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Studies on the association between population ageing and health spending are inconclusive. Though per capita health spending has a strong age gradient, evidence from the developed countries attributes increasing health expenditure to high spending in terminal year of life. In India, though studies have examined the level, trends and determinants of health care spending, no attempt has been made on association of population ageing and per capita health spending across the districts of India. The objective of this paper was to examine the spatial dependencies and heterogeneities of population ageing and per capita health spending across 640 districts of India. Data from the Census of India (2011) and the consumption expenditure rounds of the National Sample Survey Organisation (NSSO) (2009–10 and 2011–2012) were used in the analysis. Univariate and bivariate LISA analysis, ordinary least square regression, and spatial error model were used to decipher the spatial pattern of population ageing and health spending in the districts of India. Results suggest that per capita health expenditure is positively associated with the proportion of the older adults (aged 60 years and above) in the districts of India. Districts with less than 5% older adults have an annual per capita health expenditure of ₹629 compared to ₹2432 in districts with older adults 12% or more. Districts of India also exhibit large spatial heterogeneity in household health spending. Bivariate Moran's I statistic of proportion of older adults and per capita annual health expenditure was 0.48, suggesting spatially association of the share of the older adults and the per capita annual health expenditure in India. Results of the spatial error model confirmed that share of urban population, mean wealth score, and mean household size are significant predictors of per capita annual health expenditure in India. This study is important to monitor the progress of universal health coverage across the disadvantaged districts and to integrate age component in universal health coverage programmes. [ABSTRACT FROM AUTHOR]

An increase proportion of elderly means additional national responsibility to meet the emerging challenges to ensure well-being. Family, kinship, and community which were the strong sources of social support and care for the elderly in India has become weaker in recent times. Eight of India's states are considered to be relatively socioeconomically backward, and are referred to as the Empowered Action Group (EAG) states, while rest of the states are demographically more advanced and many have achieved replacement level of fertility. The purpose of this paper is to compare the pattern of living arrangements and economic dependency among elderly in EAG and non-EAG states of India. Data from the National Sample Survey 71st round was used for analysis (N = 27,245). Results suggest that majority of the elderly co-resided both in EAG and non-EAG states. The major difference in living alone between EAG and non- EAG states is found according to religion, consumer expenditure quintile, and perceived health. Overall, 72% elderly are economically dependent on others. The differences between EAG and non-EAG states in economic dependency are considerable according to marital status, education, religion, and consumer expenditure quintile. Multivariate analysis revealed that the chances of living alone and economic dependency are higher in non-EAG states than EAG states. Number of surviving children, education, and consumer expenditure quintile are the significant predictors of living alone, while age, gender, and education significantly influence economic dependency. The findings call for making appropriate changes in policies and programmes to ensure social security and health of the elderly. [ABSTRACT FROM AUTHOR]