By focusing on four target areas such as the income support, education, family oriented initiatives and local or regional policies, the current framework for assessing the mental health among older adults in India can be modified. A move towards a guaranteed pension for eligible older individuals by which they do not have to remain as a financial burden on their children, may reduce their self-perceived economic distress and result in higher levels of wellbeing in older ages. Also, strategies to address socioeconomic disadvantages and gender differentials related to mental health status among older population are urgently needed.
Various studies in India have analysed the risk factors such as lower levels of income, not working, not receiving any pension, not owning any asset, being a woman, and not having an adult child for care and support that are associated with mental health among older adults [33,34,35,36]. However, there is less on the association of particular SES indicators with psychological health and SWB. Among the ones that do so, very few specifically analyse the subjective income status and its association with mental health outcomes. In addition, self-perceived income sufficiency is recommended as a useful question in assessing health outcomes of vulnerable populations [37]. Since better psychological health and SWB are associated with positive health outcomes and increased longevity [38], the present study contributes to the literature on understanding the association of socioeconomic variables and self-perceived income status in particular, with mental health outcomes (psychological distress and SWB) among older adults (60 years and above) in India. The study hypothesized that:-
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Table 1 represents the socio-economic and demographic profile of older adults in India. The sample represents the Indian older adult population. About 43% of older adults had no income whereas 7% has income but not sufficient to fulfil their basic needs. Nearly, 9% of older adults were retired from regular employment. Almost, 70% older adults had no pension and nearly, 18% of older adults had no asset ownership. About 53% of older adults were women and nearly 26% of older adults belong to rural areas. Nearly, 30% of older adults do not co-reside with their children. Eleven per cent of older adults belong to 80 and above age group. Nearly, 51% of older adults had no education and only 6% had 11 and above years of education. About, 40% of older adults were no in marital union during the survey period. Nearly, 70% of older adults had an absolute role in decision making in the household. About 20.5% and 17.3% of older adults had no community involvement and had no one to trust respectively. Almost, 5% of older adults reported that they suffered from some type of economic abuse after turning age 60. About 35.4% of older adults suffered from chronic diseases. About, 24% of older adults belonged to the poorest wealth quintile and 15% belong to richest wealth quintile households.
Older adults who had income but that was not sufficient for the fulfilment of basic needs had the highest prevalence of psychological distress (35.1%) and low SWB (39.4%). Older adults who never worked had the highest prevalence of psychological distress (27.1%) and low SWB (30.4%). Older adults who do not have pension had a higher prevalence of psychological distress (23.9%) and low SWB (27.6%). Those older adults who do not own any asset had a higher prevalence of psychological distress (31.1%) and low SWB (36.5%). Older women had a higher prevalence of psychological distress (25.5%) and low SWB (29.3%). Older adults who were not co-residing with their children had a higher prevalence of psychological distress (24.6%) and low SWB (29.9%). Older adults with age 80 years and above had a higher burden of psychological distress (34.9%) and low SWB (38.7%).
Furthermore, despite the efforts of government interventions, the coverage of the Indian old-age pension system has remained low due to the discretionary or voluntary nature of the schemes [62]. A recent study observed that the pension receipt directly affects the well-being of retired older adults with low economic status [63]. Further, the pension receipt is found to be associated with increased household expenditure, indicating that most of the income from pension received is used for either improving the health or educational outcomes of other family members [64]. A recent study also observed that though the households spent most of the old-age pension income on improving overall family welfare, it reduced the work participation of older adults substantially [65]. In line with this, older adults in our study who received pension reported poor mental health outcomes.
By focusing on four target areas such as income support, education, family-oriented initiatives, and local or regional policies, the current framework for assessing the mental health among older adults in India can be modified. A move towards a guaranteed pension for eligible older individuals, by which they do not have to remain as a financial burden on their children may reduce their self-perceived economic distress and result in higher levels of wellbeing in older ages. Also, strategies to address socioeconomic disadvantages and gender differentials related to mental health status among older population are urgently needed.
Population ageing is the increase in the number and proportion of older people in society. Population ageing has three possible causes: migration, longer life expectancy (decreased death rate) and decreased birth rate. Ageing has a significant impact on society. Young people tend to have fewer legal privileges (if they are below the age of majority), they are more likely to push for political and social change, to develop and adopt new technologies, and to need education. Older people have different requirements from society and government, and frequently have differing values as well, such as for property and pension rights.[216]
As life expectancy rises and birth rates decline in developed countries, the median age rises accordingly. According to the United Nations, this process is taking place in nearly every country in the world.[219] A rising median age can have significant social and economic implications, as the workforce gets progressively older and the number of old workers and retirees grows relative to the number of young workers. Older people generally incur more health-related costs than do younger people in the workplace and can also cost more in worker's compensation and pension liabilities.[220] In most developed countries an older workforce is somewhat inevitable. In the United States for instance, the Bureau of Labor Statistics estimates that one in four American workers will be 55 or older by 2020.[220][needs update]
Among the most urgent concerns of older persons worldwide is income security. This poses challenges for governments with ageing populations to ensure investments in pension systems continues in order to provide economic independence and reduce poverty in old age. These challenges vary for developing and developed countries. UNFPA stated that, "Sustainability of these systems is of particular concern, particularly in developed countries, while social protection and old-age pension coverage remain a challenge for developing countries, where a large proportion of the labour force is found in the informal sector."[214]
It has been argued that population ageing has undermined economic development[221] and can lead to lower inflation because elderly individuals care especially strongly about the value of their pensions and savings Evidence suggests that pensions, while making a difference to the well-being of older persons, also benefit entire families especially in times of crisis when there may be a shortage or loss of employment within households. A study by the Australian Government in 2003 estimated that "women between the ages of 65 and 74 years contribute A$16 billion per year in unpaid caregiving and voluntary work. Similarly, men in the same age group contributed A$10 billion per year."[214] 2ff7e9595c
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