An anatomy of old-age disability in low- and middle-income countries: Time use, emotional experiences and subjective wellbeing

Old-age disability is generally associated with poor socioeconomic outcomes and low levels of general life satisfaction. Yet, there is only limited evidence on the association between old-age disability, time use, emotional experiences during activities and corresponding experienced wellbeing, especially in developing countries. To fill this gap, our study explores differences in time use, emotional experiences during activities and experienced wellbeing between older persons with and without disabilities using novel day-reconstruction data from five low- and middle-income countries. We use data on persons aged 50 and older from the first wave of the WHO Study on Global AGEing and Adult Health (SAGE) conducted between 2007 and 2010 in China, Ghana, India, the Russian Federation and South Africa. The final sample consists of 22,136 individuals. In line with the International Classification of Functioning, Disability and Health, we define disability based on a composite measure of self-reported difficulties with cognition, mobility, self-care, life activities and participation. Our main outcome of interest—experienced wellbeing—is measured on the basis of an abbreviated version of the Day Reconstruction Method (Kahneman et al., 2004), which combines data on time use and emotional experiences during activities performed throughout the day. For each country, we use linear regression and multivariate fractional regression models to assess differences in time allocation, activity-specific emotional experiences and resulting experienced wellbeing between older persons with and without disabilities. Differences in experienced wellbeing between persons with and without disabilities are then decomposed into 1) a saddening effect and 2) a time-composition effect. The saddening effect describes differences in experienced wellbeing due to differences in emotional experiences during daily activities treating the allocation of time as fixed. Likewise, the time composition effect isolates the impact of differences in time use on experienced wellbeing, treating emotional experiences across activities as fixed. We find that average experienced wellbeing is lower for persons with disabilities than those without disabilities. We first show that persons with disabilities report lower emotional experiences during all activities. Yet, disability is also associated with more time spent in more pleasant leisure and self-care activities and less time in unpleasant work-related activities. While this positive time composition effect partially compensates for the negative saddening effect of disability on experienced wellbeing, it is not strong enough to fully compensate for the overall wellbeing disadvantage of persons with disabilities. In sum, persons with disabilities in low- and middle-income countries report lower levels of experienced wellbeing due to lower emotional experiences, which can be partially mitigated by changes in time allocation. From a policy perspective, our results suggest that a combination of facilitating the performance of daily tasks and more flexibility in terms of work arrangements may proof beneficial for the experienced wellbeing of persons with disabilities.