Half of India’s over 1.2 billion population is 25 years or younger, with only about nine per cent over 60 years. Over the next three decades this is expected to balloon to 20 per cent or 340 million — roughly the entire population of the United States.
The effect? An ageing population that can topple existing insurance and pension systems, strain the public health-care system and fundamentally alter disease burdens, economies and trade, and human migration.
To prepare for this, India wants to better understand those on the cusp of being senior citizens. Later this year a host of research organisations, and supported by the Indian government, will be initiating the world’s largest survey of the elderly. Called the Longitudinal Ageing Study of India (LASI), it will follow the health and socio-economic condition of 60,000 Indians over the age of 45 for at least 25 years and provide regular reports on how ageing affects Indians.
With increased life expectancy and the breakdown of the joint family system, those involved with the project say that ageing will pose unique challenges. “We need to be able to design policies to mainstream the elderly, to reduce their vulnerabilities and enhance access to various services,” says Anita Agnihotri, Secretary, Social Justice and Empowerment Ministry, which is among the key government agencies involved.
The project — to involve researchers from the International Institute for Population Studies (IIPS), Mumbai, Harvard School of Public Health and the University of Southern California — will interview selected respondents and measure several biomarkers such as height, weight, lung function, blood sugar levels, mobility and mental acuity. It will also investigate the emotional life of the aged such as happiness, their satisfaction with life so far and thus provide additional perspective which earlier studies on ageing in India haven’t closely explored.
From 2010 project
The LASI survey is an expansion of a test run that was conducted in 2010 where 1,600 individuals, aged 45 and older, and their spouses, from Karnataka, Kerala, Punjab, and Rajasthan, were interviewed. The aim of this pilot survey, according to the Director of IIPS, Dr. F. Ram, is an attempt to obtain a broader representation of India. “Punjab is an example of an economically developed State, while Rajasthan is relatively poor, with very low female literacy, high fertility, and persisting gender disparities. Kerala, which is known for its relatively efficient health-care system, has undergone rapid social development and is included as a potential harbinger of how other Indian States might evolve,” he adds.
There are unique challenges of conducting longitudinal surveys, in that researchers must have the diligence to consistently track their subjects over the years. Given that the survey focusses on the old there will be frequent deaths and, therefore, newer participants consistently need to be recruited. “We have done some studies before, of following children till they were 25, but the scale here is unprecedented and requires steady support and finance,” says Dr. Soumya Swaminathan, Director General, Indian Council of Medical Research, also involved with the survey.
Methodology
For the first phase, which spans till 2020, LASI has a budget of Rs.100 crore.
As far as ensuring that interviewees are tracked, Dr. Ram says that the selected households would be tracked via GPS. “There will be migrations and other movements but addresses and information will be accessible in a centralised way through their geo-location and so we have means to follow up,” he says.
There are also the unprecedented challenges like during the test survey in Karnataka, where the researchers had to take blood samples from mining workers in Bellary, but couldn’t do so. Years of working in the mining pits had calloused their hands so much that the needles refused to go through their skin.
“The first set of results from the survey may take three to four years, but the plan is to have a biennial update,” says Dr. Swaminathan.
jacob.koshy@thehindu.co.in
