The hidden cost of ageing: measuring the impact of health expenditure on poverty among households with older adults in India.
4 affiliations
- 1Department of Economic Affairs, Government of India, New Delhi, India.
- 2Sri Sathya Sai Institute of Higher Learning (Deemed to be University), Puttaparthi, India.
- 3BITS Law School, Kalyan, India.
- 4Shailesh J. Mehta School of Management, Mumbai, India.
Abstract
According to the World Bank's poverty and inequality platform, 11.09% of India's population lived below the international poverty line of $2.15 (2017 PPP) per day in 2018. Moreover, 48.2% of total health expenditure is financed through out-of-pocket payments (OOPHE), underscoring their role in driving households into poverty. With 31.4% of households reporting at least one older adult (census 2011), this study focuses on the impoverishing effects of OOPHE among older adults-inclusive households. Using nationally representative data from the NSS 75th round: household social consumption - health (2017-2018), we estimate the poverty headcount and poverty gap at the household level, before and after accounting for OOPHE for households with at least one older adult member. We further employ a binary logistic regression to identify socio-economic and demographic determinants of post-OOPHE impoverishment. The results show that longer hospitalization spells, larger household size, caste status, and reliance on private healthcare significantly elevate the risk of falling into poverty. In contrast, health insurance coverage and higher educational attainment reduce this risk. Despite multiple public schemes and insurance initiatives, coverage remains inadequate and uneven, leaving a substantial share of older adults financially unprotected. These findings point to an urgent need to expand and strengthen publicly financed health insurance and financial risk protection, with targeted safeguards for households with older adults, to prevent healthcare costs from exacerbating poverty.
Related
- Family Mealtimes in Hispanic Households: Associations of General Parenting Styles and Food Parenting Practices with Adolescent Food Group Intake
- Overweight in children under five in urban and wealthier households in Bangladesh: trends and inequalities across three Multiple Indicator Cluster Surveys, 2012-13 to 2025
- Real-time wearable detection of respiratory infections in pediatric transplant households
- Health-Related Quality of Life, Healthcare Utilization, and Expenditure in US Adults With Myocardial Infarction and Heart Failure: The Medical Expenditure Panel Survey 2019 to 2024
- Disability, discrimination and mental health concerns among young women living in urban poverty: empirical analyses of the TOPOWA study
BibTeX
@article{soni2026hidden,
title = {{The hidden cost of ageing: measuring the impact of health expenditure on poverty among households with older adults in India.}},
author = {Neeraj Soni and Rajabhushan Jagadish Nayak and Meghna Ghosh and Ashish Singh},
journal = {Frontiers in public health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1950585},
url = {https://europepmc.org/article/MED/42908591},
note = {CC BY},
}
RIS
TY - JOUR
TI - The hidden cost of ageing: measuring the impact of health expenditure on poverty among households with older adults in India.
AU - Neeraj Soni
AU - Rajabhushan Jagadish Nayak
AU - Meghna Ghosh
AU - Ashish Singh
PY - 2026
DA - 2026/10/07
JO - Frontiers in public health
DO - 10.3389/fpubh.2026.1950585
UR - https://europepmc.org/article/MED/42908591
AB - According to the World Bank's poverty and inequality platform, 11.09% of India's population lived below the international poverty line of $2.15 (2017 PPP) per day in 2018. Moreover, 48.2% of total health expenditure is financed through out-of-pocket payments (OOPHE), underscoring their role in driving households into poverty. With 31.4% of households reporting at least one older adult (census 2011), this study focuses on the impoverishing effects of OOPHE among older adults-inclusive households. Using nationally representative data from the NSS 75th round: household social consumption - health (2017-2018), we estimate the poverty headcount and poverty gap at the household level, before and after accounting for OOPHE for households with at least one older adult member. We further employ a binary logistic regression to identify socio-economic and demographic determinants of post-OOPHE impoverishment. The results show that longer hospitalization spells, larger household size, caste status, and reliance on private healthcare significantly elevate the risk of falling into poverty. In contrast, health insurance coverage and higher educational attainment reduce this risk. Despite multiple public schemes and insurance initiatives, coverage remains inadequate and uneven, leaving a substantial share of older adults financially unprotected. These findings point to an urgent need to expand and strengthen publicly financed health insurance and financial risk protection, with targeted safeguards for households with older adults, to prevent healthcare costs from exacerbating poverty.
SN - 2296-2565
ER -