Living arrangements and health of older adults in India: a multilevel analysis

Abstract

Objectives: To examine if co-residence has protective health effects on older adults in India. We also address selection bias by examining the living arrangement-health relationship in a non-experimental study design. Methods: Using data from the India Human Development Survey (2004-05) - a nationally representative, multi-topic data set of 41,554 households, this paper examines the association between living arrangements-older persons living alone versus living in co-resident family types-and short-term illness. Propensity score methods (stratification and weighting) have been used to account for the selectivity problem. Results: Our analyses indicate that older adults living with family members have a substantially lower likelihood (approximately 50% lower, as estimated by propensity score stratified analysis) of short-term illness compared to older adults who live alone. Results also suggest that household wealth, gender, marital status and urban location affect short-term illness. Discussion: Overall, results highlight the importance of multigenerational families in older adult wellbeing in India. By systematically examining the living arrangement-health link, the study integrates propensity score methods into the demographic literature on aging in developing countries. Additionally, considering the limited availability of longitudinal data on older adults in India, methods such as this one can help address the effect of confounding variables in health research.