Health and ageing in low, middle and high-income countries (1)

The main objective of this presentation is to explore the demographic dynamics of the aged population in Bangladesh. It is important as aged people have appeared in national population and development context as a significant proportion of 7.5% of the total population in the last census, 2011. Secondary information was analysed to have an overview of demographic and related socio-economic context. The dramatic fertility decline in the 1990s and declining mortality trends have set the demographic background for the emergence of ageing. The situation became more favourable and absolute number of aged people has become an overwhelming 10.77 million in 2011 which is larger than total population of many countries. The growth rate of aged has always been higher than the national population since the 1990s and it has become more than double than the national population for the first time in 2011. With lots of demographic and socio-economic diversity, this huge population is struggling to maintain humanly amidst an emerging unfavourable socio-cultural milieu due to urbanisation, modernisation and overall underdevelopment context. This presentation found it necessary to explore and analyse aged population’s demographic and socio-economic dynamics to have proper policies and its implementation to ameliorate its vulnerability.

This paper investigates the relationship between positive attitude and the remaining time lived healthily and happily over individual’s life cycle for Brazil and Mexico. Building on principles derived from theories of reasoned action and subjective norms, coupled with the multidimensional concept of attitude from Cacioppo & Berntson (1994), we estimate an empirical measure of multidimensional attitude based on three levels of perception: the self, the relations to social networks, and the surrounding environment. Our empirical measure of multidimensional attitude (estimated by means of GoM models) is then used to evaluate differences in healthy (HLE) and happy life expectancy (GLE) over the individual’s life cycle (estimated by Sullivan Method) according to the degree of one’s attitude. At last, we apply demographic decomposition techniques to estimate to what extent morbidity compression is happening in each country and how sensitive this trend is to attitudinal levels. Using the World Values Survey (Brazil 1997, 2006; Mexico 1996, 2005), we find evidence of a positive association between positive attitude and HLE and GLE, although the association is not linear over individual’s life cycle for health. Brazilians experience higher proportion of time happy and in good health then Mexicans, regardless of attitudinal status.

A state-funded non-contributory pension plays an important role in poor and AIDS-affected rural South African households. Earlier cross-sectional analyses of 2006 and 2010 WHO-INDEPTH Study of Global Aging and Adult Health (WHO-SAGE) survey from the MRC/University of the Witwatersrand Rural Public Health and Health Transitions Unit (Agincourt) show strong sex differences in reports of health and wellbeing in persons over the age of 50, as well as gendered but temporary positive impact of pension receipt on older persons’ health and wellbeing. This paper builds on the earlier work through longitudinal analyses within individuals interviewed in both 2006 and 2010 to assess whether individual results mirror the cross-sectional results. Specifically, we hypothesize that for individuals, reported health and wellbeing will improve in the five years following pension receipt, and decrease in the years following; and, that the “pension bump” will be more prominent for women than for men.

Declining mortality and fertility has resulted in a proportionate increase in old age (60+) population in rural India, largely characterized by limited economic resources, poor health status and inadequate use of health facilities that heightens their vulnerability to various ill-health outcomes. Using data from 60th round of National Sample Survey (NSSO-2004), we examine the socio-economic differentials in self-reported ailments among rural elderly population. Employing Verbruse and Jette’s (1994) Disability Framework, we test the association between socio-economic inequalities and selected health outcomes- active pathology, impairment, functional limitation and disability. Result shows that elderly from richest, rich and middle quintiles were more likely to report various health ailments than the poorest one. Economic inequalities were largest in functional limitation followed by disability. Age advancement has a profound impact on physical impairment, which could be explained by the living arrangement and working status of the elderly. Therefore, in order to ensure healthy aging, there is an urgent to establish equitable old age security schemes providing physical, social as-well-as economic support to the elderly population, particularly among economically disadvantageous groups in rural India.

The objective of this study is twofold, firstly, to estimate the prevalence of multiple disabilities among the older population in India; secondly, to examine the socioeconomic determinants of multiple disabilities among the older population. This study used the India Human Development Survey Data (IHDS) for the analysis. Bivariate, Multinomial Logit Regression and Multiple Classification Analysis are used as methods of analyses. Disability score is constructed for measuring the multiple disabilities among the older population. The results of disability prevalence show, a high prevalence of multiple disabilities among the older population in India. Further, disability prevalence varies considerably by age and socio-economic characteristics of the older population. Among all the socioeconomic factors, economic factor emerged as a dominant predictor of prevalence of multiple disabilities among the older population in India. The findings of the dimension specific assessment reveal that the disability in walking is the highest among all the disabilities.

While the sex ratio generally favors men in India,the trend reverses in favor of females at older ages.More often than not, women are over burdened with cumulative inequalities.Thus,a longer life span is directly correlated to greater morbidity and higher incidence of chronic diseases and sufferings for the older women.However,only few studies addressed the existing gender differentials in health status and health seeking behavior,particularly among the aged population.Using the data “Study of Global Ageing and Adult Health”(India)this paper aims to find out the gender differentials between self-reported morbidity and symptom-based morbidity of selected chronic diseases between men and women aged 50+ for India.An attempt is made to identify the risk factors that are leading to gender differentials in health among the elderly by applying the gender framework for chronic diseases.It will also probe the extent of gender differentials in treatment seeking behavior.Results show that for most of the chronic diseases the symptom based prevalence is much higher than the self-reported prevalence for both the sexes.But this difference is higher among the elderly women than the elderly men.The higher prevalence of symptom based disease among women shows that women are mostly unaware of their health needs and problems as compared to men.

Health status at older ages around the globe has changed due to changes in epidemiological environment, diet/nutrition, medical technology, public and individual health practices. But the change is likely to vary across countries with different economic, epidemiological, and policy circumstances. Using 2 waves of nationally representative datasets from 5 countries with varying income levels, we examine changes in biological risk in US, England, Mexico, Taiwan and Indonesia. Biological risk factors include systolic and diastolic blood pressure (BP), BMI, total, HDL cholesterol, and HbA1c. Our analysis includes those age 50+ who participated in physical exam and blood collection. We find patterns of age-specific onset of high-risk levels of biological risk vary across countries. No single country has the highest or lowest onset levels for all factors. A relatively low-income country, Indonesia, has the highest onset rates for high BP, though its rate of overweight onset is the lowest;while the high-income countries (US, England) have higher onset rates of overweight, their onset rates of high BP tend to be lower. The US had fairly high levels of onset of high HbA1c;England had relatively high levels of high cholesterol onset. Our findings indicate different levels of onset of biological risk across countries with different income.

Although many efforts have been developed for better accessibility in France since the 90’s, people who feel difficulty while travelling have increased. To what extent has the population structure influenced this rise? In the paper, we address the factors of this increase by means of a demographic approach to study the links between disability and mobility. Hence this paper firstly aims to better understand the socio-demographic situation of people disabled while travelling. Secondly, the medical factors and health conditions of people with a disability are studied.
Three surveys are used: the two latest French National Travel Surveys (1993 and 2007) which report 8% of the population have difficulty while travelling in 1993 against 9% in 2007 and the National Survey on Disability, Impairment and Dependence realized in 1999. They permit firstly to compare the difficulty while travelling over time, secondly to give medical reasons of difficulty while travelling in order to encompass individual and environmental characteristics of disability.
Difficulty while travelling is highly determined by age which is the main reason for this rise from 1993 to 2007. Yet, age is linked with the appearance of deficiencies that cause inabilities and limit mobility.

The aim of the study is to investigate relations between religion, health and coping in ageing societies. We focus our work on seniors in chosen European countries. Increasing proportion of older people can have a significant impact of health conditions and quality of life of those populations. Many seniors have health conditions that can impair the quality of life, including disabling conditions, depressions and mental health problems.
We use data from the Survey of Health, Ageing and Retirement in Europe (SHARE), which gives representative data on non-institutionalized sample of the 50 plus population in Europe and detailed information on health, work, household-situation, cognition and financial situation.
Tentative results suggest that both being less religious and having high cognitive function seems to be associated with lower risk of depression. However, among those who have experienced a heart attack higher religiosity is positively correlated with an absence of depression. These findings hold for all regions in Europe and for both women and men.

Using 66th round of consumption expenditure data, National Sample Survey, 2009-10, this paper tests the hypothesis that the monthly per capita household health spending is significantly higher among elderly households compared to non-elderly households. The households are classified into three mutually exclusive groups; households with only elderly members (elderly households), households with elderly and non-elderly members and households without any elderly member. The health spending include the institutional (hospitalization) and non-institutional health expenditure of the household, standardized for 30 days. Descriptive statistics and two part model are used to understand the differentials of health expenditure across households. Results indicate that the monthly per capita health spending of elderly households is 3.8 times higher than non-elderly households. Health spending accounts 13 percentage of consumption expenditure of elderly households, 7% among households with elderly and non-elderly members and 5% among non-elderly households. Controlling for social, economic and demographic correlates, the per-capita household health spending among elderly households was significantly higher than non-elderly households. The health expenditure is catastrophic for poorer households, casual laborer and households with elderly m