Socioeconomic determinants of chronic health diseases among older Indian adults: a nationally representative cross-sectional multilevel study.

Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE

Original Publication: [London] : BMJ Publishing Group Ltd, 2011-

Social Determinants of Health* ; Socioeconomic Factors*; Chronic Disease/*epidemiology; Aged ; Aged, 80 and over ; Alcohol Drinking/epidemiology ; Cross-Sectional Studies ; Female ; Health Surveys ; Humans ; India/epidemiology ; Logistic Models ; Male ; Middle Aged ; Residence Characteristics ; Rural Health ; Smoking/epidemiology ; Tobacco, Smokeless ; Urban Health

Objective: Study uses multilevel modelling to examine the effect of individual, household and contextual characteristics on chronic diseases among older Indian adults.
Design: Nationally representative cross-sectional study.
Participants: Data from the nationally representative, India Human Development Survey conducted in 2011-2012 was used in this study. The survey asked information related to the diagnosed chronic illnesses such as cataract, tuberculosis, hypertension, heart disease and others. The sample size of this study comprised 39 493 individuals who belonged to the age group 50 years and above.
Measures: Self-reported diagnosed chronic illness.
Method: Considering the hierarchal structure of the data multilevel logistic regression analysis was applied to attain the study objective.
Results: Older adults aged 80 years and older were found with three times more chances (OR: 3.99, 95% CI 2.91 to 5.48) of suffering from a chronic ailment than 50-54 years old. Lifestyle risk factors such as alcohol and tobacco (smoked and smokeless) consumption were noted to be significantly associated with the presence of chronic illness whereas older adults who have never consumed smokeless tobacco stood 20% fewer chances (OR: 0.80, 95% CI 0.68 to 0.94) of having any chronic illness. Contextual level variables such as older adults residing in the rural areas were found with 17% fewer chances (OR: 0.83, 95% CI 0.70 to 0.97) of suffering from a chronic illness.
Conclusion: Even after controlling for various characteristics at the individual, household and contextual levels, significant variations in chronic illness remain unexplained at the community and state level, respectively. The findings of this study could effectively be utilised to consider more contextual variables to examine the chronic health status among the growing older population of India.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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Keywords: Chronic morbidity; India; multilevel analysis; older adults

Date Created: 20190909 Date Completed: 20200930 Latest Revision: 20200930

20231215

PMC6731792

10.1136/bmjopen-2018-028426

31494603