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The impact of ill-health on labour force participation is a well-recognized concern in both developed and developing countries. However, previous studies have often overlooked age differentials in this relationship, assuming uniform effects across age groups. This study aims to fill this gap by examining how ill-health affects labour outcomes among different age segments in India. Utilizing data from the Longitudinal Ageing Study in India (LASI) Wave 1, which covers over 72,000 individuals aged 45 and above, this research investigates the linkage between health and labour force outcomes. The labour outcomes in this study includes labour force participation, labour earnings and hours worked. Present study used instrumental variable approach to mitigate endogeneity issues and establish causal relationships between health and labour outcomes. The Heckman selection model is utilized to address selection bias in analysing wage and hours worked. The study reveals several key findings. Firstly, ill-health consistently leads to a decline in labour force participation among both middle-aged (28 percent) and elderly (36 percent) individuals in India. This underscores the pervasive impact of health on workforce engagement, particularly in a context with limited social security measures. Secondly, the research identifies significant variations in the effects of ill-health on wages and hours worked based on age. Among elderly individuals, there is a pronounced reduction in both wages and hours worked due to ill-health. However, this effect is less pronounced among middle-aged adults. Furthermore, socioeconomic factors play a pivotal role in shaping how ill-health influences labour outcomes among different age groups. This study underscores the importance of considering age differentials in the impact of ill-health on labour outcomes, offering valuable insights for policymakers, practitioners, and researchers seeking to address this critical issue in India's dynamic socio-economic landscape. [ABSTRACT FROM AUTHOR]

A known health effect of widowhood is an increased mortality risk among surviving spouses, with gender- and age-specific observations. While morbidity conditions with socio-economic factors may exacerbate the effect of widowhood on mortality, no research has attempted to predict mortality among the widowed over the married population with the presence of morbidity in India. Thus, the present study concurrently examines marital status and health in the Indian setting, bringing substantial empirical evidence to explore the link between marital status, morbidity, and mortality. The study used prospective data from India Human Development Survey (IHDS) wave 1 (2004–2005) and wave 2 (2011–2012). In total, 82,607 individuals aged 25 years and above were considered for the analysis. To present the preliminary findings, descriptive statistics and bivariate analysis were used. Using multivariable logistic regression, the interaction effect of marital status and morbidity status was estimated to predict the likelihood of mortality. Across all socio-economic groups, widowed individuals reporting any morbidity had a higher mortality proportion than married people. Young widowers with any morbidity are more susceptible to increased mortality. Asthma among young widowers and cardiovascular diseases among elderly widowers significantly elevate the probability of mortality. However, older widowed women with diabetes had a lower probability of mortality than older married women with diabetes. The widowers' disadvantage in mortality and morbidity may be attributable to less care-receiving and the greater incidence of unhealthy lifestyle practices during the post-widowhood period, indicating the need for more research. [ABSTRACT FROM AUTHOR]

Background: The paper aims to explore the elderly caregiving process in India from the perspective of both elderly as well as working women care providers, along with the challenges faced and the coping strategies adopted by them during the process. Methods: In-depth interviews with 48 participants (care providers and care receivers) from 25 multi-generational households were conducted in the slums of Mumbai and analysed using QSR-NVivo-10. Results: Working women care providers supported the needs of the dependent elderly along with performing household chores and paid work. However, the way the care was perceived and demanded, was not often same as delivered by the care providers. Care provider suffered silently with poor social, physical and emotional welling in absence of support system and lack of time. Sometimes, physically exhausted care providers unknowingly resorted to elderly abuse and neglect. At the same time, a bidirectional flow of support from elderly also existed in the form of childcare, household chores and financial support. Though caregiving overstrained the care providers, strong family ties, acknowledgement of the contributions of the elderly during their young days, and the desire to set a precedent for the young generation did not let them step back from their duties. The main coping mechanism for both care receivers and providers was largely centred around the notion of acceptance of their situation. Conclusion: Conversations between generations can help in enhancing family ties and reduce conflicts. The support of family and community can also ease the burden of caregiving. [ABSTRACT FROM AUTHOR]

Aim: Recent National Family Health Survey results portray striking improvements in most population and health indicators, including fertility, family planning, maternal and child health, gender treatment, household environments, and health insurance coverage of the Pradhan Mantri Jan Arogya Yojana (PM-JAY), with all India resonance. However, the prevalence of any anaemia (< 11 g/dl) among children under age five has exhibited a reversed trajectory in recent years. Therefore, the present study explores key drivers of the reversal of the trend in the prevalence of childhood anaemia between 2015 and2021. Methods: Data of four rounds of the National Family Health Survey (NFHS) were used to show the overall trend of anaemia among children. However, for the analysis of key drivers of the reversal trend of childhood anaemia, only the recent two rounds (NFHS-4 & NFHS-5) were used. Descriptive, bivariate multivariable analysis and Fairlie decomposition model were used to explore the drivers of the reversal of the trend in childhood anaemia. Results: During the past two decades, India has seen a decline in the prevalence of childhood anaemia (NFHS-2 to NFHS-4). However, a reversal of trend was observed recently. The prevalence of anaemia among children aged 6–59 months increased from 59 percent in NFHS-4 to 67 percent in NFHS-5. In addition, the prevalence of mild anaemia increased from 23.3 percent in NFHS-2 to 28.7 percent in NFHS-5. However, the prevalence of moderate and severe anaemia declined considerably from NFHS-2 (40 percent and 4.1 percent) to NFHS-4 (28.7 percent and 1.6 percent), but showed an increase in the prevalence in NFHS-5 (36.3 percent and 2.2 percent). Among others, mothers' educational attainment, anaemia status and socio-economic status emerge as the key drivers of the change in the prevalence of childhood anaemia. Conclusion: These findings may have vital implications for the ongoing Anaemia Mukt Bharat Programme, one of the government's dream projects in India. [ABSTRACT FROM AUTHOR]

Background: The present study tries to provide a comprehensive estimate of gender differences in the years of life lost due to CVD across the major states of India during 2017–18. Methods: The information on the CVD related data were collected from medical certification of causes of death (MCCD reports, 2018). Apart from this, information from census of India (2001, 2011), SRS (2018) were also used to estimate YLL. To understand the variation in YLL due to CVD at the state level, nine sets of covariates were chosen: share of elderly population, percentage of urban population, literacy rate, health expenditure, social sector expenditure, labour force participation, HDI Score and co-existence of other NCDs such as diabetes, & obesity. The absolute number of YLL and YLL rates were calculated. Further, Pearson's correlation had been calculated and to understand the effect of explanatory variables on YLL due to CVD, multiple linear regression analysis had been applied. Results: Men have a higher burden of premature mortality in terms of Years of life lost (YLL) due to CVD than women in India, with pronounced differences at adult ages of 50–54 years and over. The age pattern of YLL rate suggests that the age group 85 + makes the highest contribution to the overall YLL rate due to CVD. YLL rate showed a J-shaped relationship with age, starting high at ages below 1 years, dropping to their lowest among children aged 1–4 years, and rising again to highest levels at 85 + years among both men and women. In all the states except Bihar men had higher estimated YLL due to CVD for all ages than women. Among men the YLL due to CVD was higher in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. On the other hand, the YLL due to CVD among men was lowest in Jharkhand followed by Assam. Similarly, among women the YLL due to CVD was highest in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. While, the YLL due to CVD among women was lowest in Jharkhand. Irrespective of gender, all factors except state health expenditure were positively linked with YLL due to CVD, i.e., as state health expenditure increases, the years of life lost (YLL) due to CVDs falls. Among all the covariates, the proportion of a state's elderly population emerges as the most significant predictor variable for YLL for CVDs (r = 0.42 for men and r = 0.50 for women). Conclusion: YLL due to cardiovascular disease varies among men and women across the states of India. The state-specific findings of gender differences in years of life lost due to CVD may be used to improve policies and programmes in India. [ABSTRACT FROM AUTHOR]

Background: The present study tries to provide a comprehensive estimate of gender differences in the years of life lost due to CVD across the major states of India during 2017–18. Methods: The information on the CVD related data were collected from medical certification of causes of death (MCCD reports, 2018). Apart from this, information from census of India (2001, 2011), SRS (2018) were also used to estimate YLL. To understand the variation in YLL due to CVD at the state level, nine sets of covariates were chosen: share of elderly population, percentage of urban population, literacy rate, health expenditure, social sector expenditure, labour force participation, HDI Score and co-existence of other NCDs such as diabetes, & obesity. The absolute number of YLL and YLL rates were calculated. Further, Pearson's correlation had been calculated and to understand the effect of explanatory variables on YLL due to CVD, multiple linear regression analysis had been applied. Results: Men have a higher burden of premature mortality in terms of Years of life lost (YLL) due to CVD than women in India, with pronounced differences at adult ages of 50–54 years and over. The age pattern of YLL rate suggests that the age group 85 + makes the highest contribution to the overall YLL rate due to CVD. YLL rate showed a J-shaped relationship with age, starting high at ages below 1 years, dropping to their lowest among children aged 1–4 years, and rising again to highest levels at 85 + years among both men and women. In all the states except Bihar men had higher estimated YLL due to CVD for all ages than women. Among men the YLL due to CVD was higher in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. On the other hand, the YLL due to CVD among men was lowest in Jharkhand followed by Assam. Similarly, among women the YLL due to CVD was highest in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. While, the YLL due to CVD among women was lowest in Jharkhand. Irrespective of gender, all factors except state health expenditure were positively linked with YLL due to CVD, i.e., as state health expenditure increases, the years of life lost (YLL) due to CVDs falls. Among all the covariates, the proportion of a state's elderly population emerges as the most significant predictor variable for YLL for CVDs (r = 0.42 for men and r = 0.50 for women). Conclusion: YLL due to cardiovascular disease varies among men and women across the states of India. The state-specific findings of gender differences in years of life lost due to CVD may be used to improve policies and programmes in India. [ABSTRACT FROM AUTHOR]

Investment in family planning (FP) provides returns through a lifetime. Global evidence shows that FP is the second-best buy in terms of return on investment after liberalizing trade. In this study, we estimate the cumulative benefits of FP investments for India from 1991 to 2016 and project them up to 2061 with four scenarios of fertility levels. The findings suggest that India will have greater elasticity of FP investments to lifetime economic returns compared to the world average (cost–revenue ratio of 1:120). We have taken four scenarios for the goalpost, viz., 2.1, 1.8, 1.6, and 1.4. Although different scenarios of total fertility rate (TFR) levels at the goalpost (i.e., the year 2061) offer varied lifetime returns from FP, scenario TFR < 1.8 will be counterproductive and will reduce the potential benefits. With a comprehensive approach, if the country focuses more on improving the quality of FP services and on reducing the unmet need for FP to enhance reproductive health care and expand maximum opportunities for education and employment for both women and men, it can improve its potential to reap more benefits. [ABSTRACT FROM AUTHOR]

Introduction: Short interpregnancy interval (IPI) is a well-known risk factor for preterm births and low birth weights. However, research on the association between interpregnancy interval (IPI) and health outcomes in children under age 5 is limited in India. We examined the associations between IPI and five child health outcomes in India. Methods: We used nationally representative cross-sectional data from three rounds of National Family Health Survey (NFHS) conducted in India during 2005-06, 2015-16 and 2019-21 to examine the associations between IPI [categorized as < 12 months, 12–17 months, 18–23 months (ref), 24–35 months, and 36–59 months] and five child health outcomes – neonatal mortality, postneonatal mortality, diarrhea and/or acute respiratory infections (ARI), stunting, and underweight, for the total sample and, secondarily, using sex-stratified analyses. We used multivariable and mother fixed-effects binary logistic regressions to examine the associations. Results: 3% and 2% of infants died during the neonatal and postneonatal period, respectively. Thirteen, 40, and 37% of children had diarrhea and/or ARI, were stunted, and were underweight, respectively. IPI < 12 months was associated with higher odds of diarrhea and/or ARI (OR: 1.11; 95% CI: 1.05–1.18), stunting (OR: 1.13; 95% CI: 1.08–1.18) and underweight (OR: 1.06; 95% CI: 1.01–1.11). Mother fixed-effects adjustments confirmed these associations and also found that births with IPI of 12–17 months and 36–59 months had higher odds of stunting, and IPI of 12–17 months was also associated with higher odds of underweight. Discussion: Our findings indicate that IPIs shorter than 12 months are a risk factor for diarrhea and/or ARI, and IPIs shorter than 12 months and 12–17 months are risk factors for stunting and underweight among children under 5 in India. Mother fixed-effects models allowed us to adjust our estimates for unobserved heterogeneity; this has rarely been done before. Increases in birth spacing may improve child health outcomes in India. [ABSTRACT FROM AUTHOR]

Social participation is considered one of the central components of successful and healthy aging. This study aimed to examine the moderating role of marital status and living arrangement with social participation and its association with life satisfaction of older Indian adults. Samples of 31,464 individuals aged ≥ 60 years were extracted from the Longitudinal Ageing Study in India, wave-1. Descriptive statistics, bivariate analysis, and multivariable linear regression were performed for the analysis. The moderation effect of marital status and living arrangements on the relationship between social participation and level of life satisfaction among Indian older adults were also analyzed. Overall, life satisfaction among older men was relatively higher than older women in this study. Older adults' involvement in social participation [β = 0.39, p < 0.05], being in marital union [β = 0.68, p < 0.001] and co-residing either with spouse [β = 1.73, p < 0.001] or with other family members [β = 2.18, p < 0.001] were positively related to their greater life satisfaction. Interaction of social participation with marital status showed that participating in social activities can boost life satisfaction only among married older people. Further, moderation effect of social participation with living arrangements showed that older adults who were not involved in social participation but living with a spouse or any other household members had higher life satisfaction, and again participation in social activities increased their life satisfaction to a greater level. The establishment of social clubs and advocating social policies oriented toward meaningful social connections are highly needed, especially for older Indians living alone or currently not in a marital union, which will help to enhance their overall life satisfaction. [ABSTRACT FROM AUTHOR]

Whole-Body Periodic Acceleration (WBPA) has been reported to induce endothelial nitric oxide and cause vasodilation. However, the effects of WBPA on blood pressure and cardiovascular hemodynamics are still unclear and controversial. The objective of this study was to determine whether a single session of 160-degree V-shape Whole-Body Periodic Acceleration (WBPA-V-160), i.e., periodic motion of the supine body headward to footward, improved blood pressure and cardiovascular parameters. A pre-evaluation and post-evaluation of blood pressure and cardiovascular hemodynamics via DynaPulse Noninvasive and Quantitative Hemodynamic Profile Analysis were performed after a single 30 min trial of WBPA-V-160 with a moving distance, headward to footward, of 2 mm, at a constant frequency of 4 Hz. Systolic BP, diastolic BP, heart rate, end systolic pressure, end diastolic pressure, mean arterial BP, and pulse pressure at post-evaluation were significantly lower than at pre-evaluation after WBPA-V-160, whereas systemic vascular compliance and brachial artery distensibility at post-evaluation were significantly higher than at pre-evaluation. The WBPA-V-160, performed for 30 min, did improve blood pressure and cardiovascular hemodynamics by lowing the BP parameters and enhancing systemic vascular compliance. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate whether or not angiotensin II type 1 receptor blocker irbesartan (ARB) with a partial agonist of PPAR-γ could protect against chronic nocturnal intermittent hypoxia (CIH)–induced cardiac Fas/FasL-mediated to mitochondria-mediated apoptosis. Methods: Sprague–Dawley rats were in a normoxic control group (CON-G), or rats were in a chronic nocturnal intermittent hypoxia group (HP-G, from 3 to 7% oxygen versus 21% oxygen per forty seconds cycle, nocturnally 8 h per day for 1 month), or rats were in a chronic nocturnal intermittent hypoxia group pretreated with ARB (50 mg/kg/day, S.C.) (ARB-HP-G). Echocardiography, H&E staining, TUNEL staining, and Western blotting were measured in the left ventricle. Results: Hypoxia-induced SIRT1 degradation, Fas receptors, FADD, active caspase-8 and caspase-3 (Fas/FasL apoptotic pathway) and Bax, tBid, active caspase-9 and -3 (mitochondrial apoptotic pathway) and TUNEL-positive apoptosis were reduced in ARB-HP-G when compared with HP-G. IGF-I, IGF1 receptor, p-PI3k, p-Akt, Bcl2, and Bcl-XL (IGF1/PI3K/AKT pro-survival pathway) were increased in ARB-HP-G compared to HP-G. Conclusions: Our findings suggest that the ARB may prevent cardiac Fas/FasL to mitochondrial apoptotic pathways and enhance cardiac IGF1/PI3K/AKT pro-survival pathway in the sleep apnea model associated with JNK de-activation and SIRT1 upregulation. ARB prevents chronic sleep apnea–enhanced cardiac apoptosis via enhancing survival pathways. [ABSTRACT FROM AUTHOR]

The states and districts are the primary focal points for policy formulation and programme intervention in India. The within‐districts variation of key health indicators is not well understood and consequently underemphasised. This study aims to partition geographic variation in low birthweight (LBW) and small birth size (SBS) in India and geovisualize the distribution of small area estimates. Applying a four‐level logistic regression model to the latest round of the National Family Health Survey (2015–2016) covering 640 districts within 36 states and union territories of India, the variance partitioning coefficient and precision‐weighted prevalence of LBW (<2.5 kg) and SBS (mother's self‐report) were estimated. For each outcome, the spatial distribution by districts of mean prevalence and small area variation (as measured by standard deviation) and the correlation between them were computed. Of the total valid sample, 17.6% (out of 193,345 children) had LBW and 12.4% (out of 253,213 children) had SBS. The small areas contributed the highest share of total geographic variance in LBW (52%) and SBS (78%). The variance of LBW attributed to small areas was unevenly distributed across the regions of India. While a strong correlation between district‐wide percent and within‐district standard deviation was identified in both LBW (r = 0.88) and SBS (r = 0.87), they were not necessarily concentrated in the aspirational districts. We find the necessity of precise policy attention specifically to the small areas in the districts of India with a high prevalence of LBW and SBS in programme formulation and intervention that may be beneficial to improve childbirth outcomes. Key messages: The small areas contribute the highest share of the total geographic variance of low birth weight (LBW) and small birth size (SBS) in India.A high burden of LBW is found mostly in the central‐western part of India and Odisha. The prevalence of SBS is high across the district of northern‐western regions and the north‐eastern regions of India.The mean prevalence and standard deviation are strongly correlated in the case of both LBW (r = 0.88) and SBS (r = 0.87) in India. It indicates that the districts which have a higher prevalence of LBW and SBS also have a higher between small area disparity within the districts.We find a similar pattern of distribution in LBW and SBS between the policy‐focused aspirational districts and other districts of India.Findings indicate reprioritizing the policy intervention, focusing on the small areas of India for better childbirth outcomes. [ABSTRACT FROM AUTHOR]

This paper examines the sequential impact of components of maternal and child health care on the continuum of care in India using data from the Indian National Family Health Surveys conducted in 2005–06 and 2015–16. Continuum of care (CoC) for maternal and child health is defined in this paper as the sequential uptake of three key maternal services (antenatal care, institutional delivery and postnatal care for the mother). Women who received all three services were classified as full CoC recipients. Characteristics odd ratios for achieving CoC were estimated by mother's place of residence, household wealth status, mother's education, birth order and child full vaccination. Odds ratios were computed to understand the relative impact of each preceding service utilization on the odds of subsequent service uptake. At national level, 30.5% and 55.5% of women achieved full CoC in 2005–06 and 2015–16, respectively, and the overall progress of CoC over the 10-year period was 25.5 percentage points, with significant variation across states and socioeconomic groups. Full CoC improved from 7.5% to 32.4% among the poorest women, whereas among the richest women it improved from 70.5% to 75.1%. Similarly, among uneducated women full CoC improved from 11.7% to 35.9% as against 75.1% to 80.5% among educated mothers over the same period. Furthermore, greater CoC was observed among parity one women. The conditionality between various components of CoC indicated that at national level the odds of having an institutional delivery with antenatal care were 9 times higher in the earlier period as against 4.5 times higher in the more recent period. Furthermore, women who had institutional deliveries complied more with mother's postnatal care compared with women who did not have institutional deliveries. This again helps increase the likelihood of a child receiving full vaccination. [ABSTRACT FROM AUTHOR]

While population ageing is rising, the educational composition of the elderly remains rather heterogeneous. This study assesses the educational differences in future population ageing in Asia and Europe, and how future population ageing in Asia and Europe would change if the educational composition of its populations changed. A comparative population ageing measure (the Comparative Prospective Old-Age Threshold [CPOAT]) was used, which recalculates old-age thresholds after accounting for differences in life expectancy, and the likelihood of adults surviving to higher ages. Combined data from projected age- and sex-specific life-tables (from the United Nations) and projected age- and sex-specific survival ratios by different levels of education (from the Wittgenstein Centre for Demography and Global Human Capital) were used to construct projected life-tables (2015–2020, ..., 2045–2050) by educational level and sex for different regions of Asia and Europe. Based on these life-tables, future comparative prospective old-age thresholds by educational level and sex were calculated. It was found that in both Asia and Europe, and among both men and women, the projected old-age thresholds are higher for higher educated people than for less-educated people. While Europe has a larger projected share of elderly in the population than Asia, Europe's older population is better educated. In alternative future scenarios in which populations hypothetically have higher levels of education, the projected shares of elderly in the population decrease across all regions of Asia and Europe, but more so in Asia. The results highlight the effectiveness of investing in education as a policy response to the challenges associated with population ageing in Asia and Europe. Such investments are more effective in the Asian regions, where the educational infrastructure is less developed. [ABSTRACT FROM AUTHOR]

Research on the association between experiences of intimate partner violence (IPV) and contraceptive use discontinuation in low‐ and middle‐income countries (LMICs) is limited. This study aims to fill this important gap using microdata collected from women aged 15–49 in the 2015–2016 National Family Health Survey (NFHS). Analyses used multivariable multinomial logistic regressions stratified by long‐acting reversible contraceptive methods (LARC)/non‐LARC and condom/pill to examine the association between experience of IPV and contraceptive use discontinuation while still in need (DWSIN). Experience of physical violence was associated with DWSIN among LARC/IUD users (RRR: 3.73, 95 percent CI [1.55–8.95]) Among condom users, DWSIN was higher among women who experienced emotional violence compared with women who did not experience any violence (RRR: 4.16, 95 percent CI [1.59–10.90]). Although we did not find an association between IPV and overall contraceptive use discontinuation, we did find compelling evidence of an association between IPV and IUD and condom use discontinuation in India. There is a need to understand women's experience of IPV as a part of a broader strategy to provide high‐quality family planning services to all women while considering individual circumstances and reproductive aspirations to support the uninterrupted use of contraception in India. [ABSTRACT FROM AUTHOR]

While existing indices of gender equality measure the role of women's status and position, they inadequately contextualize the broader construct of patriarchy, a social system that underlies many gender inequitable practices. An index capturing patriarchy may afford increased understanding of this social system, and may serve to complement other gender equality indices. This paper involves the development and testing of a novel composite measure, the India Patriarchy Index, to quantify the social and ideological construct of patriarchy using empirical data on family structure and gender roles. Using data from India's National Family Health Survey, we develop an India Patriarchy Index to measure gendered social positioning in families based on sex by age, patrilocality, sex ratio imbalance among offspring, and gendered economic roles. Psychometric testing demonstrates good internal reliability and construct validity of this index, with validity indicated by its association with three gender equality indices used in India. Spatial and temporal analyses further indicate much state-level variation in India Patriarchy Index scores as well as slow change on this indicator over time, based on time trend analyses from 1992–93 to 2015–16. Results demonstrate the utility of the India Patriarchy Index to measure and track gender equality progress in India. [ABSTRACT FROM AUTHOR]

Child undernutrition remains high in India with far-reaching consequences for child health and development. Anthropometry reflects undernutrition. We examined the state-level trends in underweight, stunting, and wasting prevalence and inequality by living standards using four rounds of the National Family Health Surveys in 26 states in India, conducted in 1992–1993, 1998–1999, 2005–2006, and 2015–2016. The average annual reduction (AAR) for underweight ranged from 0.04 percentage points (pp) (95% CI − 0.12, 0.20) in Haryana to 1.05 pp (95% CI 0.88, 1.22) in West Bengal for underweight; 0.35 pp (95% CI 0.11, 0.59) in Manipur to 1.47 (95% CI 1.19, 1.75) in Himachal Pradesh for stunting; and − 0.65 pp (95% CI − 0.77, − 0.52) in Haryana to 0.36 pp (95% CI 0.22, 0.51) in Bihar & Jharkhand for wasting. We find that change in the pp difference between children with the poorest and richest household living standards varied by states: statistically significant decline (increase) was observed in 5 (3) states for underweight, 5 (4) states for stunting, and 2 (1) states for wasting. Prevalence of poor anthropometric outcomes as well as disparities by states and living standards remain a problem in India. [ABSTRACT FROM AUTHOR]

A continuous rise of female life expectancy above that of males among older adults in India and China may give the impression that the relative gender gap in health in these countries is decreasing. However, given the systemic gender bias against older females in these countries across multiple dimensions of health, a fuller understanding of the gender gap in health calls for a multi-dimensional perspective. We estimate a multi-dimensional old-age threshold (MOAT) that specifies different old-age thresholds for female and male populations which accommodates multiple dimensions related to physical, intellectual and general health. We use the MOAT to evaluate the multi-dimensional gender gap in India and China by differencing the MOAT for females with that of males. Females in both countries have a lower MOAT than their male counterparts, indicating an earlier advent of 'old age' for females. The multi-dimensional estimates of the gender gap are also higher than the estimates based on only one dimension of health. A considerable level of variation is also observed in the gender gap across provinces. The study illustrates the need to understand the gender gap in health in India and China from a multi-dimensional perspective and provides an innovative way to quantify such a gap. Province-specific as well as health dimension-specific interventions are vital in reducing the gender gap among older adults in these countries. [ABSTRACT FROM AUTHOR]

Previous research on sex ratio at birth (SRB) in India has largely relied on macro‐analysis of census data that do not contain the breadth of factors needed to explain patterns in SRB. Additionally, no previous research has examined the differentiation of factors associated with SRB across birth orders, a key determinant in societies affected by son preference. This study aims to fill these gaps using micro‐data related to 553,461 births occurring between 2005 and 2016 collected as part of the 2015–2016 National Family Health Survey. Analyses used multivariable logistic regressions stratified by birth order to examine associations with SRB at the national level. The SRB at birth order 1 was outside the biological normal limit, and generally increased with birth order. First births in households with wealth in the middle and richest quintiles, with mothers who desired a higher ideal number of sons than daughters, and in lower fertility communities had a higher probability of being male. Most SRB correlates were visible at birth orders 3 or higher. Programs and policies designed to address India's male‐skewed SRB must consider the diverse factors that influence SRB, particularly for higher order births. [ABSTRACT FROM AUTHOR]

India has an unenviable reputation as one of the world's most gender disparate countries. Previous studies of sex bias in childhood have shown large differences between Indian boys and girls in immunization and curative healthcare, but little difference in health status as indicated by anaemia and stunting. India has changed rapidly in past decades, hence we reappraise the situation with the National Family Health Survey-4 (2015–16). We found no evidence of sex differentials in immunization coverage but a small degree of discrimination in favour of boys in medical treatment for common symptoms of infection. This discrimination was no greater in the North and Central regions of India, where severe excess mortality among female children persists. Sex differences in anaemia and stunting were small, with no regional pattern. We found no evidence that healthcare or health status of girls was influenced by the presence of other daughters in the family. [ABSTRACT FROM AUTHOR]

Objective: We compare population aging in Europe and Asia using a measure that is both consistent over time and appropriate for cross-country comparison. Method: Sanderson and Scherbov proposed to estimate the old-age threshold by the age at which the remaining life expectancy (RLE) equals 15 years. We propose an adjustment of this measure, taking into account cross-national differences in the exceptionality of reaching that age. Results: Our old-age threshold was lower than 65 years in 2012 in Central Asia, Southern Asia, Southeastern Asia, and many Eastern European countries. These populations also experienced a higher share of elderly compared with the RLE15 method. Our method revealed more geographical diversity in the shares of elderly. Both methods exhibited similar time trends for the old-age thresholds and the shares of elderly. Discussion: Our prospective and comparative measure reveals higher population aging estimates in most Asian and Eastern European countries and more diversity in aging. [ABSTRACT FROM AUTHOR]

We have identified a proteolysis targeting chimera (PROTAC) of class I HDACs 1, 2 and 3. The most active degrader consists of a benzamide HDAC inhibitor, an alkyl linker, and the von Hippel-Lindau E3 ligand. Our PROTAC increased histone acetylation levels and compromised colon cancer HCT116 cell viability, establishing a degradation strategy as an alternative to class I HDAC inhibition. [ABSTRACT FROM AUTHOR]

Background: The link between marital status and health differences has long been a topic of debate. The substantial research on marriage and health has been conducted under two important hypotheses: marital protection and marriage selection. While the majority of evidence on the marriage-health relationship using these hypotheses comes from developed countries, there is a lack of evidence from Asia, particularly from India.Objectives: The current study examines theoretical frameworks of marriage i.e., marital protection and marriage selection in the Indian setting concurrently, bringing substantial empirical evidence to explore the link between marriage and health, considering this subject in the context of self-reported health (SRH). Secondly, this study will aid in investigating age and gender differences in marriage and health.Methods: Using the Study on Global AGEing and Adult Health (SAGE), a cohort study of individuals aged 50 years and older with a small section of individuals aged 18 to 49 for comparative reasons, the present study population was 25 years and above individuals with complete marital information. Logistic regressions were employed to explore the connection between marital status and self-reported health. In the marriage protection hypothesis, the follow-up poor SRH was the dependent variable, whereas the initial unmarried status was the independent variable. For the marriage selection effects, initial poor SRH as the independent variable and follow-up unmarried status as the dependent variable had considered.Results: Examining the marital protection hypothesis, the initial unmarried status (OR: 2.14; CI at 95%: 1.17, 3.92) was associated with the followed-up SRH transition from good to poor between 2007 and 2015 for young men, while initial unmarried status was linked with a lower likelihood of stable good SRH and a higher likelihood of stable poor SRH status across all age categories among women. Focusing on the marriage selection hypothesis, among young men, a significant association exists between the initial poor SRH and departure in marital status from married to unmarried. Young women with initial poor SRH (OR: 0.68; CI at 95%: 0.40, 1.00) had lower odds of stable married. In comparison, women with initially poor SRH, irrespective of age, were more likely to have higher odds of being stably unmarried.Conclusion: Marriage indeed protects health. There are also shreds of evidence on health-selected marital status in India. Taken together, the aspect of marital protection or marriage selection is gender and age-specific in India. The findings contribute to a more comprehensive understanding of the relationship between marriage and health, which may have significant implications for health-related public policies aimed at unmarried women. [ABSTRACT FROM AUTHOR]

During the last century, India has experienced a drastic reduction in mortality and a high improvement in life expectancy. However, a question is raised regarding the quality of life. Have the extra years gained with respect to life expectancy really improved the quality of life in India? Such a question becomes prominent particularly when one considers the changes in morbidity in the country. So far, there is no study available that combines mortality and morbidity changes to a single index by representing health status in India. This paper is an exploration of quality of life, based on Disability Free Life Expectancy (DFLE) rates for India. It follows the methodology developed by Sullivan (1971), using three levels of disability rates -- perceived morbidity, restricted activity and also confined to bed. Mortality data given by Sample Registration System (SRS) and morbidity data given by National Sample Survey Organisation (NSSO) were used for the analysis. The study finds higher rates of decline in DFLE in advanced states with high life expectancy as compared to others indicating a considerable decline in the quality of life with an advancement in life expectancy. Such a reduction is very much higher towards the older ages. On the other side, females and urbanites experienced considerable decline in the quality of life related to males and rural people respectively, which indicates that even though females and urban people show more expected years of life, they spend more years in morbidity. An exploration by major groups of diseases finds a prominent role for chronic/degenerative diseases in losses in DFLE. The study concludes that a mere increase in longevity does not mean a better life, especially at older ages. It is high time for India to have effective interventions to improve the quality of life along with life expectancy. [ABSTRACT FROM AUTHOR]

Background Abuse against the elderly is recognized as an important challenge to elderly health, but its determinants are not yet well understood. We present findings from a new dataset which covers a representative sample of the population aged 60 years and above from seven Indian states across India - all of which have a higher proportion aged 60 plus compared to the national average. Earlier studies suggest that schooling levels can be relevant in determining the level of abuse against seniors. This study focuses on the role of education on the prevalence of elderly abuse in India. Methods We conduct an analysis of cross sectional primary data that contains information on elderly abuse. The households in the sample were randomly selected from the seven demographically oldest states in India. These states are Himachal Pradesh, Kerala, Maharashtra, Odisha, Punjab, Tamil Nadu and West Bengal. A total of 9852 elderly from 8329 households were interviewed. The statistical analysis is based on logistic regression to understand the independent relation of education with abuse against the elderly. Results Our findings reveal that 11% of 60+ year olds have experienced at least one type of elderly abuse (Physical 5.3%, Verbal 10.2%, Economic 5.4%, Disrespect 6%, Neglect 5.2%). The most common perpetrator is the son, who is reported to be responsible for the abuse among 41% of male victims and 43% of female victims. The formal education among elderly beyond a certain level (8 years) has a strong relation with reduced violence against elderly. Conclusions Our findings suggest that level of schooling among elderly is strongly negatively related to abuse against them. More members in the household reduce the chance of abuse while having a greater number of children increases the chance of abuse (neglect and verbal abuse). We find that education even after controlling for wealth and other relevant variables is the factor that most consistently lowers elderly abuse. However, the relation of education to abuse is limited to those with more than 8 years of schooling. This suggest that the ongoing educational expansion beyond the basic schooling years in India may lead to a decline in the incidence of elderly abuse. [ABSTRACT FROM AUTHOR]

The parish records of Syrian Catholics and Latin Catholics in twentieth-century Kerala, India, can be used to assess the seasonal fluctuations and interdependence of such vital events as births, deaths, and marriages in the short run. That the effect of seasonality has been more pronounced among the Syrian Catholic community than among the Latin Catholic community is due largely to socioeconomic, cultural, religious, and, more important, occupational differences. [ABSTRACT FROM AUTHOR]

In transnational families, it is often the older adults who are left-behind or choose to stay behind. Currently the population aged 60 years and older in India constitutes over 7 percent of the total population (1.25 billion) and is projected to triple in the next four decades. In the past family has been the major source of support in later life. One of the consequences of increased mobility is the decreasing role of family in care provision. The Indian middle-class norms on higher education, which stressed on engineering and medicine, have resulted in professionally educated children leaving the parental home to seek work and thus family life in other geographical locations. In this paper we examine how transregional and transnational mobilities and the resulting absences impact the lives of older adults. We draw upon 37 in-depth interviews conducted in Dharwad district of Karnataka, India. The results show that older adults employ two strategies of rationalizing absence and compensating absence of migrant children. These strategies reflect the resilience of the older adults to make sense of this trans-local family life, that in a previous generation they were not aware of. [ABSTRACT FROM AUTHOR]

Background: Previous research has demonstrated health benefits of marriage and the potential for worse outcomes during widowhood in some populations. However, few studies have assessed the relevance of widowhood and widowhood duration to a variety of health-related outcomes and chronic diseases among older adults in India, and even fewer have examined these relationships stratified by gender.Methods: Using a cross-sectional representative sample of 9,615 adults aged 60 years or older from 7 states in diverse regions of India, we examine the relationship between widowhood and self-rated health, psychological distress, cognitive ability, and four chronic diseases before and after adjusting for demographic characteristics, socioeconomic status, living with children, and rural-urban location for men and women, separately. We then assess these associations when widowhood accounts for duration.Results: Being widowed as opposed to married was associated with worse health outcomes for women after adjusting for other explanatory factors. Widowhood in general was not associated with any outcomes for men except for cognitive ability, though men who were widowed within 0-4 years were at greater risk for diabetes compared to married men. Moreover, recently widowed women and women who were widowed long-term were more likely to experience psychological distress, worse self-rated health, and hypertension, even after adjusting for other explanatory variables, whereas women widowed 5-9 years were not, compared to married women.Conclusions: Gender, the duration of widowhood, and type of outcome are each relevant pieces of information when assessing the potential for widowhood to negatively impact health. Future research should explore how the mechanisms linking widowhood to health vary over the course of widowhood. Incorporating information about marital relationships into the design of intervention programs may help better target potential beneficiaries among older adults in India. [ABSTRACT FROM AUTHOR]

Background: Abuse against the elderly is recognized as an important challenge to elderly health, but its determinants are not yet well understood. We present findings from a new dataset which covers a representative sample of the population aged 60 years and above from seven Indian states across India - all of which have a higher proportion aged 60 plus compared to the national average. Earlier studies suggest that schooling levels can be relevant in determining the level of abuse against seniors. This study focuses on the role of education on the prevalence of elderly abuse in India.Methods: We conduct an analysis of cross sectional primary data that contains information on elderly abuse. The households in the sample were randomly selected from the seven demographically oldest states in India. These states are Himachal Pradesh, Kerala, Maharashtra, Odisha, Punjab, Tamil Nadu and West Bengal. A total of 9852 elderly from 8329 households were interviewed. The statistical analysis is based on logistic regression to understand the independent relation of education with abuse against the elderly.Results: Our findings reveal that 11% of 60+ year olds have experienced at least one type of elderly abuse (Physical 5.3%, Verbal 10.2%, Economic 5.4%, Disrespect 6%, Neglect 5.2%). The most common perpetrator is the son, who is reported to be responsible for the abuse among 41% of male victims and 43% of female victims. Formal education among elderly beyond a certain level (8 years) has a strong relation with reduced violence against elderly.Conclusions: Our findings suggest that level of schooling among elderly is strongly negatively related to abuse against them. More members in the household reduces the chance of abuse while having a greater number of children increases the chance of abuse (neglect and verbal abuse). We find that education even after controlling for wealth and other relevant variables is the factor that most consistently lowers elderly abuse. However, the relation of education to abuse is limited to those with more than 8 years of schooling. This suggests that the ongoing educational expansion beyond the basic schooling years in India may lead to a decline in the incidence of elderly abuse. [ABSTRACT FROM AUTHOR]