Introduction
According to census 2011, In India, 8 % of the total population were above the age of 60 years [
1], and as per the estimates prepared by United Nations, it is likely to rise to 19% by 2050 [
2]. Among a rapidly growing older population, a multitude of resource constraints contributes to loss of self-esteem and adverse psychological effects [
3]. In the South Asian settings where family ties are considered paramount, intergenerational conflicts may have negative consequences on the well-being of older individuals [
4].
The status of household headship accorded to the older members of the Indian families which is often symbolic and seldom vested with some control over resources is ambivalent in the existing literature. Study shows that increased dependency and diminished ability to contribute to household economy were found as major factors that lead to a decline in the respect accorded to older people and their status in the family [
5]. While grown-up children tend to make decisions as they become the main breadwinners in the household, the decision-making power of older persons in India has been declining [
6]. It is found that although they own private assets and share the same amount of intra-household transfers, older adults who reside with young and adult children were less likely to be household heads than were those with spouses and grandchildren [
7]. Nevertheless, older adults often tend to maintain some control over their resources to prevent themselves from feeling like a burden to the family members and to retain children’s respect [
8]. For this cause, they may actively involve in household decision-making and try to establish themselves as independent heads of the household [
9].
As evidence suggests, if older individuals consider themselves as the household heads and their adult children stop taking their opinion into account for important household decisions, it can negatively affect their mental well-being [
10]. Similarly, functional capacities are recognized as being shaped by class, gender, and other factors and functional old age can be delayed through the provision of adequate care and support [
11,
12]. On the other hand, older adults depending on their children or family members to look after them who often consider them as a burden may result in ill-treatment and a multitude of health issues [
13,
14]. Also, older members who take on fewer and lighter domestic duties, gain respect but experience a decline in their tangible household political and economic powers [
15]. Hence, those older individuals who withdraw from active engagement in household activities after reaching a particular age are considered as transitioning from household headship to merely a senior member in the household and eventually giving up the material pleasure in their lifecycle [
16]. Notably, evidence suggests that in order to promote active engagement of older adults, there is a need for an increased sense of coherence and personal autonomy [
10,
17]. Thus, despite satisfaction with participation being a challenge to successful aging of the older population, it can also be a distinctive factor of actual participation and the quality of participation [
18].
Furthermore, normal functioning that includes involvement in daily household activities is crucial to the well-being of older adults [
16]. And with increased age, the likelihood that a person aged 60 and older will head his or her household increases [
19]. However, the linkage between perceived statuses and functional support that is actually provided has been examined with less care. Besides, a headship status representing members’ shared interests is regarded as inadequate and inappropriate when it is automatically ascribed to the senior male’ [
20]. Even though, when the value system becomes stronger and actual receipt of social supports are ensured, people generally become satisfied in old age and experience relatively high levels of emotional well-being [
21]. Further, studies found gender differences in personal significance that a person attributes to the roles he or she occupies and the satisfaction from such role-making varies by its meanings [
22]. Hence, with an unprecedented increase in the proportion of population over age 60 years in India that is expected to rise to nearly 20% by the year 2050 [
23], it is important to better understand the conditions under which wellbeing of older adults can be ensured.
In this regard, we hypothesize that older adults who reported having a role in household decision-making were more likely to functionally head their households than their counterparts who often remain heads without any role-making. And the present study attempts to fill in a gap in well-being research in India by accessing data that explicitly have asked questions concerning decision-making in the household and examining the distinction between the functional and nominal household headship status of older adults based on their decision making power and how it is associated with their subjective well-being.
Results
Table
1 provides the socio-economic and demographic profile of the Indian older adults included in the analysis. The mean age of the study population was 68 years [CI: 67.8–68.2]. In the sample, about 5 % of older adults had nominal while 95% had functional headship status. More than half of the individuals (63%) belong to the age-group 60–69 years and nearly 10% were 80 years or older. Three-fourths (73%) of the older adults were male. Around 41% of the elderly were uneducated, and 62% had attained less than primary education. Two-third of the elderly (64%) were currently in a union and around 70% were co-residing with their children. One-third of the older adults (32%) were working, while 15% were retired at the time of the survey. Nearly 18% of the elderly reported no community involvement and around 17% reported that they do not trust someone. The health-related factors of the older adults were also included in the analysis. More than half of the elderly (53%) reported poor health status, and nearly 20% had a high level of psychological distress. Nearly 62% of older adults had chronic morbidity, and around 70% were disabled. According to religion, the majority of respondents were Hindus (80%). Nearly 72% of the older adults were rural residents.
Table 1
Socio-economic and demographic profile of the study population in India
Headship status |
Nominal | 207 | 4.5 |
Functional | 4397 | 95.5 |
Age group (years) |
60–69 | 2903 | 63.1 |
70–79 | 1254 | 27.2 |
80+ | 447 | 9.7 |
Sex |
Male | 3342 | 72.6 |
Female | 1262 | 27.4 |
Educational attainment |
Not educated | 1876 | 40.7 |
5 years or less | 985 | 21.4 |
6–10 years | 1381 | 30.0 |
11+ years | 362 | 7.9 |
Marital status |
Not in union | 1670 | 36.3 |
Currently in union | 2934 | 63.7 |
Children co-residing |
No | 1381 | 30.0 |
Yes | 3223 | 70.0 |
Working status (last 1 year) |
Not working | 2504 | 54.4 |
Working | 1476 | 32.1 |
Retired | 624 | 14.6 |
Community involvement |
No | 837 | 18.2 |
Yes | 3767 | 81.8 |
Trust over someone |
No | 788 | 17.1 |
yes | 3816 | 82.9 |
Self-rated health |
Good | 2137 | 46.4 |
Poor | 2467 | 53.6 |
Psychological distress |
Low | 3667 | 79.6 |
High | 937 | 20.4 |
Chronic morbidity |
No | 1748 | 38.0 |
Yes | 2856 | 62.0 |
Disability |
No | 1382 | 30.0 |
Yes | 3222 | 70.0 |
Wealth status |
Poorest | 1066 | 23.2 |
Poorer | 1005 | 21.8 |
Middle | 972 | 21.1 |
Richer | 873 | 19.0 |
Richest | 686 | 14.9 |
Religion |
Hindu | 3650 | 79.3 |
Muslim | 327 | 7.1 |
Sikh | 423 | 9.2 |
Others | 203 | 4.4 |
Caste |
Scheduled Tribe | 981 | 21.3 |
Scheduled Caste | 225 | 4.9 |
Other Backward Class | 1726 | 37.5 |
Others | 1673 | 36.3 |
Type of residence |
Rural | 3298 | 71.6 |
Urban | 1306 | 28.4 |
State |
Himachal Pradesh | 738 | 16.0 |
Punjab | 649 | 14.1 |
West Bengal | 584 | 12.7 |
Orissa | 544 | 11.8 |
Maharashtra | 660 | 14.3 |
Kerala | 636 | 13.8 |
Tamil Nadu | 792 | 17.2 |
Total | 4604 | 100.0 |
Bivariate analysis
The bivariate analysis of LSWB by various socio-economic and demographic characteristics is presented in Table
2. The results suggest the significant bivariate associations between LSWB and all the selected background characteristics included in the analysis. The prevalence of LSWB was significantly higher among older adults with nominal headship status (58%) than functional headship status (23%). The proportion of older adults with LSWB increases with an increase in age-groups. The prevalence of LSWB was found significantly higher among females, uneducated, separated or widowed, and non-working older adults than their respective counterparts. According to health status, the LSWB was more prevalent among older adults with chronic morbidity, psychological distress, poor self-rated health, and disability. The older adults with the poorest wealth status (45%) and rural place of residence (25%) reported higher LSWB. According to various Indian states, the prevalence of LSWB was reportedly highest in West Bengal (48%), followed by Maharashtra (34%) and Tamil Nadu (33%).
Table 2
Percentage of low subjective well-being by background characteristics among older adults in India
Headship status | 0.001 |
Nominal | 58.0 | |
Functional | 22.8 | |
Age group (years) | 0.001 |
60–69 | 22.1 | |
70–79 | 26.3 | |
80+ | 33.4 | |
Sex | 0.001 |
Male | 22.0 | |
Female | 30.5 | |
Educational attainment | 0.001 |
Not educated | 33.7 | |
5 years or less | 25.9 | |
6–10 years | 13.7 | |
11+ years | 12.0 | |
Marital status | 0.001 |
Not in union | 30.0 | |
Currently in union | 21.1 | |
Children co-residing | 0.001 |
No | 29.5 | |
Yes | 22.1 | |
Working status (last 1 year) | 0.001 |
Not working | 31.0 | |
Working | 20.5 | |
Retired | 6.7 | |
Community involvement | 0.001 |
No | 37.7 | |
Yes | 21.4 | |
Trust over someone | 0.001 |
No | 41.6 | |
yes | 20.8 | |
Self-rated health | 0.001 |
Good | 12.4 | |
Poor | 34.6 | |
Psychological distress | 0.001 |
Low | 15.2 | |
High | 60.0 | |
Chronic morbidity | 0.001 |
No | 21.0 | |
Yes | 26.4 | |
Disability | 0.001 |
No | 14.8 | |
Yes | 28.4 | |
Wealth status | 0.001 |
Poorest | 44.7 | |
Poorer | 31.7 | |
Middle | 17.4 | |
Richer | 11.8 | |
Richest | 7.7 | |
Religion | 0.001 |
Hindu | 26.1 | |
Muslim | 26.5 | |
Sikh | 8.8 | |
Others | 22.4 | |
Caste | 0.001 |
Scheduled Tribe | 31.0 | |
Scheduled Caste | 28.5 | |
Other Backward Class | 25.2 | |
Others | 19.0 | |
Type of residence | 0.001 |
Rural | 25.1 | |
Urban | 22.5 | |
State | 0.001 |
Himachal Pradesh | 11.0 | |
Punjab | 9.5 | |
West Bengal | 47.8 | |
Orissa | 26.8 | |
Maharashtra | 33.6 | |
Kerala | 11.5 | |
Tamil Nadu | 32.5 | |
Total | 24.3 | |
Multivariate analysis
Table
3 summarises the adjusted odds ratio estimates for low subjective well-being (LSWB) by background characteristics of Indian older adults. After controlling for various other variables, older adults with nominal headship status were 1.59 times significantly more likely to have LSWB than individuals with functional headship status (OR = 1.59; 95% CI: 1.10, 2.31). The individuals aged 80 years and above had 34% significantly higher odds of having LSWB compared to the individuals belonging to the age group 60 to 69 years (OR = 1.34; 95% CI: 1.01, 1.79). According to educational attainment, older adults with no or less than the primary level of education had significantly higher odds of having LSWB than those with more than 11 years of education. We did not find any association between marital status and LSWB among older adults. Results further showed that the LSWB among older adults is not associated with their status of living with children. Non-working older adults were found to have 30% significantly higher odds of LSWB than working older adults (OR = 1.30; 95% CI: 1.06, 1.61).
Table 3
Logistic regression estimates for low subjective well-being by background characteristics among older adults in India
Headship status |
Nominal | 1.59*(1.10,2.31) |
Functional | Ref. |
Age group (years) |
60–69 | Ref. |
70–79 | 1.05 (0.87,1.28) |
80+ | 1.34*(1.01,1.79) |
Sex |
Male | Ref. |
Female | 0.95 (0.70,1.27) |
Educational attainment |
Not educated | 1.83*(1.2,2.78) |
5 years or less | 1.71*(1.13,2.59) |
6–10 years | 1.15 (0.77,1.71) |
11+ years | Ref. |
Marital status |
Not in union | Ref. |
Currently in union | 0.99 (0.75,1.3) |
Children co-residing |
No | Ref. |
Yes | 1.00 (0.82,1.21) |
Working status (last 1 year) |
Not working | 1.30*(1.06,1.61) |
Working | Ref. |
Retired | 0.770.53, 1.12) |
Community involvement |
No | 1.49*(1.20,1.84) |
Yes | Ref. |
Trust over someone |
No | 1.72*(1.38,2.15) |
yes | Ref. |
Self-rated health |
Good | |
Poor | 2.09*(1.73,2.52) |
Psychological distress |
Low | Ref. |
High | 5.60*(4.64,6.76) |
Chronic morbidity |
No | Ref. |
Yes | 1.21*(1.00,1.47) |
Disability | |
No | Ref. |
Yes | 1.60*(1.28,1.99) |
Wealth status |
Poorest | 3.13*(2.14,4.58) |
Poorer | 2.34*(1.66,3.32) |
Middle | 1.71*(1.22,2.39) |
Richer | 1.45*(1.03,2.03) |
Richest | Ref. |
Religion |
Hindu | Ref. |
Muslim | 1.18 (0.85,1.64) |
Sikh | 0.87 (0.50,1.52) |
Others | 1.14 (0.73,1.77) |
Caste |
Scheduled Tribe | Ref. |
Scheduled Caste | 0.84 (0.55,1.27) |
Other Backward Class | 1.00 (0.78,1.28) |
Others | 0.92 (0.72,1.17) |
Type of residence |
Rural | Ref. |
Urban | 1.39*(1.15,1.69) |
Older adults with psychological distress, chronic morbidity, poor self-reported health, no community involvement and no one trust to on were at comparatively higher risk of LSWB than their counterparts. According to the wealth index, the odds of having LSBW increases with a decline in wealth index; for instance, the older adults in the poorest category do have almost three times significantly higher odds of having LSBW compared to older adults in the richest category (OR = 3.13; 95% CI: 2.14, 4.58). The older adults’ who resided in the urban area had nearly 39% significantly higher likelihood of having LSWB compared to their rural counterparts (OR = 1.39; 95% CI: 1.15, 1.69). We did not find any association of LSWB with religion and caste.
Table
4 represents the stratified analysis by gender. It was found that older males who were nominal heads had a 60% significantly higher likelihood to suffer from LSWB than the older males who were functional heads [AOR: 1.60; 95% CI: 1.33–2.93]. Similarly, older females who were nominal head had a 69% significantly higher likelihood to suffer from LSWB than the older females who were functional head [AOR: 1.69; 95% CI: 1.03–2.79].
Table 4
Logistic regression estimates for low subjective well-being by sex among older adults in India
Headship status |
Nominal | 1.60*(1.33–2.93) | 1.69*(1.03–2.79) |
Functional | Ref. | Ref. |
Discussion
In order to determine the major factors associated with the level of subjective well-being of older individuals especially their actual headship status, a binary logistic regression was employed and it has shown statistically significant associations. Older people after a certain age consider themselves as physically aged and mentally withdraw from the roles and responsibilities they feel they are unable to perform [
19]. Such a withdrawal itself reinforces the feelings of sickness and weakness and results in a decline in their overall well-being [
16]. Consistently, the older adults who were nominal heads with no role in household decision making in the current study were more likely to report lower levels of subjective wellbeing. This finding suggests that policies and interventions can create more opportunities for meaningful engagement of older individuals and establish a more age-friendly household environment with an ultimate goal of promoting their late-life wellbeing. Also, the older parents should be enabled to become more actively involved in household activities and strengthen the intergenerational relationships.
Other findings of the present study suggest that several socio-demographic factors including age, level of education, community involvement, and trust were significant predictors of subjective well-being in old age. Age was found a significant predictor of subjective well-being among older Indian adults and it shows that with increasing age, subjective well-being will decrease. On the whole, the finding is consistent with and supports current wellbeing literature [
34‐
36]. A possible explanation for the negative effects of age on subjective well-being may be the result of life stresses, such as widowhood, poor health condition, the decline in social and family roles, and decline in social engagement. Consistent with previous studies, older adults who were involved in community activities or had trust in someone reported a higher level of subjective well-being than their counterparts [
28]. It is believed that social support is a powerful source of emotional wellbeing that results in higher levels of overall well-being especially in traditional societies [
37,
38]. Similarly, older people who are socially active have a better chance of benefiting from interpersonal relationships and suffer less from loneliness [
39,
40]. While being in a marital union was significantly associated with subjective well-being at a bivariate level, it was not a predictor in the multivariable analyses.
Education has always been hailed as an essential factor of wellbeing in late life. It has been linked with better opportunities, better health, and a high standard of living [
41]. Also, a vast proportion of the older Indian adults is uneducated and thereby unskilled and is mostly engaged in the unorganized sector leading to higher dependency on their children at old age and to a lower status [
42]. The same is reflected in the current regression results where the likelihood of low well-being increases with a decrease in educational status. Illiterates and older individuals with primary schooling are likely to be of low well-being with reference to highly educated and it is statistically significant. The finding suggests the importance of higher education that leads to better awareness as well as better economic opportunities thereby ensuring higher levels of well-being in older ages [
43]. The implications are particularly relevant in an Indian socio-cultural setting where people are oftentimes classified as old in relation to their inability to perform roles and responsibilities [
16].
The positive association of psychological distress with LSWB observed in our study can be explained as the psychological distress may reflect the differences in health conditions and issues of access to resources and mental health care [
44]. As evidence suggests physical health status plays a preponderant role in late-life wellbeing [
45‐
47]. Consistently, the present study found a significant positive association of poor self-rated health and prevalence of chronic morbidity with LSWB. The finding that disability had a significant positive association with LSWB was in concordance with earlier studies that highlighted functional activities namely, activities of daily living (ADLs), instrumental ADLs as predictors of subjective well-being in later years of life [
17,
18]. This also supports the findings that reduced physical functionality among older adults is related to poor mental wellbeing [
48,
49].
In addition, household wealth status appeared to be an important factor associated with subjective well-being among older Indian adults. This finding is consistent with some previous studies which have found that household economic status is a significant predictor of quality of life and psychological well-being [
50‐
52]. Also it supports the notion that people from higher wealth quintiles can easily satisfy their basic needs such as food, housing, and health; therefore, a higher level of well-being is attained. Finally, several studies have found rural–urban differences in terms of psychological well-being, quality of life, life satisfaction, depression, happiness, and mental health among elderly people [
53,
54]. The finding of our study that indicated that urban place of residence as a positive factor of subjective wellbeing in old age can be explained by the differentials in rural-urban lifestyles and the highly available social networks in urban areas.
As with any study, there are several limitations to this study to be acknowledged. The first is the cross-sectional nature of this study which prevents the possibility of drawing conclusions about causal relationships between the variables studied. Second, although this study had a large sample size, since it was carried out among older individuals in seven states of India, there should be caution while results being generalized to the older population across the country.
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