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Self-Reported Morbidity and Self-Rated Health among the Elderly in India: Revisiting the Puzzles

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Abstract

Both self-reported morbidity (SRM) and self-rated health (SRH) have been questioned on the grounds of reliability and validity, particularly in the context of developing countries such as India. It has been argued that indicators of self-perceived health often do not move in tandem with objective indicators of health and are not reflective of socioeconomic inequalities. This paper attempts to systematically examine the validity of SRH and SRM, analysing data for the aged population from the last two health rounds of the Indian National Sample Survey. We consider two indicators of SRM: chronic and acute, and test their association with different positional parameters such as economic condition, educational attainment and availability of healthcare facilities, using multivariable logistic regressions. We also test the association of SRH with these parameters and SRM, using ordered probit regression. In an alternative specification, we replace the general indicators of acute and chronic morbidity with the presence of specific diseases and health conditions, and examine the validity of SRH. Though SRM is typically lower for people who are disadvantaged in terms of different socioeconomic parameters, the latter are more likely to report worse SRH. Self-reported presence of specific illnesses and health conditions also significantly increases the likelihood of giving worse ratings for SRH among the aged in India. Our findings suggest that while SRH is a valid health indicator among the aged in India, one cannot be entirely dismissive of SRM, particularly with regard to its predictive validity for SRH.

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Notes

  1. As one of the referees have pointed out, it is difficult to make a neat classification of ailments into two mutually exclusive categories (chronic and acute) because of a limited recall period and NSSO’s definition of ailments, which sometimes mixes up disease and symptoms. However, to make this classification we use the responses to the question in the block on demographic particulars, where the respondent is directly asked if any member of the household suffered from chronic or any other ailment during the reference period. We do this to place the paper in continuum of previous studies, such as Murray and Chen (1992), which use the same dataset and make such a distinction. However, to address this limitation, we replace these ‘general’ indicators with the ‘specific’ indicators, namely self-reported presence of specific diseases to see if and how they co-vary with SRH (Table 4).

  2. In the absence of information on supply side variables, we use this variable as an imperfect proxy for the individual’s access to healthcare services.

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Acknowledgments

This project, ‘Health inequalities in India and Switzerland: Measurement and distribution of well-being and vulnerability’, was funded by the Indo-Swiss Joint Research Programme in the Social Sciences and supported by the Swiss State Secretariat for Education and Innovation and the Indian Council for Social Science Research.

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Authors and Affiliations

  1. Institute of Development Studies Kolkata, Kolkata, India

    Simantini Mukhopadhyay & Achin Chakraborty

  2. Institute of Sociological Research, University of Geneva, Geneva, Switzerland

    Stéphane Cullati & Claudine Burton-Jeangros

  3. Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland

    Stefan Sieber & Claudine Burton-Jeangros

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  1. Simantini Mukhopadhyay
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  2. Stéphane Cullati
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  3. Stefan Sieber
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  5. Claudine Burton-Jeangros
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Correspondence to Simantini Mukhopadhyay.

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Mukhopadhyay, S., Cullati, S., Sieber, S. et al. Self-Reported Morbidity and Self-Rated Health among the Elderly in India: Revisiting the Puzzles. Population Ageing 16, 67–102 (2023). https://doi.org/10.1007/s12062-020-09301-7

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