Longitudinal

Aging Study in
India (LASI)

P . Arokiasamy
International Institute for Population Sciences
Mumbai, India

Policy Research and Data Needs to Meet

Challenges of Population Ageing in Asia, Beijing
December 9-0, 2010
 The Economist weighs in again
¡ India’s age structure is evolving
in the same direction as
China’s.
¡ It’s behind China, but the
share of its population that is of
working age is growing. India
stands ready to reap a
demographic dividend.

Longitudinal Aging Study in India (LASI)

 Older Indians

UN World Population Prospects , 2008 Revision

Longitudinal Aging Study in India (LASI)

 Rapid growth in number and share
of older Indians expected by 2050

UN World Population Prospects , 2008 Revision

Longitudinal Aging Study in India (LASI)

Figure 2 Trends in population growth rate by
broad age groups in south Indian States

Longitudinal Aging Study in India (LASI)

1950
1960
1970
1980
1990
2000
2010
2020
2030
2040
2050
1950
1960
1970
1980
1990
2000
2010
2020
2030
2040
2050
Total Fertility Rate, India and states, 2005-06
 Challenges of population
aging in India
¡Breakdown of extended
family structure
¡ Falling fertility rates
¡ Urbanization
¡ Women to work – so less
caregiving
¡ Mobility of younger
generation
¡ Generation gap
¡Access to health care
¡Old-age economic
security

Longitudinal Aging Study in India (LASI)

The LASI story

Longitudinal Aging Study in India (LASI)

 Core LASI team

HARVARD INTERNATIONAL RAND

SCHOOL OF INSTITUTE FOR CORPORATION
PUBLIC POPULATION
HEALTH SCIENCES

Longitudinal Aging Study in India (LASI)

LASI team members National advisory committee International advisory
Perianayagam Arokiasamy, IIPS (co- Director, IIPS (ex officio) committee
Principal Investigator) Director-General, Indian Council of Medical
James Banks, University College
David E. Bloom, Harvard University Research and Secretary, Department of Health
London
(Principal Investigator) Research, Ministry of Health and Family Welfare Axel Börsch-Supan, Universitat
Jinkook Lee, RAND Corporation (co- (MOHFW), Government of India (GOI) (ex Mannheim
Principal Investigator) officio) Somnath Chatterji, World Health
Director-General of Health Services, MOHFW, Organization
Lisa Berkman, Harvard University GOI (ex officio)
Arie Kapteyn, RAND
David Canning, Harvard University Additional Director-General, Statistics, MOHFW,
Corporation
Amitabh Chandra, Harvard University GOI (ex officio)
Michael Marmot, University
Nicholas Christakis, Harvard University Chief Director, Statistics MOHFW, GOI (ex
College London
Adeline Delavande, RAND officio) James P. Smith, RAND
Corporation Corporation
Peifeng Hu, University of California, Mooneer Alam, Institute of Economic Growth David Weir, University of
Los Angeles Suman Bery, National Council for Applied Michigan
Tarun Khanna, Harvard University Economic Research
David Wise, Harvard University
Ajay Mahal, Monash University Shalini Bharat, Tata Institute of Social Sciences
Yaohui Zhao, Beijing University
Arvind Mathur, IAG P.M. Kulkarni, Jawaharlal Nehru University
S.K. Mohanty, IIPS I.S. Gambhir, Banares Hindu University
Sulabha Parasuraman, IIPS S. Irudaya Rajan, Center for Development
Arun Risbud, NARI Studies
T.V. Sekher, IIPS S. Siva Raju, Tata Institute of Social Sciences
Kavita Sivaramakrishnan, Columbia K. Srinath Reddy, Public Health Foundation of
University India
S.V. Subramanian, Harvard University Gita Sen, Indian Institute of Management
Bas Weerman, RAND Corporation

Longitudinal Aging Study in India (LASI)

 LASI
¡Vision and Goals
¡Evidence base that can be used to
conduct descriptive, causal, and policy
analyses
¡Harmonization with other HRS
¡Follow 30,000 individuals longitudinally

Longitudinal Aging Study in India (LASI)

HRS: an instrument to help address the
problem of global population aging
¡ Measure health and its determinants and
consequences over the later portions of the life cycle
¡ Integration of major domains of life into a common
survey
¡ Science-based agenda
¡ Methodologically innovative
¡ Respect for local knowledge
¡ Public access to data
¡ Power of adopting a longitudinal focus

Longitudinal Aging Study in India (LASI)

 HRS worldwide
¡ English Longitudinal Study of Ageing (ELSA)
¡ Survey of Health, Ageing and Retirement in Europe (SHARE): aims
to include all EU member countries
¡ Austria, Belgium, Czech Republic, Denmark, France, Germany, Greece,
Ireland, Israel, Italy, The Netherlands, Poland, Spain, Sweden and
Switzerland.
¡ 2010-2011: Estonia, Hungary, Luxembourg and Portugal

¡ Mexican Health and Aging Study (MHAS)

¡ Korean Longitudinal Study on Aging (KLoSA)
¡ Chinese Health and Retirement Study (CHARLS)
¡ Irish Longitudinal study on Ageing (TILDA)
¡ Japanese Study of Aging and Retirement (JSTAR)

Longitudinal Aging Study in India (LASI)

Survey HRS CHARLS KLoSA J-STAR

Country United States P .R. of China Rep. of Korea Japan

Enrolment years 1992, 1993, 1998, 2008, 2011 2006 2007,

2004, 2010 2009

Follow-up Every 2 years Follow-up in 2011 Every 2 years Every 2 years

frequency then every 2 years

Number of waves 8 1 2 1
available to date

Sample size 30,000 10,000 10,000 4,200

Age eligibility 50+ 45+ 45+ 50 – 75

Response rate, 70-81% 82% 65% 60%

baseline
 Harmonization across countries

¡Countries can learn from the experience of

each other
¡Institutional responses to demographic change
vary across countries, thus creating an
“experiment” of sorts
¡To take advantage of this experiment, data
must be comparable

Longitudinal Aging Study in India (LASI)

 Challenges of an Indian HRS
¡ Heavily rural
¡ Large informal economy
¡ Institutional complexity
¡ Many languages
¡ Urbanization and migration
¡ Heterogeneity within urban areas
¡ Seasonal considerations
¡ Survey challenges: knowledge of age, notion of
retirement

Longitudinal Aging Study in India (LASI)

 Research Design

¡ Representativeness –National

¡ Panel Sample size- 30,000

¡ Longitudinal – 25 years

¡ Every 2 years

¡ First wave in 2012 (after 2011 census results)

¡ Households with one and more persons in age 45+

¡ All persons in age 45 + and their spouses

Longitudinal Aging Study in India (LASI)

Multi-stage Area Probability Sample Design

¡ LASI sample selection will consists of three-stage

area probability sampling. The primary (first) stage
and second stage of sample selection involve
probability proportionate to size. The first two stages
involve sample area selection and third stage
involves household selection.
¡ LASI sampling design involves independent drawing
of sample in each region of North, Center, East,
North-east, West and South in each of four regions of
North, East, West and South sample consists of
metropolitan city (self-representing unit) and other
areas (Non-self-representing units).

Longitudinal Aging Study in India (LASI)

 LASI innovations
¡LASI Instrument
¡CAPI
¡Show cards
¡Biomarkers
¡Physical measures

Longitudinal Aging Study in India (LASI)

 LASI Innovations
¡ Community level data using GIS -Verification,
geocoding, thematic mapping and community
analysis
¡ Physical Environment- land, water, indoor and outdoor
air-quality, access to sanitation, and climatic
conditions
¡ Survey scope expanded to include information on
infectious diseases, diet and nutritional intake
¡ Comprehensive coverage of biomarkers

Longitudinal Aging Study in India (LASI)

 LASI instrument
¡Final product: Two-part survey
¡ Household questionnaire
¡ Coverscreen, Housing and Environment, Income,
Assets and Debts, Consumption

¡ Individual questionnaire
¡ Demographics, Family and Social Networks,
Health, Biomarkers, Health Care Utilization, Work
and Employment,
Pension, Experimental Modules (Anchoring
Vignettes, Social Connectedness, Expectations )

Longitudinal Aging Study in India (LASI)

 Refining the survey instrument
¡Pre-Pilot - Pre-test: 100 CAPI interviews
¡Purpose: to understand how LASI instrument
functions in the field
¡Translation of the survey instrument
¡State language specific pre-test to gauge
language and cultural differences.
50 pretest interviews for each language

Longitudinal Aging Study in India (LASI)

Computer Assisted Personal Interviewing
(CAPI)

¡Field teams are equipped with laptop

computers
¡Responses are input directly into
computers
¡Checking data accuracy in real-time

Longitudinal Aging Study in India (LASI)

Longitudinal Aging Study in India (LASI)
Longitudinal Aging Study in India (LASI)
Longitudinal Aging Study in India (LASI)
Show cards: sources of water

Longitudinal Aging Study in India (LASI)

Show cards: types of toilet facilities

Longitudinal Aging Study in India (LASI)

 LASI Biomarkers
¡ Proposed to test the dried blood spots (DBS) collected
during LASI for the presence of 5 key markers
¡ Apolipoproteins B and A-1
¡ C-reactive protein (CRP)
¡ Epstein-Barr virus (EBV)
¡ Hemoglobin (Hb)
¡ HbA1c

¡ Assembled strong team

with wealth of knowledge
related to serological
analyses, DBS in particular

Longitudinal Aging Study in India (LASI)

Longitudinal Aging Study in India (LASI)
¡Short term goals
¡ conduct LASI-Pilot to cover a target sample of 1600
completed interviews of men/women age 45+ years.

¡ 400 completed interviews in four selected stated of

Karnataka , and Rajasthan (covered in SAGE) Kerala and
Punjab (new).

Longitudinal Aging Study in India (LASI)

 Pilot study
¡Sample size: 1500 (targeting individuals 45+
and their spouses, age-eligible or not)
¡States involved:
¡ Karnataka
¡ Kerala
¡ Punjab
¡ Rajasthan

Longitudinal Aging Study in India (LASI)

 Data management and analysis
¡ Central office validation checks, feedback to field
teams, cleaning and coding for open ended/verbatim
questions
¡ DBS results will be integrated when available
¡ Data analysis plan will be discussed in the LASI advisory
committee meeting
¡ Data will be protected with access to designated
persons and LASI coordinators
¡ Final data set will be delivered for harmonization with
HRS and dissemination
¡ GIS data will be anonymised
Longitudinal Aging Study in India (LASI)
 LASI Progress so far
Tasks completed
¡Instrument
¡CAPI
¡Manuals - Module-based, supervisor,
training
¡Main Wave sampling plan
¡Four state Pilot – in progress – 2 states
completed; end date – 25 December
¡First Results – Delhi meeting in March14-15,
2010
Longitudinal Aging Study in India (LASI)
Expected Evolution of LASI

Longitudinal Aging Study in India (LASI)

Longitudinal Aging Study in India

The project described is supported by grants from the National Institute on Aging, Award Numbers
R21AG032572 and P30AG024409. The content is solely the responsibility of the authors and does
not necessarily represent the official views of the National Institute on Aging or the National
Institutes of Health.

Photo credits: Dickson Chiramel Abraham and Gail Shotlander.

New international effort on aging in Asia

”Strengthening the Scientific Basis of Policy

Development”