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Studies on the association between population ageing and health spending are inconclusive. Though per capita health spending has a strong age gradient, evidence from the developed countries attributes increasing health expenditure to high spending in terminal year of life. In India, though studies have examined the level, trends and determinants of health care spending, no attempt has been made on association of population ageing and per capita health spending across the districts of India. The objective of this paper was to examine the spatial dependencies and heterogeneities of population ageing and per capita health spending across 640 districts of India. Data from the Census of India (2011) and the consumption expenditure rounds of the National Sample Survey Organisation (NSSO) (2009–10 and 2011–2012) were used in the analysis. Univariate and bivariate LISA analysis, ordinary least square regression, and spatial error model were used to decipher the spatial pattern of population ageing and health spending in the districts of India. Results suggest that per capita health expenditure is positively associated with the proportion of the older adults (aged 60 years and above) in the districts of India. Districts with less than 5% older adults have an annual per capita health expenditure of ₹629 compared to ₹2432 in districts with older adults 12% or more. Districts of India also exhibit large spatial heterogeneity in household health spending. Bivariate Moran's I statistic of proportion of older adults and per capita annual health expenditure was 0.48, suggesting spatially association of the share of the older adults and the per capita annual health expenditure in India. Results of the spatial error model confirmed that share of urban population, mean wealth score, and mean household size are significant predictors of per capita annual health expenditure in India. This study is important to monitor the progress of universal health coverage across the disadvantaged districts and to integrate age component in universal health coverage programmes. [ABSTRACT FROM AUTHOR]

Changing family structure from joint to nuclear posits a challenge among older people. Increasing prevalence of nuclear family promotes household headship among older adults but leaves them vulnerable as they have to live alone at older ages. Therefore, the study aims to estimate the trends and determine the factors associated with household headship among older adults from 1992-93 to 2015–16. The analysis of this paper is based on four rounds of the National Family Health Survey, which were conducted during the periods between 1992-93, 1998–99, 2005–06, and 2015–16, respectively. The study carried out bivariate and multivariate analysis to observe the association between outcome and independent variables. Results found that household headship among older adults had increased from 59.5% in 1992–93 to 67.8% in 2015–16. Further, the study found a rise in the proportion of nuclear families and household headship among older adults from 1992-93 to 2015–16. In older ages, household headship was more among older women than older men. The likelihood of household headship among older adults in a joint family is low as compared to household headship in a nuclear family. While the rise in household headship among older adults may be attributable to a variety of socio-economic influences, it has been noted that household headship among older adults has varied between men and women and by type of family structure. Moreover, there was a clear relationship between headship and wealth status of a household. [ABSTRACT FROM AUTHOR]