As published on The Hindu, authored by Abhinay Lakshman
With the decadal growth rate of the elderly population of India currently estimated to be at 41%, and the percentage of elderly population in the country projected to double to over 20% of total population by 2050, the United Nations Population Fund, India (UNFPA) in its 2023 India Ageing Report has said that by 2046 it is likely that elderly population will have surpassed the population of children (aged 0 to 15 years) in the country.
Over 40% poorest
More than 40% of the elderly in India are in the poorest wealth quintile, with about 18.7% of them living without an income, the report said, adding that such levels of poverty may affect their quality of life and healthcare utilisation.
The report, unveiled by the Secretary, Social Justice, Saurabh Garg and UNFPA India Representative, Andrea M. Wojnar on Wednesday in Delhi, projected that the population of people aged 80+ years will grow at a rate of around 279% between 2022 and 2050 with a “predominance of widowed and highly dependent very old women” - a finding in line with the pattern across several nations.
The data showed that women, on average, had higher life expectancy at the age of 60 and at the 80, when compared to men — with variations across States and Union Territories.
For instance, in Himachal Pradesh and Kerala, women at 60 years have a life expectancy of 23 and 22 years, respectively, which is four years greater than men at 60 years in these States — as compared to the national average differential of only 1.5 years, the report said.
Higher life expectancy
Life expectancy of women at 60 years is greater than 20 years in States such as Rajasthan, Haryana, Gujarat, Uttarakhand, Kerala, Himachal Pradesh, and the Union Territory of Jammu & Kashmir, raising concerns about their social and economic well-being, the report said.
Further, the sex ratio (females per 1,000 males) among the elderly has been climbing steadily since 1991, with the ratio in the general population stagnating. Between 2011 and 2021, the ratio increased in India as a whole and across all regions, barring the Union Territories and western India.
In the northeast and the east, while the sex ratio of the elderly increased, it remained below 1,000 in both years, indicating that men still outnumber the women in these regions even at 60-plus years.
This, however, is not true for the other regions (which has a bearing on the country’s average). “A case in point is central India, where the sex ratio went from 973 in 2011 to 1,053 in 2021, implying that the women caught up with and outperformed the men in survival after 60 years over the decade,” the report said.
‘Inherently gendered’
“Poverty is inherently gendered in old age when older women are more likely to be widowed, living alone, with no income and with fewer assets of their own, and fully dependent on family for support,” the report said, pointing out that the major challenges facing India’s ageing population are the feminisation and ruralisation of this older population and that policies must be designed to suit their specific needs.
The report noted that there was a significant inter-State variation in absolute levels and growth (and hence, share) of the elderly population as well, reflecting the different stages and pace of demographic transition across States.
Most States in the southern region and select northern States such as Himachal Pradesh and Punjab reported a higher share of the elderly population than the national average in 2021, a gap that is expected to widen by 2036, the report said.
While States reporting higher fertility rates and lagging in demographic transition, including Bihar and Uttar Pradesh, expect to see an increase in the share of the elderly population between 2021 and 2036, the level will remain lower than the Indian average, the report said. Compared with southern and western India, central and northeastern regions have the younger group of States as indicated by the ageing index.
“In the southern region, the old-age dependency ratio (elderly people per 100 people between 15 and 59 years) was higher than the national average at around 20 as is true of western India at 17. Overall, Union Territories (13) and the north-eastern region (13) reflected lower old age dependency ratios,” it said.
The report also reviewed the response of the government and state authorities to the needs of elderly people during the Covid-19 pandemic based on experiences of older people. It said that while most said they received state aid, this was not enough; that there were no accessible public healthcare facilities; and that nobody except NGOs or CBOs (community-based organisations) helped them. In light of this, the report called for a special focus on older persons in disaster-preparedness plans that are formulated henceforth.
The report added that there is a lack of credible data on various issues related to the elderly in India and more could be done by including questions on relevant and emerging issues related to older persons in the upcoming data collection exercises of the National Sample Survey, the National Family Health Survey, and the Census of India, respectively.
The UNFPA report suggested that the government must work on increasing awareness about schemes for older persons, bring all Old Age Homes under regulatory purview and focus on facilitating in-situ ageing to the extent possible.
Mr. Garg called the report, prepared a “valuable roadmap”, while Ms. Wojnar said it will become an important resource for scholars, policymakers, program managers, and all stakeholders involved in elder care.
The report used data from the 2011 Census, the 2017-18 Longitudinal Ageing Survey in India (LASI) conducted by the Health Ministry, population projections of the Government of India and the World Population Projection 2022 report, among other sources.
Among other suggestions, the report called for the government to encourage the creation and running of elderly self-help groups, and stressed the importance of having elderly people live in multigenerational households. The report also suggested that the government should encourage in situ (at home) ageing as much as possible by creating short-term care facilities like creches or day-care facilities, citing better care when elderly people live with their respective families.
