Longitudinal Aging Study in India (LASI)

Longitudinal Aging Study in India (LASI) P . Arokiasamy International Institute for Population Sciences Mumbai, India Policy Research and Data Needs t...
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Longitudinal Aging Study in India (LASI) P . Arokiasamy International Institute for Population Sciences Mumbai, India Policy Research and Data Needs to Meet Challenges of Population Ageing in Asia, Beijing December 9-0, 2010

The Economist weighs in again ¡ India’s age structure is evolving in the same direction as China’s. ¡ It’s behind China, but the share of its population that is of working age is growing. India stands ready to reap a demographic dividend.

Longitudinal Aging Study in India (LASI)

Older Indians

UN World Population Prospects , 2008 Revision

Longitudinal Aging Study in India (LASI)

Rapid growth in number and share of older Indians expected by 2050

UN World Population Prospects , 2008 Revision

Longitudinal Aging Study in India (LASI)

Figure 2 Trends in population growth rate by broad age groups in south Indian States

Longitudinal Aging Study in India (LASI)

1950

1960

1970

1980

1990

2000

2010

2020

2030

2040

2050

1950

1960

1970

1980

1990

2000

2010

2020

2030

2040

2050

Total Fertility Rate, India and states, 2005-06

Challenges of population aging in India ¡Breakdown of extended family structure ¡ Falling fertility rates ¡ Urbanization ¡ Women to work – so less caregiving ¡ Mobility of younger generation ¡ Generation gap

¡Access to health care ¡Old-age economic security Longitudinal Aging Study in India (LASI)

The LASI story

Longitudinal Aging Study in India (LASI)

Core LASI team

HARVARD SCHOOL OF PUBLIC HEALTH

INTERNATIONAL INSTITUTE FOR POPULATION SCIENCES

RAND CORPORATION

Longitudinal Aging Study in India (LASI)

LASI team members

National advisory committee

Director, IIPS (ex officio) Director-General, Indian Council of Medical Research and Secretary, Department of Health Research, Ministry of Health and Family Welfare (MOHFW), Government of India (GOI) (ex officio) Director-General of Health Services, MOHFW, GOI (ex officio) Lisa Berkman, Harvard University Additional Director-General, Statistics, MOHFW, David Canning, Harvard University Amitabh Chandra, Harvard University GOI (ex officio) Nicholas Christakis, Harvard University Chief Director, Statistics MOHFW, GOI (ex officio) Adeline Delavande, RAND Corporation Mooneer Alam, Institute of Economic Growth Peifeng Hu, University of California, Suman Bery, National Council for Applied Los Angeles Economic Research Tarun Khanna, Harvard University Shalini Bharat, Tata Institute of Social Sciences Ajay Mahal, Monash University P.M. Kulkarni, Jawaharlal Nehru University Arvind Mathur, IAG I.S. Gambhir, Banares Hindu University S.K. Mohanty, IIPS S. Irudaya Rajan, Center for Development Sulabha Parasuraman, IIPS Studies Arun Risbud, NARI S. Siva Raju, Tata Institute of Social Sciences T.V. Sekher, IIPS Kavita Sivaramakrishnan, Columbia K. Srinath Reddy, Public Health Foundation of India University S.V. Subramanian, Harvard University Gita Sen, Indian Institute of Management Bas Weerman, RAND Corporation Perianayagam Arokiasamy, IIPS (coPrincipal Investigator) David E. Bloom, Harvard University (Principal Investigator) Jinkook Lee, RAND Corporation (coPrincipal Investigator)

International advisory committee James Banks, University College London Axel Börsch-Supan, Universitat Mannheim Somnath Chatterji, World Health Organization Arie Kapteyn, RAND Corporation Michael Marmot, University College London James P. Smith, RAND Corporation David Weir, University of Michigan David Wise, Harvard University Yaohui Zhao, Beijing University

Longitudinal Aging Study in India (LASI)

LASI ¡Vision and Goals ¡Evidence base that can be used to conduct descriptive, causal, and policy analyses ¡Harmonization with other HRS ¡Follow 30,000 individuals longitudinally

Longitudinal Aging Study in India (LASI)

HRS: an instrument to help address the problem of global population aging ¡ Measure health and its determinants and consequences over the later portions of the life cycle ¡ Integration of major domains of life into a common survey ¡ Science-based agenda ¡ Methodologically innovative ¡ Respect for local knowledge ¡ Public access to data ¡ Power of adopting a longitudinal focus Longitudinal Aging Study in India (LASI)

HRS worldwide ¡ English Longitudinal Study of Ageing (ELSA) ¡ Survey of Health, Ageing and Retirement in Europe (SHARE): aims to include all EU member countries ¡ Austria, Belgium, Czech Republic, Denmark, France, Germany, Greece, Ireland, Israel, Italy, The Netherlands, Poland, Spain, Sweden and Switzerland. ¡ 2010-2011: Estonia, Hungary, Luxembourg and Portugal

¡ Mexican Health and Aging Study (MHAS) ¡ Korean Longitudinal Study on Aging (KLoSA) ¡ Chinese Health and Retirement Study (CHARLS) ¡ Irish Longitudinal study on Ageing (TILDA) ¡ Japanese Study of Aging and Retirement (JSTAR) Longitudinal Aging Study in India (LASI)

Survey

HRS

CHARLS

KLoSA

J-STAR

Country

United States

P .R. of China

Rep. of Korea

Japan

1992, 1993, 1998, 2004, 2010

2008, 2011

2006

2007, 2009

Every 2 years

Follow-up in 2011 then every 2 years

Every 2 years

Every 2 years

8

1

2

1

30,000

10,000

10,000

4,200

Age eligibility

50+

45+

45+

50 – 75

Response rate, baseline

70-81%

82%

65%

60%

Enrolment years

Follow-up frequency Number of waves available to date Sample size

Harmonization across countries ¡Countries can learn from the experience of each other ¡Institutional responses to demographic change vary across countries, thus creating an “experiment” of sorts ¡To take advantage of this experiment, data must be comparable

Longitudinal Aging Study in India (LASI)

Challenges of an Indian HRS ¡ Heavily rural ¡ Large informal economy ¡ Institutional complexity ¡ Many languages ¡ Urbanization and migration ¡ Heterogeneity within urban areas ¡ Seasonal considerations ¡ Survey challenges: knowledge of age, notion of retirement Longitudinal Aging Study in India (LASI)

Research Design ¡ Representativeness –National ¡ Panel Sample size- 30,000 ¡ Longitudinal – 25 years ¡ Every 2 years ¡ First wave in 2012 (after 2011 census results) ¡ Households with one and more persons in age 45+ ¡ All persons in age 45 + and their spouses

Longitudinal Aging Study in India (LASI)

Multi-stage Area Probability Sample Design ¡ LASI sample selection will consists of three-stage area probability sampling. The primary (first) stage and second stage of sample selection involve probability proportionate to size. The first two stages involve sample area selection and third stage involves household selection. ¡ LASI sampling design involves independent drawing of sample in each region of North, Center, East, North-east, West and South in each of four regions of North, East, West and South sample consists of metropolitan city (self-representing unit) and other areas (Non-self-representing units). Longitudinal Aging Study in India (LASI)

LASI innovations ¡LASI Instrument ¡CAPI ¡Show cards

¡Biomarkers ¡Physical measures

Longitudinal Aging Study in India (LASI)

LASI Innovations ¡ Community level data using GIS -Verification, geocoding, thematic mapping and community analysis ¡ Physical Environment- land, water, indoor and outdoor air-quality, access to sanitation, and climatic conditions ¡ Survey scope expanded to include information on infectious diseases, diet and nutritional intake ¡ Comprehensive coverage of biomarkers

Longitudinal Aging Study in India (LASI)

LASI instrument ¡Final product: Two-part survey ¡ Household questionnaire ¡ Coverscreen, Housing and Environment, Income, Assets and Debts, Consumption ¡ Individual questionnaire ¡ Demographics, Family and Social Networks, Health, Biomarkers, Health Care Utilization, Work and Employment, Pension, Experimental Modules (Anchoring Vignettes, Social Connectedness, Expectations ) Longitudinal Aging Study in India (LASI)

Refining the survey instrument ¡Pre-Pilot - Pre-test: 100 CAPI interviews ¡Purpose: to understand how LASI instrument functions in the field

¡Translation of the survey instrument ¡State language specific pre-test to gauge language and cultural differences. 50 pretest interviews for each language

Longitudinal Aging Study in India (LASI)

Computer Assisted Personal Interviewing (CAPI) ¡Field teams are equipped with laptop computers ¡Responses are input directly into computers ¡Checking data accuracy in real-time

Longitudinal Aging Study in India (LASI)

Longitudinal Aging Study in India (LASI)

Longitudinal Aging Study in India (LASI)

Longitudinal Aging Study in India (LASI)

Show cards: sources of water

Longitudinal Aging Study in India (LASI)

Show cards: types of toilet facilities

Longitudinal Aging Study in India (LASI)

LASI Biomarkers ¡ Proposed to test the dried blood spots (DBS) collected during LASI for the presence of 5 key markers ¡ Apolipoproteins B and A-1 ¡ C-reactive protein (CRP) ¡ Epstein-Barr virus (EBV) ¡ Hemoglobin (Hb) ¡ HbA1c

¡ Assembled strong team with wealth of knowledge related to serological analyses, DBS in particular Longitudinal Aging Study in India (LASI)

Longitudinal Aging Study in India (LASI)

¡Short term goals ¡ conduct LASI-Pilot to cover a target sample of 1600 completed interviews of men/women age 45+ years. ¡ 400 completed interviews in four selected stated of Karnataka , and Rajasthan (covered in SAGE) Kerala and Punjab (new).

Longitudinal Aging Study in India (LASI)

Pilot study ¡Sample size: 1500 (targeting individuals 45+ and their spouses, age-eligible or not) ¡States involved: ¡ Karnataka ¡ Kerala ¡ Punjab ¡ Rajasthan

Longitudinal Aging Study in India (LASI)

Data management and analysis ¡ Central office validation checks, feedback to field teams, cleaning and coding for open ended/verbatim questions ¡ DBS results will be integrated when available ¡ Data analysis plan will be discussed in the LASI advisory committee meeting ¡ Data will be protected with access to designated persons and LASI coordinators ¡ Final data set will be delivered for harmonization with HRS and dissemination ¡ GIS data will be anonymised Longitudinal Aging Study in India (LASI)

LASI Progress so far Tasks completed ¡Instrument ¡CAPI ¡Manuals - Module-based, supervisor, training ¡Main Wave sampling plan ¡Four state Pilot – in progress – 2 states completed; end date – 25 December ¡First Results – Delhi meeting in March14-15, 2010 Longitudinal Aging Study in India (LASI)

Expected Evolution of LASI

Longitudinal Aging Study in India (LASI)

Longitudinal Aging Study in India The project described is supported by grants from the National Institute on Aging, Award Numbers R21AG032572 and P30AG024409. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging or the National Institutes of Health. Photo credits: Dickson Chiramel Abraham and Gail Shotlander.

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