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OCR for page 261
11
Social Networks, Family, and Care
Giving Among Older Adults in India
Lisa F. Berkman, T.V. Sekher,
Benjamin Capistrant, and Yuhui Zheng
S
ocial networks and family ties are among the core institutions pro -
viding support and opportunities for engagement to older adults
around the world (Berkman, 2000; Bloom et al., 2010; Bongaarts and
Zimmer, 2002; Wachter, 1997). Social networks are defined by the web of
associations and the structure of ties that surround a person (Berkman
and Glass, 2000; McPherson, Smith-Lovin, and Cook, 2001; Wellman and
Berkowitz, 1988). The network has several functions including the pro -
vision of emotional, instrumental, appraisal, and financial support. At
the same time, it is important to acknowledge that social networks may
involve both negative and positive interactions, with resulting health
impacts (Berkman, 2009; Berkman and Glass, 2000; Seeman et al., 2001).
Furthermore, the contribution of support provided by older adults to their
families and communities is important and often not well recognized. As
societies undergo demographic transitions with rising life expectancy and
decreases in fertility, societies as a whole “age” (Kirk, 1996). India, while
early in this transition, has started to experience the growing pains associ-
ated not only with population growth but also an aging society. Over the
next decades, the demographic and health transition will challenge core
institutions to adapt and to develop innovative approaches to work, fam-
ily life, caregiving, and education across the life course (Lee, 2003; Lloyd-
Sherlock, 2010). Globally, somewhere around 2020, there will be more
people aged 65 and older than children under 5. In India, this crossover
will happen later, but not so much later. Furthermore as women continue
to join the paid labor force, integrating care needs of older and younger
261
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262 AGING IN ASIA
family members while remaining in the labor force will pose challenges
to both women and men in most societies (Budlender, 2008; Das et al.,
2010; Sabates-Wheeler and Roelen, 2011). The changing older dependency
ratios for world regions for 2000, 2020, and 2040 suggest that in Asia
(excluding the Near East), the number of people aged 65 and older for
every 100 people 20–64 will grow from 11 to 28 in this time period (United
Nations, 2008). In this regard, India is no exception. Thus, it is critical that
data regarding the family and network dynamics of older people in India
be understood so that both formal and informal sectors can develop and
plan effectively to maintain health, well-being, and productivity in the
growing population of older adults and their families.
As in many countries, the family is a cherished institution in India
and often provides important nonformal social security for the older pop-
ulation (Bloom et al., 2010). Most older men and women in India live with
their families, and it is the most preferred living arrangement of older
people (Gupta, 2009). Families continue to be the central organizing unit
for economic support and for providing care for those physically unable
to care for themselves (Kozel and Parker, 2000; Samuel and Thyloth, 2002).
In the absence of institutions that provide social insurance (Barrientos,
Gorman, and Heslop, 2003; Lloyd-Sherlock, 2002), we suspect that India’s
older populations will continue to rely on the family and social networks
(Gupta, 2009; Gupta, Rowe, and Pillai, 2009). Social networks comprised
of both family and friends are an important resource in the older person’s
life (Cohen and Wills, 1985; Shanas, 1973, 1979), although there is little evi-
dence in India of the impacts of social networks on physical and mental
well-being. As the nature of family, intergenerational relationships, and
the role of women in the family are changing, these transitions may well
impact the care and welfare of older people (Lloyd-Sherlock, 2000, 2002).
In some instances, the family in the 21st century may be unable to meet
the needs of the aged, thereby creating a need to look for other support
services. India’s National Policy on Older Persons (Government of India,
1999) emphasizes that programs will be developed to promote family
values and sensitize the young to the necessity and desirability of inter-
generational bonding and continuity.
The aim of this chapter is to provide a description of family and
network ties among older men and women in India and to illustrate the
dynamic interplay between caregiving and receiving among older people.
In this chapter, we present findings from the Longitudinal Aging Study in
India (LASI) pilot study, a cross-sectional survey of men and women over
the age of 45 and their spouses in four states in India. In all our analysis,
we will only include participants aged 45 and older: spouses younger
than 45 were excluded because they were a representative sample of the
population of their ages.
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LISA BERKMAN, T.V. SEKHER, BENJAMIN CAPISTRANT, and YUHUI ZHENG
METHODS
Sample
LASI is a panel survey representing persons at least 45 years of age in
India. Its pilot study is funded by the National Institute on Aging and sam-
ples individuals in four states (Karnataka, Kerala, Punjab, and Rajasthan).
The survey instrument has been designed to collect information that is
conceptually comparable to the U.S. Health and Retirement Study (HRS)
and its sister surveys in Asia, and includes variables on demographics;
family structure and social network; health and health behaviors; health
care utilization; work and pension; housing and environment; and income,
assets, debts, and consumption. The LASI survey instrument captures local
characteristics of India. To capture regional variation, we will include 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 will
demonstrate our ability to obtain a broader representation of India, where
geographic variations accompanied by socioeconomic and cultural differ-
ences call for careful study and deliberation, especially when preparing for
the nationally representative sampling for the subsequent baseline study.
Punjab is an example of an economically developed state, while Rajasthan
is relatively poor. Rajasthan is also one of the states with the highest ratio
of males to females and is the capital of the practice of sati; thus, the well-
being of widows may be particularly low in this state. Kerala, which is
known for its relatively efficient healthcare system, has undergone rapid
social development and is included as a potential harbinger of how the
situation might evolve in other Indian states. The sampling frame for LASI
is drawn from the 2001 Census Primary Census Abstract. We use listing
directories of villages and towns to select sample areas within each state
for the pilot project. The primary sampling units (PSUs) are the randomly
selected villages in rural areas and census enumeration blocks in urban
areas that typically consist of 100–150 households. Basic distributions by
gender are shown in Tables 11-1A and 11-1B.
Three Measures of Family and Social Networks
Social networks are comprised of multiple ties with family, friends,
and links to more formal and informal social institutions. These ties form
a web that provides resources to its members, often in the form of social
support. Social support itself takes a number of forms, including emo-
tional, instrumental, appraisal, and financial support. Social ties need
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264 AGING IN ASIA
not be positive but can also lead to negative outcomes including conflict
and abuse. In this section, we explore some of the basic kinds of ties with
spouse or partner, friends, and social activities often involving weaker ties
and their social patterning in terms of social, economic, and demographic
characteristics. We start with an exploration of three different aspects of
social networks: ties with spouse, ties with close friends, and participation
in social activities. These ties range from the most intimate and close ties
with a partner to more extended and weaker ties with those who engage
in social activities. There is little information currently available on these
types of ties in India so basic information is essential.
We examined three measures of family and social networks. The
first measure is closeness with spouse. The question asks “How close is
your relationship with your spouse or partner?” The response categories
include “Very close/Quite close/Not very close/Not at all close.” We
generated a binary variable about closeness with spouse, which takes a
value of 1 if reporting “Very close” and 0 for reporting other categories.
The second measure is related to ties outside of the household. It
indicates whether a respondent reported having any close friends. This
measure was generated based on two questions in LASI. The first was “Do
you have any friends?” If the answer is yes, then a second question was:
“How many of these friends would you say you have a close relation-
ship with?” If a respondent reported having any friend, and had a close
relationship with one or more friends, then the measure of “having any
close friend” takes the value of 1. Otherwise, it is 0.
The third measure is related to participation in social activities. LASI
asks about how frequently a person participates in each of the following
seven activities: (1) Go to the cinema, (2) eat out of the house, (3) go to a
park/beach, (4) play cards or games, (5) visit relatives /friends, (6) attend
cultural performances/shows, and (7) attend religious functions /events
(outside home). The response categories are as follows: Twice a month or
more / About once a month / Every few months / About once or twice a
year / Less than once a year. Since activity 7, attending religious events,
is strongly correlated with religion, we decided to exclude this activity
for the measure of participation in social activities. The measure takes the
value of 1 if for one or more of the other six activities, a person reported
participating “Twice a month or more” or “About once a month.”
Analysis
Since all three outcomes are binary, we applied a logit model to exam-
ine how social ties are associated with various sociodemographic char-
acteristics and economic positions. Demographic characteristics include
age group, gender, living in urban area, marital status, and living with a
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LISA BERKMAN, T.V. SEKHER, BENJAMIN CAPISTRANT, and YUHUI ZHENG
child or not. Economic positions are measured by education and per capita
consumption. Per capita consumption is preferred over income for low-
income regions and rural areas. LASI collected detailed data on household
consumption. We used the variable of per capita consumption on Organisa-
tion for Economic Co-operation and Development equivalence, which takes
into account not only number of household members, but also different
consumption burden by age. The household adult was assigned a weight
of 1, additional adults each were assigned a weight of 0.5, and each child
was assigned a weight of 0.3. The per capita consumption measure was
generated by adding all weights of the household members, and dividing
the total household consumption by this summed value. Since LASI pro-
vides imputed data for missing values using a hot deck method, we control
for imputed consumption in the models to adjust for any systematic bias
due to missing data for some components of household consumption. We
recoded the per capita consumption measure into terciles: low, middle, and
high. The cutoff values for the terciles were 31,100 (RPs) and 57,033 (RPs).
Finally, we control for region, caste, and state.
RESULTS
Sociodemographic Characteristics of LASI Participants
Sample characteristics of LASI are shown in Tables 11-1A and 11-1B.
The pilot survey was done in selected states including Karnataka, Kerala,
Punjab, and Rajasthan. Table 11-1A shows the distribution of the three social
tie measures of interest, and Table 11-1B shows the other demographic con-
ditions. Seventy-one percent of women and 75% of men lived in rural areas.
Women were much less likely to be currently married: 65% versus 91%
among men. This is not due to differences in age structure in our sample:
Table 11-1B shows that for female participants, 61% were aged between
45–59, 30% aged between 60–74, and 9% were 75 and older. The correspond-
ing percentages for male participants were 58%, 33%, and 9%, respectively.
In LASI, 32% of women are currently widowed. There is a growing
concern about the increasing proportion of widows among older persons.
The two main reasons for the significant gender disparity in widowhood
are the longer life span of women compared to men and the general ten-
dency in India for women to marry men older than themselves. Adjust-
ment to widowhood can be difficult for women in all societies, particularly
in India. Widows often face restrictions and social stigma. Lack of inheri -
tance rights and property, and insufficient incomes and earnings expose
elderly widows to deprivation and social isolation. As has been noted,
“Widowhood is more than the loss of a husband—it may mean the loss of
a separate identity” (United Nations Population Fund, 1998, p. 42).
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266 AGING IN ASIA
TABLE 11-1A Distribution of Outcomes by Gender (in percentage)
Men Women
Very close to spouse if married
No 22 20
Yes 78 80
Total 100 100
Any social activities
No 33 40
Yes 67 60
Total 100 100
Any close friend
No 44 66
Yes 56 34
Total 100 100
NOTE: Data are weighted by individual all-state representative sampling weight.
SOURCE: Data from LASI pilot study, respondents aged 45 and older.
Living arrangements are an important component of analysis of wel -
fare of elderly. In other words, the care and support experienced by the
elderly are commonly linked to the place of their residence. Table 11-1B
shows that among women, 51% were living with spouse and children, 12%
living with spouse only, 28% living with children only, and 8% living with
neither spouse nor child. For men, 77% were living with both spouse and
child, 13% were living with spouse only, 6% were living with spouse only,
and 4% were living with neither spouse nor child. However, the large
numbers of women surviving their spouses as compared to men may cre-
ate increasing economic vulnerability of older Indians. One of the main
social effects of extension of life is the extended period of widow hood for
many women. According to the 2001 Census of India, 51% of the women
aged 60 years and older are widowed, compared to only 15% among men.
Men commonly have wives to care for them into older ages, but spouses
may not be the major source of care for the majority of older women in
India. Finally, in LASI, we have created a measure of economic status of
the households by categorizing into them into five wealth quintiles: The
lowest quintile constitutes the poorest households, and the highest quin-
tile represents the richest households.
Distribution of Outcome Measures
Table 11-1A shows the distributions of the three outcome measures by
gender. Men and women reported similar level of closeness to spouses,
if married: 78% among men and 80% among women. However, women
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LISA BERKMAN, T.V. SEKHER, BENJAMIN CAPISTRANT, and YUHUI ZHENG
TABLE 11-1B Distributions of Demographic and Socioeconomic
Variables by Gender (in percentage)
Men Women
Age Group
45−59 58 61
60−74 33 30
75 and older 9 9
Residence
Rural 75 71
Urban 25 29
Marital Status
Married 91 65
Never married/divorced/separated 3 4
Widowed 6 32
Living Arrangement
Live with spouse and child 77 51
Live only with spouse, not child 13 12
Live only with child, not spouse 6 28
Live with neither spouse nor child 4 8
Education
Illiterate 40 56
Primary 27 23
Secondary 11 8
High school or more 22 14
Per capita Consumption Terciles
Low 33 33
Middle 33 34
High 34 32
Consumption Values Imputed 18 18
Religion
Other 2 1
Hindu 75 76
Muslim 9 8
Christian 6 7
Sikh 8 7
Caste
Other/none 32 32
Scheduled caste/scheduled tribe 27 28
Other backward class 41 40
State
Karnataka 32 32
Kerala 21 25
Punjab 14 13
Rajasthan 33 30
NOTE: Data are weighted by individual all-state representative sampling weight.
SOURCE: Data from LASI pilot study, respondents aged 45 and older.
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268 AGING IN ASIA
were less likely to participate in any social activities: 60% among women
versus 67% among men. Finally, only 34% of women reported having any
close friend, while 56% of men did. The gender distributions across the
four regions in LASI are very similar.
Regression Analysis
Closeness with Spouse
We first assess the relationship quality between the spouse and the
participant in LASI. A set of questions was included in the survey to mea -
sure the extent of satisfaction with life and current situations. One ques-
tion is about a respondent’s relationship with a spouse. The responses
were categorized into three levels: completely/very satisfied, somewhat
satisfied, and not satisfied. Table 11-2 shows the odds ratios for “feeling
very close to your spouse” among men and women who were married
in LASI. Respondents who are somewhat satisfied or not satisfied are
contrasted with those who are completely or very satisfied.
The results of this analysis suggest that there is little difference in
marital satisfaction with age. While those aged 60 and older are slightly
less likely to report being close to their partners, these results are not
significant. Gender differences are also not substantial in these analyses
once we control for covariates. Those living in urban areas were likely to
be close to their spouses but the association was not significant (OR 0.77,
95% CI 0.45–1.30). When comparing educational levels with terciles of
consumption, some important differences emerge. Within educational
levels, relative to the illiterate group, those with any education, pri -
mary, secondary, or high school and above were twice or more likely to
report being close to their spouses. In contrast, those in the middle and
high tercile of consumption were more likely to report being close to a
spouse, but the associations were not significant. Those with imputed
consumption values were more likely to report being close to spouses.
Finally, religion, caste, and state were not associated with closeness to
spouse.
Ties with Close Friends
Ties with close friends are a potential source of support, friendship,
and intimacy. Even in countries where close ties are often kinship based,
close friends turn out to have a critical role in social networks. Table 11-3
shows the association of close friendships with the same set of social
and demographic characteristics we examined previously in a multiple
logistic analysis looking at the independent association of each variable.
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LISA BERKMAN, T.V. SEKHER, BENJAMIN CAPISTRANT, and YUHUI ZHENG
TABLE 11-2 Odds Ratios of Logistic Regression for the Outcome of
“Very Close to Spouse,” if Married
Covariates Odds Ratio 95% CI
Age Group
60−74 0.86 [0.59,1.24]
75 and older 0.76 [0.35,1.63]
Gender
Female 1.23 [0.92,1.66]
Residence
Urban 0.77 [0.45,1.30]
Living Arrangement
Live with child 1.34 [0.76,2.38]
Education
Primary 2.58** [1.60,4.16]
Secondary 1.85 [0.93,3.69]
High school or more 2.05* [1.15,3.65]
Per Capita Consumption Terciles
Middle 1.13 [0.71,1.81]
High 1.48 [0.84,2.59]
Consumption Values Imputed 1.82* [1.06,3.12]
Religion
Muslim 0.83 [0.35,1.98]
Christian 2.19 [0.84,5.75]
Sikh 1.42 [0.69,2.89]
State
Kerala 1.62 [0.76,3.44]
Punjab 1.17 [0.52,2.59]
Rajasthan 1.02 [0.51,2.04]
Observations 1,110
NOTES: Data are weighted by individual all-state representative sampling weight. Com -
plex sample design is taken into account for estimating standard errors. * denotes p < 0.05;
** p < 0.01.
SOURCE: Data from LASI pilot study, respondents aged 45 and older and reported being
currently married.
The results of this analysis contrast in some significant ways with
those related to spousal relationships. Age, for instance, is strongly asso -
ciated with friendship patterns, with older men and women much less
likely to have close friends. Younger respondents are more than three
times as likely to have close friends compared to older people. Surpris -
ingly, since women are often thought of as caregivers and social “connec -
tors,” in this analysis, they are much less likely to report close friends than
are men (OR .35, 95% CI .24–.51). There is a hint, though not statistically
significant, that widowed, divorced, and single respondents are more
likely to have close friends than their married counterparts, suggestive of
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270 AGING IN ASIA
TABLE 11-3 Odds Ratios of Logistic Regression for the Outcome of
“Any Close Friend”
Covariates Odds ratio 95% CI
Age Group
60−74 0.70* [0.52,0.95]
75 and older 0.29*** [0.18,0.45]
Gender
Female 0.35*** [0.24,0.51]
Residence
Urban 0.99 [0.58,1.69]
Marital Status
Never married/divorced/separated 1.34 [0.56,3.19]
Widowed 1.2 [0.82,1.77]
Living Arrangement
Live with child 0.69** [0.52,0.91]
Education
Primary 1.55* [1.02,2.36]
Secondary 2.63*** [1.64,4.22]
High school or more 2.43*** [1.53,3.84]
Per Capita Consumption Terciles
Middle 1.3 [0.90,1.88]
High 1.80* [1.12,2.88]
Consumption Values Imputed 1.66* [1.12,2.46]
Religion
Muslim 0.45** [0.26,0.78]
Christian 1.02 [0.59,1.76]
Sikh 2.79* [1.24,6.26]
Caste
Scheduled caste/scheduled tribe 1.1 [0.69,1.73]
Other backward class 1.08 [0.78,1.50]
State
Kerala 1.94* [1.11,3.41]
Punjab 0.54 [0.24,1.20]
Rajasthan 0.82 [0.46,1.45]
Observations 1,420
NOTES: Data are weighted by individual all-state representative sampling weight. Com -
plex sample design is taken into account for estimating standard errors. * denotes p < 0.05;
** p < 0.01; *** p < 0.001.
SOURCE: Data from LASI pilot study, respondents aged 45 and older.
some level of substitution among types of ties. These odds ratios, how -
ever, are relatively small. Finally, increasing education and consumption
were associated with an increasing likelihood of having close friends.
Respondents living in Kerala were more likely to report having close
friends than those living in other regions.
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LISA BERKMAN, T.V. SEKHER, BENJAMIN CAPISTRANT, and YUHUI ZHENG
Social Activities and Social Participation
The LASI pilot survey included questions about social participation.
Specifically, a question asked about social activities including going to the
cinema, eating out of the house, going to the park/beach, playing cards
or games, visiting relatives/friends, attending cultural performances/
shows, and attending religious functions/events (outside home). In a
multivariate logistic regression analysis, we examined the associations
between demographic and economic conditions and participation in
social activities. Table 11-4 shows the results of the analysis with odds
ratios and 95% confidence intervals.
The results from this analysis indicate the participation in social activ-
ities is substantially lower among those aged 75 and older than those at
younger ages. Women are less likely to engage in social activities than are
men. The strongest associations, however, are in relation to socioeconomic
position. Both men and women with high levels of education and in
middle and high consumption terciles are more likely to engage in social
activities. In these analyses, respondents living in Rajasthan were much
less likely to participate in social activities than those in other regions.
Positive and Negative Aspects of Social Relationships
Social networks may be positive and enriching as well as negative
and conflict-laden. While a deep analysis of these dimensions is beyond
the scope of this chapter, here we present some preliminary findings
with regard to the quality of different types of social ties. Our aim was to
explore both positive and negative aspects of ties, including ill treatment
of older men and women, patterns of communication among friends, and
patterns of financial support in terms of support both given and received
by participants. We describe these findings in the text. The data are avail-
able from the authors upon request.
Ill Treatment of Elderly within the Family
Elder abuse and neglect are increasingly acknowledged as a social
problem internationally (Acierno et al., 2010; Cooper, Selwood, and
Livingston, 2008; Dong et al., 2009), and India is no exception. The respon-
sibility of caring for the elderly in India is traditionally borne by the
immediate family (Gupta, 2009). However, with a changing trend toward
nuclear family set-ups, the vulnerability of the elderly is considerably
increasing. The intersection of high care demands and competing time-
use priorities can result in low-quality care and high caregiver burden
(Boggatz et al., 2007; Dias and Patel, 2009; Navaie-Waliser, Spriggs, and
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272 AGING IN ASIA
TABLE 11-4 Odds Ratios of Logistic Regression for the Outcome of
“Any Social Activities”
Covariates Odds ratio 95% CI
Age Group
60−74 0.75 [0.54,1.03]
75 and older 0.30*** [0.19,0.48]
Gender
Female 0.70* [0.51,0.96]
Residence
Urban 1.56 [0.92,2.64]
Marital Status
Never married/divorced/separated 0.59 [0.29,1.19]
Widowed 0.85 [0.60,1.22]
Living Arrangement
Live with child 1.12 [0.74,1.70]
Education
Primary 1.57 [0.98,2.52]
Secondary 2.32* [1.10,4.86]
High school or more 2.77*** [1.56,4.91]
Per Capita Consumption Terciles
Middle 1.56* [1.08,2.26]
High 1.66* [1.11,2.50]
Consumption Values Imputed 1.05 [0.63,1.76]
Religion
Muslim 0.74 [0.40,1.38]
Christian 1.2 [0.72,1.99]
Sikh 2.72** [1.33,5.56]
Caste
Scheduled caste/scheduled tribe 0.76 [0.52,1.12]
Other backward class 0.9 [0.67,1.22]
State
Kerala 0.61 [0.33,1.11]
Punjab 0.88 [0.37,2.05]
Rajasthan 0.12*** [0.07,0.22]
Observations 1,422
NOTES: Data are weighted by individual all-state representative sampling weight. Com -
plex sample design is taken into account for estimating standard errors. * denotes p < 0.05;
** p < 0.01; *** p < 0.001.
SOURCE: Data from LASI pilot study, respondents aged 45 and older.
Feldman, 2002), which may manifest in continued unmet needs/neglect
and, in the most extreme cases, even direct abuse. Even though there is
a general perception about the mistreatment perpetrated on older adults
(Cooper et al., 2008; Newman, 2006), the exact magnitude and nature of
abuse is still unknown in India. A recent study (Sebastian and Sekher, 2010)
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LISA BERKMAN, T.V. SEKHER, BENJAMIN CAPISTRANT, and YUHUI ZHENG
observed that female elderly, especially widows, those in the oldest-old
age group (80+ years), and the physically immobile, are more vulnerable
to abuse than others. Not only the poor, but also the rich are susceptible
to neglect and abuse in many families. Chokkanathan and Lee (2005)
found that the prevalence of mistreatment was 14% among older adults
in an urban setting in India. The mistreatment of elderly is multidimen -
sional and multilayered, emerging from differences in gender, economic
position, and physical condition (Selwood, Cooper, and Livingston, 2007;
World Health Organizagiton, 2008). The general perception that families
are the safest place for the aged in India has been questioned by micro-
level studies in recent years (Chokkanathan and Lee, 2005; Selwood,
Cooper, and Livingston, 2007; Srinivasan, 2009).
The question “How often do you feel ill-treated within your family?”
was posed to all respondents in the LASI pilot survey. This question is not
an explicit question about abuse but taps a more general domain related
to perceptions of being treated poorly. About 7% stated “often” and 19%
responded by stating “some of the time.” However, no significant differ-
ence was observed between males and females and also between rural
and urban areas. It is also important to note that about three-fourth of
respondents stated that they never/hardly ever felt ill-treated within the
family. Reporting being ill-treated often is higher among lower-income
groups and also among the less educated. The findings of this survey are
in tune with prevalence estimates of earlier studies (Chokkanathan and
Lee, 2005).
Communication with Friends
Frequency of communication is often identified as an indicator of
closeness among social ties. In LASI, if the respondent has friends, the
question was asked, “On average, how often do you do each of the follow-
ing (meet up, speak on phone) with any of your friends?” This section
describes how often the older respondents maintain close relationships
with their friends through meeting with them or speaking over the phone.
The responses given were grouped into three categories: frequently, some-
times, and rarely. Nearly 85% of elderly meet up with a friend frequently.
Only 7% responded “rarely.” Meeting with a friend frequently is relatively
less common among urban residents and among females. Nearly half of
the older respondents (47%) talk with their friends over the phone fre -
quently. Among the older population, speaking over the phone is not as
frequent as meeting their friends. Half of the males and 42% of the females
speak with their friends frequently. Speaking frequently over the phone
is more common among higher economic groups and those with better
education.
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274 AGING IN ASIA
Financial Support Given to or Received from Family and Friends
LASI asked questions about household financial help given to or
received from family members and friends. Financial help includes giv -
ing money, helping pay bills, covering the cost of medical care or insur-
ance, schooling, marriages, religious events, rent for housing, and other
expenses. Only 5.5% of respondents (N = 81) received any financial help
from family; and only 7.4% (N = 110) gave any financial help to family.
While financial help is a relatively rare occurrence in this cohort, it is of
interest to note that support was given about as much as it was received
among older men and women and their families.
CONCLUSIONS
Social networks, family dynamics, and both positive and negative
aspects of these relationships are central to the well-being and functioning
of men and women across the globe. In this chapter, we have described
the basic relationships of older Indian men and women across four states
from the LASI pilot study. In this study, the vast majority of both men
and women are well connected both in terms of their intimate family ties
as well as to more extended, weaker social networks. While 4% of men
and 8% of women lived with neither spouse nor children, about 32% of
women were widowed. As India continues to experience demographic
and health transitions, it will be critical to monitor the ways in which
informal social networks from both family and friends will continue to
support Indians well into old age.
Another important aspect of these analyses points out that older men
and women both give and receive support. In our present analyses, this
is particularly true with regard to financial support. One critical aspect of
an aging society is the recognition that with increases in life expectancy
and healthier functioning into older ages, older men and women will be
able to contribute to the well-being of their families and communities
(Hughes et al., 2007; Verbugge and Chan, 2008). Older men and women
are not only on the receiving end of support, but also contribute to the
dynamic and interdependent aspects of social institutions (Cong and
Silverstein, 2011; Silverstein et al., 2002). This bidirectional force is often
less recognized as societies begin to have larger older populations with a
resultant undue emphasis on the burden of older people in rapidly evolv-
ing societies such as India.
Socioeconomic conditions, as well as rural versus urban geography,
may also shape patterns of social networks and perceptions about the
quality of social relations (Pinquart and Sörensen, 2000; Yen and Syme,
1999). In the LASI data, increasing education and income are associ -
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LISA BERKMAN, T.V. SEKHER, BENJAMIN CAPISTRANT, and YUHUI ZHENG
ated with a greater likelihood of social participation and having close
friends. This pattern is often found in Western industrialized countries,
particularly the United States (Berkman and Glass, 2000). In other studies,
participation in religious activities and ties with close family are not socio-
economically stratified as much as other types of contacts (Berkman and
Glass, 2000). Among both indicators on socioeconomic position, those
who are most disadvantaged are least likely to be satisfied with their
spouses. Within educational levels, those with primary-level education
are most likely to be satisfied with the relationship with their spouse.
Interestingly, rural residents are about twice as likely as urban residents
to report being satisfied with their spousal relationships. These differ-
ences suggest more subtle processes of either experience or evaluation of
social relationships (Gerstel, Riessman, and Rosenfield, 1985; Goldman,
Korenman, and Weinstein, 1995; Julien and Markman, 1991). It is impor-
tant to note, of course, that this is a cross-sectional study and that the
relationship between social networks and socioeconomic and geographic
locale is likely to be bidirectional with selection processes going in both
senses: that is, that social ties shape both socioeconomic opportunities and
geographic mobility.
Our initial analyses are descriptive; however, the next phases of anal -
yses will be aimed at gaining a more nuanced understanding of the social
networks of older men and women in India and the social and economic
forces that shape them. With more longitudinal data, we will be able to
understand the ways in which such social ties and the positive and nega -
tive aspects of these ties shape health outcomes and are, in turn, shaped
by them.
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