Health impacts of a disaster among older adults and its association with endemic disease: Evidence from Longitudinal Ageing Survey of India (LASI), 2017-18

Abstract

Abstract Background: The emergence of infectious diseases in the era of globalization and urbanization has become a bottleneck in efforts aimed at reducing the burden associated with various communicable and non-communicable diseases. Moreover, the risk of having an infectious disease is further exacerbated by climate change, and natural disasters, combined with severe poverty and poor access to health services. This study aims to identify the risk factors affecting the emergence of endemic diseases among the Indian older adult population with an emphasis on individual health impacted by disasters. Data & Methods: This study utilizes data from the first wave of the Longitudinal Ageing Survey of India, 2017-18 with an eligible sample of 66,606 individuals aged 45 years and above. Binary logistic regression analysis and the Fairlie decomposition technique were used to understand the factors affecting endemic disease and to predict the contribution toward rural-urban inequality in disease prevalence. Results: Overall prevalence of endemic disease in the country was 26% with the burden of these diseases being substantially higher among females, rural residents, and unimproved water and sanitation. The prevalence of endemic disease was 48% among individuals whose health was affected by the disaster and 25% among those whose health was not affected by the disaster. The Odds Ratio (ORs) of having endemic disease among disaster-affected older adultswas found to be uniformly higher in rural areas [OR: 2.6 (2.2,3.0)] than in urban areas [OR: 1.84 (1.4,2.5)]. In the adjusted model, the risk of endemic disease among disaster-affected older adults in rural areas was 2.17 times and 1.42 times higher in urban areas than individuals without any health impact of a disaster. Conclusion: Efforts aimed at education on hygiene and hand-washing, and provisions of safe water and sanitation will significantly contribute to reducing the public health burden. Preparedness in disaster-prone areas, training the health and local community, efficient resource allocation, and identification and management of the particular disease will help minimize disease transmission.