Socio-Economic Inequalities in the Prevalence of Poor Self-Rated Health among Older Adults in India from 2004 to 2014: A Decomposition Analysis

The older population in India has increased significantly from 24.71 million in 1961 to 43.98 million in 1981 and further to 104 million in 2011. There is an urgent need to study the health conditions of older adults and also a need to examine factors contributing to poor self-rated health (SRH). This study determines the decadal difference for poor self-rated health among older adults in India. It also explores whether decadal variations in poor SRH can be attributed to the socio-economic context in which older adults live. This study used two rounds of the National Sample Survey Office (NSSO) data; 60th round (2004) and 71st round (2014). Logistic regression and Wagstaff's decomposition analysis were used to carve out the results. The study found a significant decrease in the relative decadal difference of 5.2% in reporting poor self-rated health among older adults in India over the two time-periods. Older adults who were economically dependent and were living alone had higher odds of reporting poor SRH than their counterparts. There is a negligible difference in the value of concentration index from 2004 (0.0183) to 2014 (0.0177) for poor self-rated health among older adults. Additionally, place of residence, education, and below poverty line status were the main contributory factors explaining the socio-economic inequality for poor SRH among older adults in 2004 and 2014. These findings suggest that an effective way to reduce socio-economic inequality in poor SRH is not only to have access to education but also to focus on improvements in health-related infrastructure in rural areas.