Data are lacking on the health, social support, and economic security of India’s growing elderly population, and concern is mounting about the well-being of this expanding group. By assembling a research team of demographers, economists, medical doctors, sociologists, and public health and policy experts, LASI aims to supply the data needed to understand the situation of India’s elderly population. This evidence base will contribute to cross-national studies of aging and will inform the design of policies that can protect and support the growing elderly community.
The pilot portion of the LASI project is supported by an R21 exploratory grant from the National Institute on Aging (NIA), one of the 27 institutes and centers of the National Institutes of Health (NIH). The results of the pilot study will inform the design of a full-scale, nationally representative LASI, with a sample of roughly 30,000 to be followed longitudinally (with refresher populations added as needed). These data will provide a much-needed foundation for scientific research and policy-making related to aging in India. Due to its harmonized design with parallel international studies, LASI will contribute to scientific insights and policy development in other countries as well. LASI will ultimately be part of a worldwide effort aimed at understanding how different institutions, cultures, and policies can understand and prepare for population aging.
Harvard School of Public Health
The overarching mission of the Harvard School of Public Health (HSPH) is to advance the public’s health through learning, discovery, and communication. To pursue this mission, HSPH produces knowledge through research, and translates knowledge into evidence that
can be communicated to the public, policy makers, and practitioners to advance the health of populations. LASI receives support from the Program on the Global Demography of Aging
(PGDA), which carries out research on important themes related to global aging and health with an emphasis on issues in the developing world. The PGDA is housed jointly by HSPH and the Center for Population and Development Studies, which brings together faculty, students, and
researchers from a wide array of disciplines including epidemiology, economics, demography, sociology, statistics, and population genetics.
International Institute for Population Sciences
The International Institute for Population Sciences (IIPS) is a Mumbai-based, deemed university engaged in high quality teaching and research in the fields of population, development, and health studies. Over the past fifty years, IIPS has operated as a premier autonomous institution under the Ministry of Health and Family Welfare, Government of India. IIPS has a long history and rich experience through collaborating with a vast network of national, state, and local organizations, as well as major international development organizations, to conduct large-scale national surveys in India.
For more than 50 years, decision makers in the public and private sectors have turned to the RAND Corporation for objective analysis and effective solutions that address the critical social and economic challenges facing the nation and the world. Today, RAND researchers and analysts continue to be on the cutting edge of their fields, working with decision makers in both the public and private sectors to find solutions to today’s difficult, sensitive, and important problems.
Other Collaborating Institutions
National AIDS Research Institute (NARI)
Indian Academy of Geriatrics (IAG)
University of California – Los Angeles (UCLA) School of Medicine
LASI Team Members
Perianayagam Arokiasamy, IIPS
David E. Bloom, Harvard University
Jinkook Lee, RAND Corporation
Lisa Berkman, Harvard University
David Canning, Harvard University
Amitabh Chandra, Harvard University
Nicholas Christakis, Harvard University
Adeline Delavande, RAND Corporation
Peifeng Hu, University of California, Los Angeles
Tarun Khanna, Harvard University
Ajay Mahal, Monash University
Arvind Mathur, IAG
S.K. Mohanty, IIPS
Sulabha Parasuraman, IIPS
Arun Risbud, NARI
T.V. Sekher, IIPS
Kavita Sivaramakrishnan, Columbia University
S.V. Subramanian, Harvard University
Bas Weerman, RAND Corporation
National Advisory Committee
Director, IIPS (ex officio)
Director-General, Indian Council of Medical Research and Secretary, Department of Health Research, Ministry of Health and Family Welfare (MOHFW), Government of India (GOI) (ex officio)
Director-General of Health Services, MOHFW, GOI (ex officio)
Additional Director-General, Statistics, MOHFW, GOI (ex officio)
Chief Director, Statistics, MOHFW, GOI (ex officio)
Mooneer Alam, Institute of Economic Growth
Suman Bery, National Council for Applied Economic Research
Shalini Bharat, Tata Institute of Social Sciences
P.M. Kulkarni, Jawaharlal Nehru University
I.S. Gambhir, Banares Hindu University
S. Irudaya Rajan, Center for Development Studies
S. Siva Raju, Tata Institute of Social Sciences
K. Srinath Reddy, Public Health Foundation of India
Gita Sen, Indian Institute of Management
International Advisory Committee
James Banks, University College London
Axel Börsch-Supan, Universitat Mannheim
Somnath Chatterji, World Health Organization
Arie Kapteyn, RAND Corporation
Michael Marmot, University College London
James P. Smith, RAND Corporation
David Weir, University of Michigan
David Wise, Harvard University
Yaohui Zhao, Beijing University
Uttam Acharya, IIPS
Grant Benson, University of Michigan
Kevin Feeney, RAND Corporation
Rajan Kumar Gupt, IIPS
Steven Heeringa, University of Michigan
Heather Lanthorn, Harvard University
Thomas McDade, Northwestern University
Jennifer O’Brien, Harvard University
Marija Ozolins, Harvard University
Jessica Perkins, Harvard University
Ashok Posture, IIPS
R.S. Reshmi, IIPS
Teresa Seeman, University of California, Los Angeles
Zubin Shroff, Harvard University
Heikrujam Amarjit Singh, IIPS
Esther Ullman, University of Michigan
Sharon Williams, Purdue University
Vaidehi Yelamanchili, IIPS
Joanne Yoong, RAND Corporation
The LASI pilot survey targeted 1,600 individuals aged 45 and older and their spouses, and will inform the design and rollout of a full-scale, nationally representative LASI survey. The expectation is that LASI will be a biennial survey and will be representative of Indians aged 45 and older, with no upper age limit. The age of 45 is chosen to (a) harmonize this survey with its sister HRS surveys in Asia; and (b) allow measurement of pre-retirement behavior, as people often begin to change their labor market, health, and consumption behaviors as they age.
1,600 age-qualifying individuals were drawn from a stratified, multistage area probability sampling design. After a series of pre-pilot studies designed to test the instrument and the
key ideas behind it, pilot data were collected through face-to-face interviews over three month time periods. Descriptive analyses of the data will be performed and lessons will be drawn to inform the launching of a full-scale LASI survey.
The LASI pilot survey was conducted in four states: Karnataka, Kerala, Punjab, and Rajasthan. To capture regional variation we have included two northern states (Punjab and Rajasthan) and two southern states (Karnataka and Kerala). Karnataka and Rajasthan were included in the Study on Global AGEing and Adult Health (SAGE), which will enable us to compare our findings with the SAGE data. The inclusion of Kerala and Punjab demonstrates our aim to obtain a broader representation of India, where geographic variations accompanied by socioeconomic and cultural differences call for careful study and deliberation. Punjab is an example of an economically developed state, while Rajasthan is relatively poor, with very low female literacy, high fertility, and persisting gender disparities. Kerala, which is known for its relatively efficient health care system, has undergone rapid social development and is included as a potential harbinger of how other Indian states might evolve.
A survey instrument has been designed to collect information that is conceptually comparable to that of the Health and Retirement Study (HRS) and its sister surveys in Asia (i.e., the Chinese Health and Retirement Longitudinal Study, the Japanese Study on Aging and Retirement, and the Korean Longitudinal Study of Aging), but that will also capture characteristics specific to India. Because we have developed LASI to be consistent with parallel international studies, we expect it will contribute to scientific insights and policy development in other countries.
The internationally harmonized survey instrument was developed in English and has been translated into local languages (Hindi, Kannada, Malayalam, and Punjabi). The expected interview duration is about two hours, using face-to-face interviews. The LASI instrument comprises the household survey, which is to be collected only once for each household by interviewing the selected key informant; the individual survey, which the interviewer will collect for each respondent; and the protocol for the collection of biomeasures.
Computer-Assisted Personal Interview (CAPI)
The LASI pilot employed computer-assisted personal interview (CAPI) techniques to record the responses of survey participants. This method requires field teams to be outfitted with laptop computers, pre-loaded with survey questions asked of respondents in a face-to-face interview. Field teams input responses directly into a laptop computer, thereby limiting data entry processes as well as minimizing data recording and entry errors. This portion of the LASI project was funded through a pilot grant from Harvard’s Program on the Global Demography of Aging (PGDA).
The use of CAPI allows for crosschecking of data in real-time, thereby minimizing data entry errors and ensuring internal consistency. The RAND Labor and Population Center has spearheaded the development of a comprehensive information system, MMIC™ (Multimode Interviewing Capability), building on work by CentERdata in The Netherlands. MMIC™ was used to program the CAPI survey for LASI, and integrates various traditional modes of collecting interview data, including telephone interviewing, self-administered surveys, and personal interviewing.
Another feature of the LASI pilot survey instrument is the collection of biomarkers, which can be analyzed to provide researchers with quantitative data on health. The National Research Council recommends that biomarkers be incorporated in a social survey to (a) capture health data from a portion of the population that otherwise would not have this type of data recorded; (b) investigate molecular determinants of common health outcomes; and (c) study interactions between biomarkers and other social conditions that may subsequently lead to declines in health outcomes. The inclusion of biomarkers and other health assessments is particularly
important for less-developed countries such as India, where access to health care tends to be limited. As a result, undiagnosed diseases are likely more common than in developed countries.
The protocol for biomarkers in the LASI pilot consisted of the collection of molecular biomarkers, anthropometry, and functional assessment. The lead field organization of our team, IIPS, successfully completed the first wave of SAGE, which also collects biomarkers.
The LASI research team has joined with DBS experts in the United States to craft a proposal to for analyzing the DBS collected during LASI. In particular, the LASI team proposes to analyze the DBS for the presence of apolipoproteins B-1 and A, C-reactive protein (CRP), Epstein-Barr virus (EBV), and hemoglobin (Hb). The DBS collected during the planned full-scale LASI project will also be analyzed by a research team at NARI.
For this and other information, please download the LASI Informational Brochure.