What makes them feel healthier? the correlates of self-perceived health among older adults in India

The physical, the mental and the social well-being constitute the health of an individual and a population in general. For populations passing through demographic transition, the life expectancies at various ages show an increasing trend over time. To ensure healthy ageing, in such populations, the later part of the life span of an individual should be free from chronic diseases and impairments. In this context, the prevailing health scenario is best measured in terms of the disease free life expectancies and the disability free life expectancies. At the individual level, the number of diseases and the number of impairments one suffers from give an account of his/her health. Besides these objective measures of health, the self-perceived health (also called the self-reported health) has received due attention in recent literature. This is due to its strong association with the life expectancy on one hand and with the future state of health on another. Moreover, including self-perceived health (SPH) in accounting for an individual’s health is akin to giving him/her a say in his/her assessment of own health. Furthermore, it is opined that SPH captures those hidden aspects of health that go unnoticed otherwise. The present study investigates the socioeconomic factors associates with the SPH for the older adults in India. Data pertaining to two sample surveys with a country-wide coverage (the 52nd and the 60th round of the National Sample Survey) of the older adults have been made use of for this purpose. SPH is usually measured on a 3-5 point ordinal scale in a relative perspective (comparing the present state of health with the state of health in an earlier reference period) or in a global perspective (absolute statement about the present state of health). The present study models the SPH (in a global perspective), measured on a 3-point ordinal scale, for its association with the immediate socioeconomic environment of the older adults using an ordinal logit regression model. The immediate socioeconomic environment of an older adult consists of the living arrangements, the financial dependence, the marital status, the number of children, the economic status of the household, the caste, the religion and the geographic region. Further, these associations have been studied after controlling for the objective measures of health, namely, the diseases, the impairments, the immobility and the relative state of health. The results indicate that the objective measures of health (the severity of immobility, the number of impairments and the number of diseases) and the relative change in the state of health during past one year contribute maximum to the information on the perception of the present state of health. This is quite obvious. Although, the information provided by immediate socioeconomic environment is lesser, it is not insignificant. SPH was found better for more educated older adults. The financial dependence and poor status of the household reduce the chances of better SPH. On the other hand co-residence and large sized households increase the chances of better SPH. The older adults in rural areas are less likely to perceive a better health status when compared to their urban counterparts. It is quite obvious from the findings that SPH, which is an indicator of the future state of health, is found to be associated not only with the present state of health but also with the prevailing socioeconomic conditions of the older adults. The solution to better health, thus, has socioeconomic components that need appropriate and timely redress.