About LASI / Anouncement / LASI Components / LASI Pilot / LASI Team / LASI-Pilot DATA 

Although adult health and ageing is a subject that is increasingly being investigated, there are currently no comprehensive and internationally comparable survey data in India that cover and connect the full range of topics necessary to understand the economic, social, psychological, and health aspects of adults and the ageing process. Longitudinal Ageing Study in India (LASI) is designed to fill this gap.

LASI focuses on the health, economic, and social well-being of India's elderly population. LASI is conceptually comparable to the Health and Retirement Study (HRS) in the United States and is appropriately harmonized with other health and retirement studies, including its sister surveys in Asia – such as the Chinese Health and Retirement Longitudinal Study (CHARLS) and the Korean Longitudinal Study of Aging (KLOSA) – thereby allowing for cross-country comparison. LASI also takes account of features unique to India, including its institutional and cultural characteristics.

LASI will be a national landmark in scientific research that will allow a better understanding of India’s adult health problems and population ageing processes and will inform the design of appropriate evidence-based policies for adults and older people. We will build on the success of the LASI pilot survey and implement the first two waves of a large-scale, national and state representative panel survey on the health, economic status, and social behaviors of older people in India, with sufficient statistical power to test hypotheses in subpopulations of interest. LASI data will advance scientific knowledge and inform policymakers in India and elsewhere. Our public, internationally harmonized data will allow for cross-national comparative research studies on ageing.

We will field the full-scale, national LASI survey in 29 states and two union territories, with a self-representing sample in four metropolitan cities of India. The survey instrument will be based on the pilot survey instrument, which was carefully designed to collect information compatible with other Longitudinal Ageing Surveys, but that would also be appropriate to key contextual characteristics of India. The target sample for LASI is non-institutionalized Indian residents aged 45 and older and their spouses (irrespective of age). We will draw 45, 000 age-qualifying individuals from a stratified, multistage, area probability sampling design. The proposed sample is planned to be representative of India and 29 states and two union territories, and it will be sufficiently powered to make meaningful inferences at both national and state levels.

The LASI team in IIPS successfully conducted the 2010 LASI pilot survey in the four states of Karnataka, Kerala, Punjab, and Rajasthan to test survey tools and protocols and to learn lessons for the main wave. The analysis of LASI pilot data revealed insightful evidence on reported and measured health status, social network characteristics, income and consumption, retirement, and pensions.

Survey Instrument

The pilot study offered invaluable lessons for planning the baseline instrument. The pilot instrument was designed to collect information that is conceptually comparable to that of the HRS and its sister surveys in Asia, but that also captures characteristics specific to India.      

The LASI instrument comprises the household survey (carried out once for each household by interviewing the selected key informant) and the individual survey (which the interviewer carries out for each respondent). We aim to keep the same interview length for the baseline as the pilot study: approximately 30 minutes for the household interview, one hour for the individual interview, and 20 minutes for the biomarker protocol.

The household survey starts with the cover screen, containing questions about the demographic composition of the household and identifying key informants for the following household modules: (1) housing and environment section, consisting of questions about the household’s physical dwelling, residential history, and physical and social characteristics of neighborhood; (2) income, which attempts to capture the complete income of all household members from all sources, as well as remittances from non-household members; (3) assets and debts, including detailed questions appropriate to the Indian context; and (4) consumption, designed to collect data on both market-purchased and home-produced consumption at the household level.

The individual survey covers: (1) demographics, including birth date, sex, religion, caste, language, marital status, literacy, education, and questions designed to approximate age for illiterate respondents; (2) family and social networks, asking detailed questions about all immediate family members, including parents, children, and siblings, both alive and deceased, social activities, and psychosocial measures of life satisfaction, emotional proximity, social status, etc.; (3) health, consisting of questions about overall health and specific diseases, health events, functional health, mental health, health behaviors, and anchoring vignettes; (4) health insurance and services utilization, designed to capture access to and use of different types of health care providers; (5) work and employment, including questions about current job (including self-employment and (subsistence) agriculture) and employment history; (6) pensions, designed to reflect India’s growing pension scheme; and (7) expectations, i.e., questions developed to measure subjective probabilities of survival to specific ages, of working to specific ages, and of health conditions for illiterate survey respondents, using visual aids. The survey also includes the biomarkers module, which administers physical measures of health and collects dried blood spots.

Computer-Assisted Personal Interview (CAPI)

The LASI will employ 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.

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 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.

Drawing from the pilot protocol, we aim to collect anthropometry (i.e., height, weight, and hip and waist circumferences), functional assessment (i.e., blood pressure, lung function, vision test, gait speed, grip strength, and balance tests), and molecular biomarkers through the collection of dried blood spots (DBS). Each respondent participating in the biomarker module will receive a report on the measurements taken (but not on the DBS, unless abnormalities are revealed by the subsequent assays). If results are abnormal, respondents will be advised to seek medical care and will be given a referral letter to a local health center or doctor.

Our preliminary analyses of pilot data demonstrated our ability to collect high-quality biometric data from a large number of respondents. These analyses also show that such data appear to correlate meaningfully with other indicators of health.

To enhance the quality of biomarker data collected, we propose to: (1) improve the interviewer manual; (2) improve interviewer training led by the biomarker co-investigator, and (3) standardize the training protocol for state-level supervisors and individual interviewers.

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 have been performed and lessons drawn will be used 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.

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.

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 Ageing (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.

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.

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
T.V. Sekher, IIPS
S.K. Mohanty, IIPS
Arun Risbud, NARI
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

Technical Advisors

Grant Benson, University of Michigan
Kevin Feeney, RAND Corporation
Ashok Posture, IIPS
R.S. Reshmi, IIPS
Steven Heeringa, University of Michigan
Heather Lanthorn, Harvard University
Thomas McDade, Northwestern University
Jennifer O’Brien, Harvard University
Jessica Perkins, Harvard University
Teresa Seeman, University of California, Los Angeles
Zubin Shroff, Harvard University
Esther Ullman, University of Michigan
Sharon Williams, Purdue University
Joanne Yoong, RAND Corporation