Abstract
Population aging is a global phenomenon, which has already been experienced in the developed countries and is now being felt in the developing countries too. India is one among such countries which accommodates a large number of elderly. Given the projected duration of life in old age, the emerging concern relates to well-being in terms of freedom from disease and disability, which has implication not only for the individual but also for the household and society at large. The state of Kerala, which achieved below replacement level fertility much ahead of other Indian states, has the highest proportion of elderly. This proportion is going to increase from 10.6 % in 2001 to 18.3 % in 2026 (India, Registrar General 2006). This evident shift in the population structure indicates intense aging of the Kerala population, which, in turn, has considerable socio-economic implication, viz., meeting health needs and proper nutrition for the elderly, providing pensions and social security, etc. Different aspects of aging have been looked upon in case the of India, but the implication of aging on health expenditure has not been given due attention yet, in the case of either Kerala or India. On this account, this research proposes to attempt an exploration of the issue of population aging and its implications for health expenditure.
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Notes
- 1.
As per projection by census of India, the proportion of elderly in Kerala will rise from 10.6% in 2001 to 18.3% in 2026, which is more than all India and other Indian states’ corresponding figure (India, Registrar General 2006).
- 2.
Migration Monitoring Study (2007) is the third round of the Migration Monitoring Studies conducted by the Research Unit on International Migration of the Centre for Development Studies. Households were randomly selected from all the 14 districts and all the 63 taluks of the state. The thrust areas covered in the survey are migration, remittances and employment. This round of the survey is different from the previous rounds as it also covers topics like education and health, amenities in the households, possession of consumer durables, and household indebtedness.
- 3.
NSS data is collected by National Sample Survey Organization, which is the Government of India body for collecting information on various aspects of Indian economy through nationwide surveys.
- 4.
In the schedule data related to the “Morbidity, Health Care and the Condition of the Aged” has been collected on both 52nd and 60th rounds.
- 5.
Migration Monitoring Study (2007) is the third round of the Migration Monitoring Studies conducted by the Research Unit on International Migration of the Centre for Development Studies, Thiruvananthapuram, India. The survey randomly collected 10,000 sample households from all the 14 districts and all the 63 taluks of Kerala.
- 6.
For details of sampling strategy and context, see NSS Report No. 441 (52/25.0/1) and 507 (60/25.0/1).
- 7.
Diseases are grouped into two categories – chronic and non-chronic – according to NSSO classification available in report number 441 of NSSO.
- 8.
NSS data on morbidity and health care is available for these points of time only in the 52nd and 60th round respectively; therefore growth rate is calculated using the data available in these two time frames.
- 9.
Consumption quintile is constructed using household consumption expenditure with quintile 1 referring to the lowest income quintile and quintile 5 referring to the highest quintile.
- 10.
Social group is categorized into three categories – Scheduled tribe (ST), Scheduled Caste (SC), and others.
- 11.
- 12.
Same exercise could not be replicated for morbidity prevalence due to the data inconsistency between NSS 52 round and NSS 60 round for this variable.
- 13.
It should be kept in mind that the same growth rate, which has been observed during 1995–1996 and 2004, is applied to estimate the cost of hospitalisation. Since the data on such costs is available for these two periods only, it is not possible to include more periods to make the estimation more robust. This is one of the major drawbacks of the study.
- 14.
Social group is categorized into three categories, ST, SC and others.
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Acknowledgements
The author would like to thank Dr. S. Irudaya Rajan, Dr. Lekha Chakraborty, Jatinder Singh, Indervir Singh, Shashi Ranjan Jha and Kaushalendra Kumar for their useful comments.
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Singh, Y. (2013). Population Aging and Health Expenditure in Kerala: An Empirical Analysis. In: Hoque, N., McGehee, M., Bradshaw, B. (eds) Applied Demography and Public Health. Applied Demography Series, vol 3. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6140-7_5
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