Journal Article

Disability and ageing in China and India – decomposing the effects of gender and residence. Results from the WHO study on global AGEing and adult health (SAGE)

Ng, Nawi, Norström, Fredrik, Stewart Williams, Jennifer

2017

Overview

Background China 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. Methods National 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. Results In 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. Conclusions Education 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.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adults / Aged / Aging / Aging (Biology) / Analysis / China - epidemiology / Chronic Disease - epidemiology / Chronic illnesses / Cross-Cultural Comparison / Decision making / Decomposition / Developing countries / Disabilities / Disability Evaluation / Disabled Persons - classification / Disabled Persons - statistics & numerical data / Disease / Economic development / Economic reform / Education / Employment / Epidemiology / Equality / Female / Gender / Geriatric Assessment - methods / Geriatric Assessment - statistics & numerical data / Geriatrics / Geriatrics/Gerontology / Global Health - statistics & numerical data / Health insurance / Humans / India - epidemiology / Inequalities / Intergenerational relationships / Labor force / Longitudinal Studies / Male / Medicine / Medicine & Public Health / Middle Aged / nutrition and epidemiology / Oaxaca-Blinder / Older people / Population / Public health / Rehabilitation / Research Article / Residence / Residence Characteristics - statistics & numerical data / Rural / Rural areas / Rural Population / Rural populations / Social interactions / Socioeconomic Factors / Womens health / World Health Organization