International Institute for Population Sciences, Mumbai, India.
PLoS One. 2023 Mar 30;18(3):e0283385. doi: 10.1371/journal.pone.0283385. eCollection 2023.
Developing countries like India grapple with significant challenges due to the double burden of communicable and non-communicable disease in older adults. Examining the distribution of the burden of different communicable and non-communicable diseases among older adults can present proper evidence to policymakers to deal with health inequality. The present study aimed to determine socioeconomic inequality in the burden of communicable and noncommunicable diseases among older adults in India. This study used Longitudinal Ageing study in India (LASI), Wave 1, conducted during 2017-2018. Descriptive statistics along with bivariate analysis was used in the present study to reveal the initial results. Binary logistic regression analysis was used to estimate the association between the outcome variables (communicable and non-communicable disease) and the chosen set of separate explanatory variables. For measurement of socioeconomic inequality, concentration curve and concentration index along with state wise poor-rich ratio was calculated. Additionally, Wagstaff's decomposition of the concentration index approach was used to reveal the contribution of each explanatory variable to the measured health inequality (Communicable and non- communicable disease). The study finds the prevalence of communicable and non-communicable disease among older adults were 24.9% and 45.5% respectively. The prevalence of communicable disease was concentrated among the poor whereas the prevalence of NCDs was concentrated among the rich older adults, but the degree of inequality is greater in case of NCD. The CI for NCD is 0.094 whereas the CI for communicable disease is -0.043. Economic status, rural residence are common factors contributing inequality in both diseases; whereas BMI and living environment (house type, drinking water source and toilet facilities) have unique contribution in explaining inequality in NCD and communicable diseases respectively. This study significantly contributes in identifying the dichotomous concentration of disease prevalence and contributing socio- economic factors in the inequalities.
发展中国家，如印度，由于老年人中传染病和非传染性疾病的双重负担，面临着重大挑战。研究老年人中不同传染病和非传染性疾病负担的分布，可以为政策制定者提供适当的证据，以应对健康不平等问题。本研究旨在确定印度老年人中传染病和非传染性疾病负担的社会经济不平等情况。本研究使用了印度纵向老龄化研究（LASI）第一波，该研究于 2017-2018 年进行。本研究采用描述性统计和双变量分析来揭示初步结果。二元逻辑回归分析用于估计因变量（传染病和非传染性疾病）与所选一组独立解释变量之间的关联。为了衡量社会经济不平等，计算了集中曲线和集中指数以及按邦划分的贫富比。此外，还使用 Wagstaff 对集中指数方法的分解来揭示每个解释变量对衡量健康不平等（传染病和非传染性疾病）的贡献。研究发现，老年人中传染病和非传染性疾病的患病率分别为 24.9%和 45.5%。传染病的患病率集中在贫困人口中，而非传染性疾病的患病率则集中在富裕的老年人中，但非传染性疾病的不平等程度更高。非传染性疾病的集中指数为 0.094，而传染病的集中指数为-0.043。经济状况和农村居住是两种疾病不平等的共同因素；而 BMI 和生活环境（房屋类型、饮用水源和卫生设施）分别对非传染性疾病和传染病的不平等有独特的贡献。本研究在确定疾病流行的二分集中以及解释不平等的社会经济因素方面做出了重要贡献。
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