Socioeconomic determinants of health inequalities among the older population in India: a decomposition analysis.

Abstract

This study quantified and decomposed health inequalities among the older population in India and analyzes how health status varies for populations between 60 to 69years and 70years and above. Data from the 60th round of the National Sample Survey (NSS) was used for the analyses. Socioeconomic inequalities in health status were measured by using Concentration Index (CI) and further decomposed to find critical determinants and their relative contributions to total health inequality. Overall, CI estimates were negative for the older population as a whole (CI = -0.1156), as well as for two disaggregated groups, 60 to 69years (CI = -0.0943) and 70years and above (CI = -0.08198). This suggests that poor health status is more concentrated among the socioeconomically disadvantaged older population. Decomposition analyses revealed that poor economic status (54%) is the dominant contributor to total health inequalities in the older population, followed by illiteracy (24%) and rural place of residence (20%). Other indicators, such as religion, gender and marital status were positive, while Caste was negatively associated with health inequality in the older populations. Finally, a comparative assessment of decomposition results suggest that critical contributors for health inequality vary for the older population of 60 to 69years and 70years and above. These findings provide important insights on health inequalities among the older population in India. Implications are advanced.