Human Development in India - NCAER

102 human development in indiathese people had been accident victims. Hypertension (14)was the next most widely reported disease. Cataracts (6),tuberculosis (4), heart disease (5), diabetes (8), and asthma(7), also were widely reported. Less often noted were theremaining seven categories: leprosy, cancer, polio, paralysis,epilepsy, mental illness, and STDs/AIDS, each reported forabout 1or 2 persons per 1,000.A total of 6 per cent of all individuals in the survey werereported to suffer from at least one of these illnesses. Of these,few (14 per cent) reported more than one illness. Slightlyover a quarter of all households (27 per cent) had a memberwho had been diagnosed with one of these illnesses. Theserates are, of course, lower bounds of true prevalence rates inthe population. Prevalence estimates of these diseases wouldrequire more sophisticated testing than the IHDS couldattempt. But analyses of how households used the medicalcare system to respond to these diseases depend on first identifyingwho was aware that they suffered from them.The risk of being diagnosed with one of these illnessesincreases dramatically with age. About 21 per cent of theelderly (aged 60 or older) have one of these illnesses. Only6 per cent of the working age population and only 1 per centof children have a diagnosed long-term illness (see Figure 7.4for gender disaggregated figures). Of course, the elderly areonly a small part of the Indian population, so most people(64 per cent) who report one of these diseases are between15 and 59 years.Although long-term illnesses are less prevalent, suchan illness is more likely to incapacitate a person for manymore days than does a short-term illness. A person who wasill with a long-term disease was, on an average, unable toperform his or her normal activities for almost 60 days duringthe previous year. The elderly were more affected thanothers. They lost 71 days of normal activity if sick with oneof these diseases (see Table A.7.1a). Across the entire population,long-term illnesses accounted for about four days of lostactivity, compared with seven days for short-term illnesses.This difference is due to the lower prevalence of long-termthan short-term morbidity. Among the elderly, the consequenceswere worse (15.2 days incapacitated for long-termillnesses versus 10.1 days for short-term illnesses).The requirement of a physician’s diagnosis limited theseassessments to small fractions of the population and tiltedreporting to those who had the best access to diagnosticmedical care. For example, urban residents are more likelyto report higher long-term morbidity than rural residents,and those in the south have higher reported morbidity thanthose in the central plains. This is quite different from thereporting pattern for short-term morbidity.DisabilityBeing blind, deaf, or unable to walk imposes enormousburdens on some individuals. How widespread are thesedisabilities? The survey asked if any household member, eightyears old or older, had to cope with any of seven problems(for example, walking one kilometre) that created difficultyfor daily activity. If there was some difficulty with a particularactivity, respondents were asked whether the person wasunable to do that activity or whether the person could do itwith some difficulty. As shown in Figure 7.5, total disabilitieswere recorded around 3–4 per cent for each of the activityof daily living.Activities that could be done only with some difficultyvaried more, so overall disability/difficulty ranged between7 persons per 1,000 (for example, speaking) to 15 personsper 1,000 (seeing from far distances).Source: IHDS 2004–5 data.Figure 7.4Long-term Morbidity by Age and Sex