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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]

India's traditional kinship behavior have undergone certain fundamental changes due to recent development and functioning of Indian society. Of all, the most dominant change is in the form of co-residence of children with their parents in old age. Without familial support, falling or no income and poor health, today, older adults are the most vulnerable population sub-group in the total population. Therefore, by using the India Human Development Survey-II, 2011-12 data we study the relevant association of living arrangement on health status of the older adults. Our results indicate that older adults living alone have significant and strong association with adverse health conditions such as Cataract, Hypertension, and Heart Disease. On the backdrop of health variations of older adults, it is understood that among other socio-economic conditions, living arrangement have serious implications on the health status of the older adults. Thus, we strongly support the notion that older adults with proper family care and support are more likely to be in a better health position as compared to those deprived of it. [ABSTRACT FROM AUTHOR]

Amidst a rapidly aging population, living alone is considered as a living arrangement with various disadvantages. The study aimed to assess the association between older adults living in one-person-households (OPH) and their socio-economic status along with associated inequalities. The data for the present study was utilized from National Family Health Survey, 2015–16 (n = 146, 657). Descriptive, bivariate along with multivariable analysis was used to fulfil the aim of the present study. For assessing socio-economic differentials in OPH, concentration index along with Wagstaff decomposition analysis was used. It was revealed that poor older adults had a higher proportion of OPH (12.7%) than older adults from the non-poor category (3.8%). The value of concentration index was -0.38 indicating the concentration of OPH among poor older adults. Manipur had the highest value of concentration index (-0.614). The highest percentage of poor OPH among older adults was in Kerala (30.7%) and whereas it was lowest among older adults in Bihar (5.9%). About 33.6% of socio-economic status related-inequality was explained by the marital status of older adults followed by older adults' place of residence (30.9%) and gender (29.3%). Older adults who are poor, women, never married, and living in rural areas need greater attention from both governmental and non-governmental organizations. In addition, policies should be designed by differentiating between older adults who live alone by choice and those who are forced by circumstances to map the vulnerabilities effectively. [ABSTRACT FROM AUTHOR]

The living arrangement is an essential social support mechanism affecting older adults' health and well-being. As the Indian family structure changes over time, India's older population needs detailed investigation for its well-being due to living arrangements. This study investigates the association between the change in living arrangements after reaching age 60 years with subjective well-being and psychological health among older adults in India. We used the survey data "Building Knowledge Base on Population Ageing" in India conducted in 2011. The effective sample size for the study was 9231 older adults. Descriptive and bivariate analysis was done to present sample distribution and unadjusted estimates, respectively. Ordered logistic regression analysis was performed to understand the association between the living arrangements of the older adults and their psychological health. The outcome variables were ordered as 0 "best", 1 "good", and 2 "worst". The results showed that older adults with a change in living arrangement after turning 60 years had a higher prevalence of poor psychological health (27.5%) and low subjective well-being (36%). It was found that older adults with change in living arrangement after turning old had 84% and 54% higher likelihood to report worst psychological health [AOR: 1.84; CI: 1.48–2.27] and worst subjective well-being [AOR: 1.54; CI: 1.22–1.93] compared to older adults who did not change their living arrangement after turning old. A change in old-age living arrangements is associated with older adults' psychological health and subjective well-being in India. Older adults with a change in living arrangements need special policy attention. [ABSTRACT FROM AUTHOR]

The proportion of older adults are increasing at a much higher rate than ever expected in both developing and developed countries, and India is no exception. High health care expenditure is attributed to deteriorating health condition among older adult following disability in later life stages and also due to the presence of chronic diseases, and multi-morbidity among them as life expectancy has substantially increased in last few decades. Data for the analysis was used from the National Sample Survey Organization conducted during the 71st (2014) and 75th round (2017-18). Descriptive statistics, bivariate analysis, and linear regression were used for the study. It was found that mean OOPE for older adults was high if the household head was an older adult in case of both men and women. Older adults from higher socio-economic status incurred high OOPE. Moreover, older adults who were financially independent incurred high OOPE compared to those who were partially or fully economically dependent. More interestingly, financially independent women incur higher OOPE than financially independent men. In most states, it was observed that mean OOPE was high for men compared to women, which depicts clear gender differentials. The findings of this study are significant and provide new information on discrepancies between older men and women in health-care spending. Older men were found to have slightly higher health care costs relative to women in this nationally representative survey, after adjusting for confounding factors. [ABSTRACT FROM AUTHOR]