Abstract
BackgroundChina and India are the world’s two most populous countries. Although their populations are growing in number and life expectancies are extending they have different trajectories of economic growth, epidemiological transition and social change. Cross-country comparisons can allow national and global insights and provide evidence for policy and decision-making. The aim of this study is to measure and compare disability in men and women, and in urban and rural dwellers in China and India, and assess the extent to which social and other factors contribute to the inequalities.MethodsNational samples of adults aged 50 to 79 years in China (n = 11,694) and India (n = 6187) from the World Health Organization (WHO) longitudinal Study on global AGEing and adult health (SAGE) Wave 1 were analysed. Stratified multiple linear regressions were undertaken to assess disability differences by sex and residence, controlling for other biological and socioeconomic determinants of disability. Oaxaca-Blinder decomposition partitioned the two-group inequalities into explained and unexplained components.ResultsIn both countries women and rural residents reported more disability. In India, the gender inequality is attributed to the distribution of the determinants (employment, education and chronic conditions) but in China about half the inequality is attributed to the same. In India, more than half of the urban rural inequality is attributed to the distribution of the determinants (education, household wealth) compared with under 20% in China.ConclusionsEducation and employment were important drivers of these measured inequalities. Overall inequalities in disability among older adults in China and India were shaped by gender and residence, suggesting the need for policies that target women and rural residents. There is a need for further research, using both qualitative and quantitative methods, to question and challenge entrenched practices and institutions and grasp the implications of global economic and social changes that are impacting on population health and ageing in China and India.
Highlights
China and India are the world’s two most populous countries
This study of adults aged 50 to 79 years in China and India shows how gender, residence, age, marital status, education, employment, household wealth and chronic conditions are associated with disability
The decomposition further elucidates how these determinants separately contribute to inequalities in disability between men and women and urban and rural residents
Summary
China and India are the world’s two most populous countries. their populations are growing in number and life expectancies are extending they have different trajectories of economic growth, epidemiological transition and social change. Cross-country comparisons can allow national and global insights and provide evidence for policy and decision-making. China and India have the world’s largest country populations - estimated at 1.4 and 1.3 billion respectively. Together they are home to 31% of the global population. Over the one and half decades, about 65% of the Chinese health burden and 44% of the Indian health burden will be borne by adults aged 60 and above [5, 6] These two population superpowers have prominent global positions in the Asia-Pacific region, yet different demographic and epidemiological trajectories.
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