Education, Gender, and State-Level Gradients in the Health of Older Indians : Evidence from Biomarker Data

This paper examines health disparities in biomarkers among a representative sample of Indians aged 45 and older, using data from the pilot round of the Longitudinal Aging Study in India (LASI). We document an educational gradient in hemoglobin (Hb) level, a marker used for diagnosing anemia. Survey respondents with no schooling have substantially lower Hb levels (0.6 g/dL less in the adjusted model) than those with some formal education. Individuals among the oldest old and those with greater body-mass index (BMI) had higher levels of C-reactive protein (CRP), an indicator of inflammation and a risk factor for cardiovascular disease. We find no evidence of educational or gender differences in CRP but do find respondents living in rural areas have CRP levels that are 0.7 to 0.8 mg/L lower than urban ones. We also find state-level disparities, with Kerala residents exhibiting the lowest CRP levels (1.96 mg/L compared to the overall mean of 3.28 mg/L in Rajasthan). This finding is consistent with data on access to health-care services across states. We use the Oaxaca-Blinder decomposition approach to explain group-level differences, and find that state-level gradients in CRP are mainly due to heterogeneity in the effect of the observed characteristics of respondents, as opposed to differences in the distribution of endowments across the sampled state populations