determinant of modern health care use. Regional and rural-urban disparities in health insurance and health care are significant. Health insurance coverage is positively related while public health care use is negatively related with household economic condition and education status. The complex axis of critical supply side imperfections and considerable demand side weaknesses necessitate a major health care reform with the viable financing and health care options

Rising Health Expenditure Due to Non-Communicable Diseases in India: An Outlook

With ongoing demographic transition, epidemiological transition has been emerged as a growing concern in India. The share of non-communicable disease in total disease burden has increased from 31% in 1990 to 45% in 2010. This paper seeks to explore the health scenario of India in the wake of the growing pace of non-communicable diseases such as diabetes and hypertension among Indian population using data from health and morbidity survey of the National Sample Survey Organisation (2004) and notifies about the resource needed to tackle this growing health risk. Given the share of private players (70%) in Indian health system, results indicate a higher private expenditure, mostly outof- pocket expense, on account of non-communicable diseases. A timely look into the matter may tackle a more dreadful situation in near future

Health insurance and health care in India: a supply-demand perspective

India’s health care and health financing provision is characterized by too little Government spending on health, meager health insurance coverage, declining public health care use contrasted by highest levels of private out-of-pocket health spending in the world. To understand the interconnectedness of these disturbing outcomes, this paper envisions a theoretical framework of health insurance and health care revisits the existing health insurance schemes and assesses the health insurance cover in relation to the pattern of health care use using data from myriad official statistics and the recent NFHS, 2005-06. Theoretical exploration of the axis of supply-demand determinants unfolds that a complex of factors such as sparse health financing options, self-obstructing heavily risk protected insurance market and weak consumer demand contribute to the measly level of health insurance penetration in India. Health insurance cover is found to be a strong determinant of modern health care use. Regional and rural-urban disparities in health insurance and health care are significant. Health insurance coverage is positively related while public health care use is negatively related with household economic condition and education status. The complex axis of critical supply side imperfections and considerable demand side weaknesses necessitate a major health care reform with the viable financing and health care options

Socioeconomic Progress across the Major Indian states: Converging or Diverging

The purpose of this paper is to examine the progress in socioeconomic conditions across the major states of India by using convergence hypothesis. Earlier studies that examined regional disparities of development used per capita State Net Domestic Product (SNDP) as an important proxy for assessing human well-being. This study attempts a more comprehensive assessment of socioeconomic convergence in terms of critical indicators of economic inequality, poverty ratios, literacy rate and Human Development Index (HDI) along with per capita SNDP. The results reveal that in the period between 1981 and 2011, statistically significant absolute and conditional Beta (β)-convergence in literacy rates and HDI have been observed but only conditional β-convergence has been evident in case of per capita SNDP and poverty ratios. β-convergence estimates for the recent period (post-2001) show, a divergence in per capita SNDP and poverty ratios but convergence in literacy rates and HDI. Kernel density plots for socioeconomic indicators show the existence of convergence clubs but not absolute convergence among all the major states. Thus, this study suggests that use of the non-parametric convergence measures is crucial to gain more clear insights on socioeconomic progress and to identify the short-term divergent paths

Socioeconomic and age gradients of health of Indian adults: an assessment of self-reported and performance-based measures of health

Objectives: This paper describes the age patterns of socioeconomic gradients of health of Indian adults for multiple health indicators encompassing the multidimensional nature of health. Methods: Cross-sectional data on 11,230 Indians aged 18-plus from the WHO-SAGE India Wave 1, 2007 is used. Multivariate logit models were estimated to examine the effects of socioeconomic status (education and household wealth) and age on four health measures: self-rated health, self-reporting functioning, chronic diseases, and performance-based health indicators. Findings: Socioeconomic status was positively associated with each health measure but with considerable heterogeneity across age groups. SES relationship with biomarkers (hypertension and COPD) was inconclusive. SES effects are significant while adjusting for background characteristics and health risk factors. The age patterns of SES gradient of health depict divergence with age, however, no conclusive age pattern emerged for performance-based health indicators. Discussion: Overall, results in this paper dispelled the conclusion of negative SES-health association found in some previous Indian studies and reinforced the hypothesis of positive association of SES with health for Indian adults. Higher prevalence of negative health outcomes and SES disparities of health outcomes among older age-groups highlight need for inclusive and focused health care interventions for older adults across socioeconomic spectrum

Socioeconomic Progress across the Major Indian states: Converging or Diverging

The purpose of this paper is to examine the progress in socioeconomic conditions across the major states of India by using convergence hypothesis. Earlier studies that examined regional disparities of development used per capita State Net Domestic Product (SNDP) as an important proxy for assessing human well-being. This study attempts a more comprehensive assessment of socioeconomic convergence in terms of critical indicators of economic inequality, poverty ratios, literacy rate and Human Development Index (HDI) along with per capita SNDP. The results reveal that in the period between 1981 and 2011, statistically significant absolute and conditional Beta (β)-convergence in literacy rates and HDI have been observed but only conditional β-convergence has been evident in case of per capita SNDP and poverty ratios. β-convergence estimates for the recent period (post-2001) show, a divergence in per capita SNDP and poverty ratios but convergence in literacy rates and HDI. Kernel density plots for socioeconomic indicators show the existence of convergence clubs but not absolute convergence among all the major states. Thus, this study suggests that use of the non-parametric convergence measures is crucial to gain more clear insights on socioeconomic progress and to identify the short-term divergent paths

Multiple Chronic Diseases and Their Linkages with Functional health and Subjective Wellbeing among adults in the low-middle income countries: An Analysis of SAGE Wave1 Data, 2007/10

This paper examines the prevalence and determinants of multiple chronic diseases and their association with the self-rated health, functional health and quality of life among adults in six SAGE countries: China, India, Russia, South Africa Mexico and Ghana. We use ADL and IADL activities as measures of functional health and WHOQoL index as a measure of quality of life. Poisson regression models are estimated to understand the social determinants of multiple chronic diseases. Logit models and OLS are estimated to examine the association between multiple chronic morbidities and self-rated health, functional health and quality of life. Russia had the highest prevalence of multi-morbidity (32.8%, 95%CI=25.5-41.1) followed by South Africa (22%, 95%CI=17.7-26.9); the other four countries had prevalence of multi-morbidity around 21%. Measures of socioeconomic status: education and wealth were found negatively associated with the number of chronic diseases. Higher number of chronic conditions was associated with the poorer self rated health, functional health and WHOQoL

Multiple Chronic Diseases and Their Linkages with Functional health and Subjective Wellbeing among adults in the low-middle income countries: An Analysis of SAGE Wave1 Data, 2007/10

This paper examines the prevalence and determinants of multiple chronic diseases and their association with the self-rated health, functional health and quality of life among adults in six SAGE countries: China, India, Russia, South Africa Mexico and Ghana. We use ADL and IADL activities as measures of functional health and WHOQoL index as a measure of quality of life. Poisson regression models are estimated to understand the social determinants of multiple chronic diseases. Logit models and OLS are estimated to examine the association between multiple chronic morbidities and self-rated health, functional health and quality of life. Russia had the highest prevalence of multi-morbidity (32.8%, 95%CI=25.5-41.1) followed by South Africa (22%, 95%CI=17.7-26.9); the other four countries had prevalence of multi-morbidity around 21%. Measures of socioeconomic status: education and wealth were found negatively associated with the number of chronic diseases. Higher number of chronic conditions was associated with the poorer self rated health, functional health and WHOQoL

Socioeconomic and age gradients of health of Indian adults: an assessment of self-reported and performance-based measures of health

Objectives: This paper describes the age patterns of socioeconomic gradients of health of Indian adults for multiple health indicators encompassing the multidimensional nature of health. Methods: Cross-sectional data on 11,230 Indians aged 18-plus from the WHO-SAGE India Wave 1, 2007 is used. Multivariate logit models were estimated to examine the effects of socioeconomic status (education and household wealth) and age on four health measures: self-rated health, self-reporting functioning, chronic diseases, and performance-based health indicators. Findings: Socioeconomic status was positively associated with each health measure but with considerable heterogeneity across age groups. SES relationship with biomarkers (hypertension and COPD) was inconclusive. SES effects are significant while adjusting for background characteristics and health risk factors. The age patterns of SES gradient of health depict divergence with age, however, no conclusive age pattern emerged for performance-based health indicators. Discussion: Overall, results in this paper dispelled the conclusion of negative SES-health association found in some previous Indian studies and reinforced the hypothesis of positive association of SES with health for Indian adults. Higher prevalence of negative health outcomes and SES disparities of health outcomes among older age-groups highlight need for inclusive and focused health care interventions for older adults across socioeconomic spectrum