No abstract

Background In an ageing society, the provision of long-term care is the prime need. In Indian cultural setting, family members are the informal, albeit primary caregivers to the elderly. Caregiving demands intense emotional and financial involvement. While taking care of elderly persons’ health and wellbeing, these family members, acting as informal caregivers, may themselves become vulnerable to poor health due to additional stress and burden. Using a nationally representative survey, the study tried to identify how health condition varies within caregivers and a comparative analysis of how in similar socio-economic background health condition varies between caregivers and non-caregivers. Method The data, used for the analysis, is taken from Longitudinal Ageing Study in India (LASI), Wave I. Both descriptive and multivariable regression analysis are done in different models along with interaction effect of caregiving to understand the difference in health status between caregiver and non-caregivers. Results Nearly 29% and 11% of the informal caregivers, reported to have depressive symptoms and poor self-rated health (SRH), respectively. Almost half of the caregivers, who provide care for more than 40 h a week, are diagnosed to have depressive symptoms. They are also at higher risk of having depressive symptoms (AOR 1.59 CI 1.16–2.18) and poor SRH (AOR 1.73 CI 1.11–2.69) than those who invest less than 40 h in a week. In almost every socio-economic condition, caregivers are at a higher risk of having depression and poor health than non-caregivers. Caregivers, who are widowed, live in rural areas or are not satisfied with current living arrangement are more vulnerable to have depressive symptoms. On the other hand, caregivers of age 45–59 years, widowed, male and who live only with their children with spouse absent, have almost 2 times higher odds of poor SRH than non-caregivers. Conclusion Caregivers are more susceptible to depression and poor self-rated health compared to non-caregivers irrespective of their socio-economic characteristics, only the magnitude of vulnerability varies.

Developing countries like India grapple with significant challenges due to the double burden of communicable and non-communicable disease in older adults. Examining the distribution of the burden of different communicable and non-communicable diseases among older adults can present proper evidence to policymakers to deal with health inequality. The present study aimed to determine socioeconomic inequality in the burden of communicable and noncommunicable diseases among older adults in India. This study used Longitudinal Ageing study in India (LASI), Wave 1, conducted during 2017–2018. Descriptive statistics along with bivariate analysis was used in the present study to reveal the initial results. Binary logistic regression analysis was used to estimate the association between the outcome variables (communicable and non-communicable disease) and the chosen set of separate explanatory variables. For measurement of socioeconomic inequality, concentration curve and concentration index along with state wise poor-rich ratio was calculated. Additionally, Wagstaff’s decomposition of the concentration index approach was used to reveal the contribution of each explanatory variable to the measured health inequality (Communicable and non- communicable disease). The study finds the prevalence of communicable and non-communicable disease among older adults were 24.9% and 45.5% respectively. The prevalence of communicable disease was concentrated among the poor whereas the prevalence of NCDs was concentrated among the rich older adults, but the degree of inequality is greater in case of NCD. The CI for NCD is 0.094 whereas the CI for communicable disease is -0.043. Economic status, rural residence are common factors contributing inequality in both diseases; whereas BMI and living environment (house type, drinking water source and toilet facilities) have unique contribution in explaining inequality in NCD and communicable diseases respectively. This study significantly contributes in identifying the dichotomous concentration of disease prevalence and contributing socio- economic factors in the inequalities.

Background The present study tries to provide a comprehensive estimate of gender differences in the years of life lost due to CVD across the major states of India during 2017–18. Methods The information on the CVD related data were collected from medical certification of causes of death (MCCD reports, 2018). Apart from this, information from census of India (2001, 2011), SRS (2018) were also used to estimate YLL. To understand the variation in YLL due to CVD at the state level, nine sets of covariates were chosen: share of elderly population, percentage of urban population, literacy rate, health expenditure, social sector expenditure, labour force participation, HDI Score and co-existence of other NCDs such as diabetes, & obesity. The absolute number of YLL and YLL rates were calculated. Further, Pearson’s correlation had been calculated and to understand the effect of explanatory variables on YLL due to CVD, multiple linear regression analysis had been applied. Results Men have a higher burden of premature mortality in terms of Years of life lost (YLL) due to CVD than women in India, with pronounced differences at adult ages of 50–54 years and over. The age pattern of YLL rate suggests that the age group 85 + makes the highest contribution to the overall YLL rate due to CVD. YLL rate showed a J-shaped relationship with age, starting high at ages below 1 years, dropping to their lowest among children aged 1–4 years, and rising again to highest levels at 85 + years among both men and women. In all the states except Bihar men had higher estimated YLL due to CVD for all ages than women. Among men the YLL due to CVD was higher in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. On the other hand, the YLL due to CVD among men was lowest in Jharkhand followed by Assam. Similarly, among women the YLL due to CVD was highest in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. While, the YLL due to CVD among women was lowest in Jharkhand. Irrespective of gender, all factors except state health expenditure were positively linked with YLL due to CVD, i.e., as state health expenditure increases, the years of life lost (YLL) due to CVDs falls. Among all the covariates, the proportion of a state's elderly population emerges as the most significant predictor variable for YLL for CVDs (r = 0.42 for men and r = 0.50 for women). Conclusion YLL due to cardiovascular disease varies among men and women across the states of India. The state-specific findings of gender differences in years of life lost due to CVD may be used to improve policies and programmes in India.