Regional mortality variations among older adults in India: Evidence from Demographic Health Survey

BackgroundStudies on regional mortality variations among older adults in India are poorly documented. Therefore, we intend to estimate the impact of individual and district level determinants on regional mortality variations among the older adults in India. Additionally, we have performed decomposition analysis to evaluate the contribution of socioeconomic and demographic factors in the inter-regional mortality variations among older adults in India. MethodsWe performed a two-level logistic regression model using data from Demographic Health Survey (2015-16) for India to quantify the impact of socio-demographic and ecomonic characteristics. We have also analyzed multivariate decomposition approach to determine the role of determinants in regional mortality variations among older adults. ResultsThe multilevel analyses results revealed that regional mortality variations exist at both individual and district levels among older adults in India. Our finding identified that older adults living in the Central region have a higher mortality risk than in Northern regions. The decomposition results showed that the Central, Eastern and North-eastern regions have significantly higher average number of excess mortality compared to other regions among older adults. The district-level literacy, insurance coverage, electricity supply and public health facilities also showed a significant impact on district level mortality among older adults in India. ConclusionOur study insights extremely important determinants for Indias public health. In order to eliminate these mortality gaps, there is a need for solid support from the state and central government to bridge the socio-demographic and economic development in India at the regional level. As a result, policy should include efforts to improve health outcomes among older adults at early stages.