Data for Development
September 2019
W elcome to the India Human Development Survey Forum

A monthly update of socio-economic developments in India by the
IHDS research community

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Special Issue on Health:
The India Human Development Survey (IHDS) continues to engage and inspire researchers throughout the world because of the vast array of data it offers through its spectrum of health, education, economy, family, and gender modules for both urban and rural samples across the country.

This edition of the IHDS newsletter has a special focus on two key health issues; (i) the rising tide of distrust against doctors and hospitals among patients, stemming from deficiencies in the healthcare ecosystem; and (ii) the hazards associated with co-morbidity of the lifestyle diseases, diabetes and hypertension.

  • The first paper uses data from IHDS to analyse the level of trust between patients, on one hand, and doctors and hospitals, on the other hand. It also identifies the challenges in building this trust, and ways to transcend them.
  • In the second paper, the authors find an alarming rise in the incidence of diabetes and hypertension spanning the two waves of the IHDS in 2004-05 and 2011-12, and pinpoint the various risk factors in the transition between the two diseases.
  • Recent publications using IHDS
Research Findings Based on IHDS Data

Trust in Hospitals—Evidence from India
Vani S. Kulkarni, Veena S. Kulkarni and Raghav Gaiha
Various explanations have been offered for outbursts of violence against doctors and other staff in India, drawing attention to critical issues such as the growing supply-demand imbalance in healthcare, deterioration in quality, overburdened doctors, lack of security for medical staff, high expectations of patients who come in advanced stages of chronic and other illnesses, and overcrowding of public hospitals with limited sanitary facilities. But underlying all these explanations is lack of trust in doctors and hospitals, especially public hospitals. The authors focus on trust and its covariates over the period 2005-2012. Using data from the India Human Development Survey (IHDS), they aim to build on the empirical evidence through a systematic state-of-art analysis of trust in public and private hospitals and doctors. Combining the analysis with other evidence, the paper identifies specific challenges in building patient–hospital trust and how these can be overcome. 
Table 1:

Vani S. Kulkarni   is a lecturer in sociology at the University of Pennsylvania and Senior Fellow in the Urban Ethnography Project in the sociology department at Yale University. She holds a PhD from the University of Pennsylvania and has held research fellowships at Penn, Harvard, and Yale. She has also been a consultant for the Asian Development Bank and International Fund for Agricultural Development at the United Nations. Her research lies at the intersection of health (global and international); urban education; race and caste; gender; identity and inequality; and development and democracy. She has published in the ANNALS of the American Academy of Political and Social Science, and in several peer-reviewed journals, and has co-authored two books. Currently, she is engaged in research in two different cultural contexts—South Asia and North America. 

Veena S. Kulkarni joined Arkansas State University after completing her PhD in Sociology with specialisation in Demography and Development from University of Maryland, College Park. Her research interests encompass studies of social and economic inequalities with a focus on labour market processes and indicators, health and educational outcomes in the context of developing and developed countries. She has published extensively in peer reviewed journals such as Demography , International Migration Review , International Review of Applied Economics , Journal of Developing Areas , Social Science Research , Sociological Forum , and World Development  

Raghav Gaiha is currently a Professorial Research Fellow at Global Development Institute, University of Manchester, England. Earlier, he has held visiting fellowships at University of Cambridge, Harvard, Yale, Stanford, and University of Pennsylvania. His research interests include poverty, nutrition, agriculture, aging, and disease. He is writing a book (jointly with Veena S. Kulkarni and Vani S. Kulkarni) on Aging, Disease and Disability in India. He obtained his PhD in Economics from University of Manchester.
Transition Specific Risk Factors Affecting the Lifestyle Disease Progression from Diabetes to Hypertension in India
Wahengbam Bigyananda Meitei and Laishram Ladusingh
Diabetes and hypertension are common co-morbid associates and co-exist in many cases. This study attempts to understand the two-way transition between diabetes and hypertension, and the risk factors affecting the transition using the multistate model. The study used data from the first and second waves of the India Human Development Survey (IHDS), conducted in 2004-05 and 2011-12, respectively. The authors find a significant rise in the level of diabetes and hypertension from 2004-05 to 2011-12. Except for transition from hypertension to diabetes, the probability of transition in all other transition decreases and the mean waiting time to stay in the healthy state increases after adjusting for several covariates. Increases in the level of smoking, drinking of alcohol, consumption of tobacco, Body Mass Index, education and household income quintile are the major risk factors affecting the transition between diabetes and hypertension. And the risk of transitioning from a healthy state to hypertension is higher among females as compared to males.
Table 1:
Wahengbam Bigyananda Meitei is a PhD scholar in Biostatistics and Demography at the International Institute for Population Sciences (IIPS), Mumbai, India.

His research interests include modelling the transition of co-morbid diseases, viz. diabetes and hypertension, and identifying the risk factors of maternal and child health outcomes. Among his significant research outputs is his recent co-authored article on the projection of undernutrition, “Projecting stunting and wasting under alternative scenarios in Odisha, India, 2015–2030: a Lives Saved Tool (LiST)-based approach”.
He holds Master of Philosophy and Master of Science degrees in Biostatistics and Demography.
Laishram Ladusingh is the Vice-Chancellor of Bodoland University, Assam, India. He has been the Officiating Director and Professor in Department of Mathematical Demography and Statistics at the International Institute for Population Sciences (IIPS), Mumbai, India.

As part of the teaching faculty at IIPS, he was associated with the fields of Statistics, Research Methodology, Survey Research, Aging, and training of post-graduate students in Clinical Trials and Designs of Experiments. He was the principal coordinator for implementing the District Level Household and Facility Survey for the Ministry of Health & Family Welfare, Government of India. He has published many papers in the areas of economics of population aging, social security, longevity and work, public health, stochastic modelling, maternal and child health in peer-reviewed scholarly journals. He serves as a member of technical advisory committees of various government and academic bodies.
He holds a Master of Science degree in Statistics and a PhD in Population Studies.
IHDS in the News

Gaiha, Raghav and Vani S. Kulkarni . “Opinion: A Classic Antidote to the Rising Venom against Doctors.” Livemint . 04 September 2019. Link .
Gaiha, Raghav and Farhana Haque Rahman . “Is There Discrimination against Women in Healthcare in India?” Inter Press Service News Agency . 9 September 2019. Link .

Kumar, Tanu. “Mumbai Residents Win Govt Housing Lottery and Spend More on Kids’ Education, Jobs: Study.” The Print , 13 September 2019. Link .

ET Energy World. “INFOGRAPHIC: Cumulative Distribution of Hours of Power Supply in India.” The Economic Times , Energy World, 11 September 2019. Link .

The Financial Express . “Increasing Age-threshold for Marriage for Women Would be a Greater Step Forward.” The Financial Express , 27 August 2019 Link .

Recent Publications Using IHDS

Gupta, Aashish and Diane Coffey. “Caste, Religion, and Mental Health in India.” Accessed on 20 September 2019. Link . [DOWNLOAD]

Kumar, Tanu. “How Welfare Can Generate Civic Action: Evidence from Affordable Housing in Mumbai.” Accessed on 17 September 2019. Link .

Singh, Prashant Kumar, Lucky Singh, Ritam Dubey, Shalini Singh, and Ravi Mehrotra. “Socio-economic Determinants of Chronic Health Diseases among Older Indian Adults: A Nationally Representative Cross-sectional Multi-level Study.” BMJ Open  2019; 9: e028426. doi: 10.1136/bmjopen-2018-028426Accessed on 12 September 2019. Link .

Chatterjee, Sayantani, Basant K. Panda, and Sanjay K. Mohanty. “Estimation, Decomposition and Convergence of Human Development Index and Gender Development Index in the States of India.” Demography India , 48(1): 19-35. Accessed on 12 September 2019. Link .
Gaiha Raghav, Veena S. Kulkarni, Vani S. Kulkarni “Trust in Hospitals-Evidence from India.” University of Pennsylvania Population Center Working Paper (PSC/PARC), 2019-27 . Accessed on 6 September 2019. Link .

Kumar, Deepak,   Bhanu Pratap , and Archana Aggarwal . “Affirmative Action in Government Jobs in India: Did the Job Reservation Policy Benefit Disadvantaged Groups?” Journal of Asian and African Studies , OnlineFirst. Accessed on 6 September 2019 . Link .

Devaraj, Srikant  and Pankaj C. Patel . “The Association between Participation in Mahatma Gandhi National Rural Employment Guarantee Program (NREGA) and Smoking in India.” Nicotine & Tobacco Research, ntz166, Accessed on 30 August 2019. Link .

LoPalo, Melissa Christine. “Essays on the Determinants of Worker Productivity and Labor Market Outcomes.” PhD Dissertation presented to University of Texas Austin. Accessed on August 21, 2019 . Link .

Ladusingh, Laishram and Wahengbam Bigyananda Meitei . “Transition Specific Risk Factors Affecting the Lifestyle Disease Progression from Diabetes to Hypertension in India.” Health , 11(8): 1055–1071. Accessed on 21 August 2019. Link .

Agarwal Smisha,  Sian L. Curtis , Gustavo Angeles Ilene S. Speizer , Kavita Singh , and James C. Thomas . “The Impact of India’s Accredited Social Health Activist (ASHA) Program on the Utilisation of Maternity Services: A Nationally Representative Longitudinal Modelling Study.” Human Resources for Health , 17(2019): 68. Accessed on 21 August 2019. Link .
About IHDS
The India Human Development Survey (IHDS) is a nationally representative, multi-topic survey of 41,554 households in 1503 villages and 971 urban neighbourhoods across India. The first round of interviews was completed in 2004-05; data are publicly available through ICPSR. A second round of IHDS re-interviewed most of these households in 2011-12 (N=42,152) and data for the same can be found here.

IHDS has been jointly organised by researchers from the University of Maryland and the National Council of Applied Economic Research (NCAER), New Delhi. Funding for the second round of this survey is provided by the National Institutes of Health, grants R01HD041455 and R01HD061048. Additional funding is provided by The Ford Foundation, IDRC and DFID.
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