Project 3 (2017-2024) - Aging and Health in India: A Longitudinal Study and an Experimental Platform

Throughout the world, the elderly share of the population is projected to increase dramatically over the next several decades. This change is expected to be particularly dramatic in India, as the population of individuals 60 years and older is expected to climb from 8.9 percent in 2015 to 19.4 percent in 2050. In India, as elsewhere, this significant demographic shift will pose a new set of health and welfare challenges, particularly: (1) an increased prevalence of non-communicable diseases, such as diabetes and hypertension, (2) a change in family structures and support systems that leave the elderly population increasingly living alone and supporting themselves, and (3) a reduction in financial security due to numerous factors including (1) and (2).

Policy-makers and governments need more data on the health and wellbeing trends within the elderly population in order to make effective policy decisions. In the proposal, we highlight how we plan to leverage the unique partnership between J-PAL South Asia and the government of Tamil Nadu to conduct a large, high quality panel health survey of the elderly within the state that is modeled on the HRS and the WHO’s SAGE. We will work closely with the government of Tamil Nadu to advise and oversee all aspects of the design and implementation of the survey; however, the government will fully fund and conduct the surveys themselves. The data collected will be immediately useful for the government of Tamil Nadu to better understand the needs of its aging population in order to create evidence-based policy, but it will also provide us with a unique opportunity to build capacity and to field a set of research experiments that can inform a wide set of policies.

Evidence regarding interventions that work to improve the health and wellbeing of the elderly is strikingly sparse. We propose using the longitudinal panel as a platform for researchers, including ourselves, to conduct randomized evaluations on a subset of the sample. Here, we propose two specific interventions: (1) home visits for the elderly to assess health and wellbeing, and (2) application support for the old age pension program. Both interventions will contribute significantly to the literature and are easily scalable. We are unaware of any interventions using regular home visits to the elderly in the context of a developing country. Furthermore, evaluations of home visits to the elderly in developed countries have had mixed results. While there is some evidence regarding the impact of non-contributory pensions, this research has been largely nonexperimental. Our intervention would thus be the first experimental study on the impact of obtaining a pension on the health and cognition of the elderly, and could contribute to a broader understanding of the tools available to support the health of aging populations.