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BRIEF RESEARCH ARTICLE
Year : 2022  |  Volume : 66  |  Issue : 3  |  Page : 362-366  

Factors influencing life satisfaction and discrimination among the elderly in India


1 Consultant, Knowledge Management Division, National Health Systems Resource Centre, NIHFW Campus, New Delhi, India
2 Lead Consultant, Knowledge Management Division, National Health Systems Resource Centre, NIHFW Campus, New Delhi, India
3 Executive Director, National Health Systems Resource Centre, New Delhi, India

Date of Submission13-Dec-2021
Date of Decision02-Aug-2022
Date of Acceptance03-Aug-2022
Date of Web Publication22-Sep-2022

Correspondence Address:
Roopani Roopani
C-92, Divya Jyoti Apartment, Sector 19, Rohini, New Delhi - 110 089
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijph.ijph_2152_21

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   Abstract 


India is moving toward a demographic transition which leads to more elderly population than younger. Maximum life satisfaction (LS) and minimum discrimination are necessary to have healthy aging. The secondary data analysis was conducted to assess the perceived LS and discrimination among the elderly based on Longitudinal Aging Study in India (LASI). Data from the LASI-Wave I were used to analyzing to assess the LS and discrimination and factors associated with them. This study reported that the majority of the elderly were satisfied with their life and does not face any kind of discrimination; however, various factors affect them. LS was positively associated with the level of Monthly per capita consumption expenditure quintile, and education, self-rated good health. Furthermore, refraining from alcohol and tobacco positively influence the LS among the elderly. The factors responsible for more LS among the elderly were education, money, social support, and a healthy lifestyle.

Keywords: Aging, discrimination, elderly, life satisfaction


How to cite this article:
Roopani R, Dumka N, Kotwal A. Factors influencing life satisfaction and discrimination among the elderly in India. Indian J Public Health 2022;66:362-6

How to cite this URL:
Roopani R, Dumka N, Kotwal A. Factors influencing life satisfaction and discrimination among the elderly in India. Indian J Public Health [serial online] 2022 [cited 2022 Oct 2];66:362-6. Available from: https://www.ijph.in/text.asp?2022/66/3/362/356604



The elderly population is increasing at an unprecedented rate worldwide, particularly in developing countries. Globally, in 2019 elderly were one billion, by 2030 and 2050 they will be 1.4 and 2.1 billion, respectively.[1] In India, the elderly population in 2015 accounted for 8% of the total population, with an estimated increase to 15% by 2036 and 19% by 2050.[2],[3] Along with the proportion of the elderly, longevity at the age of 60 years is also increasing and is projected to increase by 21 year by 2050.[2],[3] According to the United Nations, ageism is a global challenge that is associated with poor physical and mental health; increased social isolation, loneliness, financial insecurity; and decreased quality of life, hence affecting the health and overall well-being of the elderly.[4] Therefore, to ensure healthy aging, the “National Programme for Health Care of the Elderly” was launched in 2010 by the Ministry of Health and Family Welfare.[5] Life satisfaction (LS) is an important dimension of successful and healthy aging that is associated with social, economic, and familial factors, and influences health care utilization and health-seeking behavior.[6] LS is considered for the overall well-being of an individual. In addition, perceived everyday discrimination is also necessary to know because the elderly who internalize cynicism or a gloomy outlook toward themselves are maybe at enhanced risk of functional and cognitive decline,[7] depression, and life dissatisfaction. Along with the social and cultural issues, physical and mental issues do persist among the elderly, which makes us think about their satisfaction level among them. The study aims to analyze how satisfied and discriminated elderly feel/perceive in India along with the factors associated with them.

The current study was secondary data analysis for which the data was extracted from Longitudinal Ageing Study in India (LASI) wave I Survey (2017–2018). Both male and female aged 60 years and above were included in the study from LASI.

The current study measured LS and discrimination along with the factors associated with them. For LS two variables were considered, “How satisfied are you with your past life as a whole” and “Life-satisfaction.” First variable was categorized as “No LS” (not very satisfied and not at all satisfied), and “Yes LS” (completely, very satisfied, and somewhat satisfied). The second variable was categorized as “low” (score of 5–20), “medium” (score of 21–25), and “high satisfaction” (score of 26–35), which was further categorized as “Yes LS” (High and medium) and “No LS” (low). Variable “Total LS” was created by compiling both above-defined variables. For discrimination “Have you felt that you were ill-treated in the past year?” was used and categorized as “Yes” and “No”.

Health-seeking behavior for individuals who need medical advice was “YES” for those who seek health care and “NO” for those who didn't. Sleep disturbance was categorized as yes (rarely, occasionally, and frequently) and no (never). Self-rated health was categorized as good (very good, good, and fair) and bad (fair and poor) for the analysis. For physical activity, both vigorous and moderate activity was considered and categorized as yes (every day, more than once a week), and no (once a week, 1 to 3 times a month, hardly ever or never).

The study used the dependent variables, i.e., LS and discrimination. Multivariate analysis was done to assess the association between the dependent variables and other independent variables. The model was created by using a forward-stepwise selection of covariates, based on literature review and significant association in bivariate analysis. The final model was adjusted for pain; physical/mental/neurological impairment; medication for sleep; currently taking any psychiatric or psychological treatment/therapy, living arrangements, Monthly Per Capita Consumption Expenditure (MPCE) quintile, education, mental health, and religion. For data management and analysis, STATA-16 (SYSTECH Technocraft Services Pvt. Ltd, Thane, Maharashtra, India) was used.

The data were obtained after taking permission from International Institute for Population Sciences (IIPS), Mumbai to use it for further analysis to overcome any propriety and copyright issues.

[Table 1] depicts the result for various sociodemographic characteristics of the elderly concerning LS and discrimination among the elderly in India. The percentage of LS decreases with increasing age and the majority of the elderly, male (66%), residing in urban (71%), rated their health as good (68%), seeking health care (63%), currently married (67%), living with family (65%), and physically active (63%) were satisfied more with their life in comparison to their respective counterparts. An increasing level of education and MPCE quintile had a positive relationship with LS.
Table 1: Distribution of sociodemographic characteristics according to perceived life satisfaction and discrimination among the elderly in India

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The majority of the elderly across all age groups, among both genders, and according to the place of residence didn't feel discriminated. Elderly with bad health felt twice discriminated (8%) than those who rated their health as good (4%). The elderly who were never married (12%), and do not seek health care (8%) experienced more discrimination than their respective counterparts.

[Table 2] depicts the factors associated with LS among the elderly. In the adjusted analysis, the likelihood for less LS was significantly (P < 0.001) 0.89 times less in urban (adjusted odd ratio [aOR] - 0.89; confidence interval [CI]: 0.891–0.901), and 0.88 times less among females (aOR - 0.88; CI: 0.878–0.889). The elderly who had bad health was 2.07 times more dissatisfied with their life (aOR– 2.07; CI 2.067–2.088), and dissatisfaction was 1.95 times more among those who are physically inactive (aOR– 1.95; CI 1.948–1.967) when compared to their respective counterparts. Smoking and drinking were negatively associated with LS, the likelihood of less LS was significantly (P < 0.001) less among those who don't smoke (aOR– 0.91; CI: 0.908–0.917) or drink alcohol (aOR– 0.71; CI: 0.705–0.715). Further, it was observed that the likelihood of less LS was less among those who do not have depression (aOR– 0.59; CI: 0.593–0.599), never diagnosed with stroke (aOR– 0.72; CI: 0.723–0.736), and never faced any kind of discrimination (aOR– 0.70; CI: 0.696–0.707).
Table 2: Factors affecting life satisfaction among the elderly in India

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Initially, the analysis plan was to assess the factors associated with discrimination as well, however, frequency distribution in discrimination as a binary variable (yes and no) was not adequately distributed to run the logistic regression. Hence, multivariate analysis was not done for the discrimination.

The study attempted to analyze LS and discrimination and the factors associated with it. The study observed that the majority of the elderly were satisfied with their life and never faced discrimination in India. However, there are multiple factors associated with LS that leads to more or less satisfaction. The current study observed that sociodemographic factors such as age, gender, residence, income, education, and income influence LS and linearly correlated with them.

Social support was an important factor for LS and the current study observed the same trend as previous studies that also confirmed the positive association between having social support with LS.[8],[9] A study by Banjare P et al. conducted in Odisha among elderly those was living alone were less satisfied with their life,[8] current study also showed a similar result as a proportion of elderly significantly satisfied with life was more if they were living with family (66%) rather than living alone (43%) or with others (54%). The study observed that LS was an important factor for seeking healthcare because those who were less satisfied with their life were avoided more to seek healthcare and vice versa which was following the findings of the previous study that stated LS was explicitly and implicitly affected the healthcare-seeking behaviour.[6]

The lifestyle of an individual further influenced satisfaction in life, the study observed less satisfaction among alcohol and tobacco users and more if they are physically active.[9] In other words, the elderly who don't consume alcohol or smoke were more satisfied in their life. A study done by Papi et al. in 2021 in Iran among older adults showed a significant level of LS among those who were physically active,[9] the current study also showed similar findings.

The current study observed a significant positive association between LS and physical and mental health. Those who were not depressed and never had a stroke was more satisfied with their life. Previous studies also stated that health conditions like mental health,[10] sleep disturbance, and stroke influence LS. Self-rated good health positively influenced LS, it was significantly less in those who rated their health as bad, and the result as per the previous study.


   Conclusion Top


Satisfaction from life amongst the elderly was reported less in those living in rural, males, living alone, divorced/separated, illiterate, and poorest in comparison to their respective counterparts. Perceived discrimination was more in the elderly those who were residing in urban, among males, living alone, and richer. Major factors responsible for more LS were education, money, social support, and a good healthy lifestyle. To ensure healthy aging with maximum LS and no discrimination, a strong foundation with a holistic approach (including health, economic and social determinants) is required before the country enters or faces the demographic transition.

Acknowledgment

We thank the IIPS, Mumbai, for timely providing the LASI data and giving permission to use it further.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
WHO. Ageing. https://www.who.int/health-topics/ageing#tab=tab_1. [Last accessed on 2021 Sep 21].  Back to cited text no. 1
    
2.
Mohfw National Commision of Population. Census of India 2011: Population Projections for India and States 2011-2036, Report of the Technical Group on Population Projections; 2020. Available from: https://main.mohfw.gov.in/sites/default/files/PopulationProjectionReport 2011-2036–upload_compressed_0.pdf. [Last accessed on 2021 Jun 10].  Back to cited text no. 2
    
3.
Ministry of Health & Family Welfare. Detailed Bried of NPHCE Background. Available from: https://main.mohfw.gov.in/sites/default/files/Detailed Breif of NPHCE.pdf. [Last accessed on 2021 Jun 14].  Back to cited text no. 3
    
4.
Nedjat S, Sahaf R, Khankeh HR, Fadayevatan R, Majdzadeh R, Karimlou M. Life satisfaction as the main factor behind the elderly's health knowledge utilization: A qualitative study in an Iranian context. Med J Islam Repub Iran 2018;32:115.  Back to cited text no. 4
    
5.
Levy BR, Slade MD, Murphy TE, Gill TM. Association between positive age stereotypes and recovery from disability in older persons. JAMA 2012;308:1972-3.  Back to cited text no. 5
    
6.
Rajabi Gilan N, Khezeli M, Zardoshtian S. The effect of self-rated health, subjective socioeconomic status, social capital, and physical activity on life satisfaction: A cross-sectional study in urban western Iran. BMC Public Health 2021;21:233.  Back to cited text no. 6
    
7.
Papi S, Cheraghi M. Multiple factors associated with life satisfaction in older adults. Prz Menopauzalny 2021;20:65-71.  Back to cited text no. 7
    
8.
Banjare P, Dwivedi R, Pradhan J. Factors associated with the life satisfaction amongst the rural elderly in Odisha, India. Health and Quality of Life Outcomes 2015;13:1-13. doi:10.1186/s12955-015-0398-y.  Back to cited text no. 8
    
9.
Papi S, Cheraghi M. Multiple factors associated with life satisfaction in older adults. Przeglad Menopauzalny 2021;20:65-71. doi:10.5114/pm.2021.107025.  Back to cited text no. 9
    
10.
Saif-Ur-Rahman KM, Mamun R, Eriksson E, He Y, Hirakawa Y. Discrimination against the elderly in health-care services: A systematic review. Psychogeriatrics.  Back to cited text no. 10
    



 
 
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