Adverse self-rated health transition among older adults in India: a retrospective life course approach

Self-rated health (SRH) is a validated epidemiological measure that captures an individual's overall health perception and predicts morbidity and mortality. Despite extensive research on SRH among older adults in India, evidence on its transition across the life course remains limited. Using data from 70,595 individuals aged 45 years and above from the Longitudinal Aging Study in India (LASI) 2017-2018, this study examined transitions in SRH from childhood to older adulthood. An adverse SRH trajectory was defined as a shift from good childhood health to poor or fair health in later life. Descriptive, bivariate, and multivariable logistic regression analyses were conducted. Overall, 51% of older adults experienced an adverse SRH trajectory. Higher odds were observed among women (AOR: 1.30), individuals with substance consumption (AOR:1.24), chronic multimorbidity (AOR: 3.37), functional limitations (AOR: 2.03), and depression (AOR: 1.51). Early-life disadvantages - child labour, child marriage, and persistent household poverty - were also significant risk factors. In contrast, higher education and participation in social and physical activities were protective. These findings indicate that an adverse subjective health trajectory is shaped by cumulative life-course exposures rather than ageing alone. Strengthening early-life social investments and community-based wellness initiatives is vital to promote healthy and equitable ageing in India.