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Ageing in India: The Health Issues
Debasis Barik
November 5, 2016
India International Centre, New Delhi
Malcolm Adiseshiah
Mid-Year Review of the Indian Economy 2016-17
Outline
• Background
• Population Ageing: The Global Scenario
• Ageing in India: Facts and Figures
• Socio-demographic Profile of Indian Elderly
• Ageing and Health – The Linkages
• Health Scenario among Indian Elderly
• Challenges faced by the elderly in India
• Discussion
• Invisible but gradual increase of elderly population in
India
• Challenges??
– Out of labour force
– Deteriorated health
– Weakening social ties
– More number of women
•
Background
Ageing in India: Facts and Figures
12.6
8.6
6.7
0 2 4 6 8 10 12 14
KeralaTamil Nadu
PunjabHimachal Pradesh
MaharashtraAndhra Pradesh
OdishaKarnataka
UttarakhandHaryana
IndiaWest Bengal
GujaratMadhya Pradesh
ChhattisgarhUttar Pradesh
RajasthanBihar
Jammu & KashmirJharkhand
DelhiAssam
Percentage of Elderly Population to Total Population
Source: Barik et al. 2015
Socio-demographic Profile of Indian
Elderly
48 52
33.1 25.9
18.5 10.8 11.8
1
61.9
36.8
0.3 4
13.6 10.7
71.7
0
10
20
30
40
50
60
70
80
Sex
Ma
le
Fem
ale
Ag
e
60–
64
yea
rs
65–
69
yea
r
70–
74
yea
r
75–
79
yea
r
80
+ y
ears
Ma
rita
l S
tatu
s
Un
ma
rrie
d
Ma
rrie
d
Wid
ow
ed
Div
./S
ep
Fa
mil
y T
yp
e
Sin
gle
Co
up
le
Nu
clea
r
Jo
int
57.4
17.8 17.4
3.1 4 0.2
25.8
35.3
18.4
6.7 9.9
3.9
67.9
32.1
67.3
32.7
0
10
20
30
40
50
60
70
80
Ed
uca
tio
na
l L
evel
Illi
tera
te
Up
to
5th
Sec
on
da
ry
Met
ric
Gra
du
ate
Mis
sin
g
Rel
igio
n/C
ast
e
Fo
rwa
rd c
ast
e
OB
C
Da
lit
Ad
iva
si
Mu
slim
Oth
er
Res
ide
nce
Ru
ral
Urb
an
Wo
rkin
g
No
Yes
Source: Based on IHDS 2011-12
Ageing and Health – The Linkages
0
5
10
15
20
25
30
35
40
45
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80+
Pe
r c
en
t w
ith
an
y o
f th
e l
on
g t
er
m
illn
es
se
s
Age
Male Female
Prevalence of major morbidities increases with age
Source: Based on IHDS 2011-12
1990 2010
Communicable, new-born, nutritional and maternal
Causes of DALYs, both sexes, all ages,
India
Non-communicable
Injuries
Source: The GBD Studies 2013
Elderly Health in India
Rising prevalence (per cent) of various major illnesses among the elderly
in India between 2004–05 and 2011–12.
2004–05 2011–12
Rural Urban Total Rural Urban Total
Cataract 4.4 4.2 4.4 8.1 7.3 7.9
Tuberculosis 0.9 0.6 0.8 1.2 0.9 1.1
High BP 5.0 11.6 6.6 8.5 18.9 11.5
Heart Disease 1.1 4.4 1.9 2.1 4.7 2.9
Diabetes 3.1 7.1 4.0 4.4 12.3 6.7
Cancer 0.2 0.3 0.2 0.2 0.4 0.3
Paralysis 0.8 1.0 0.9 1.8 2.5 2.0
Mental Illness 0.2 0.1 0.2 0.7 0.5 0.6
Any difficulty in Performing ADL* 10.6 10.3 10.6 29.9 28.5 29.5
Unable to perform ADL* 4.2 3.1 3.9 11.8 10.5 11.4
Source: Based on IHDS 2004-12
Elderly Health…
• Prevalence of all the morbidities, mentioned in the table
have increased between the two surveys
• Cataract is the commonly reported health problem which
reduces the visual acuity among the elderly
• Higher prevalence of chronic morbidities like high Blood
Pressure (BP), heart disease and diabetes among the
elderly residing in urban areas than rural
• Awareness about the disease and access to medical
facilities explain the reporting pattern
• ADL – Any difficulty 30%; Unable 11%
Health Expenditure by Income Class
Rich household with elderly spend more
7749
5560
7988
10584
13380
0
2000
4000
6000
8000
10000
12000
14000
16000
Lowest Second Third Fourth Highest
Household Income Quintile
Major Morbidities
Source: Based on IHDS 2011-12
Challenges faced by the elderly in India
• Decline in traditional value system and the joint family system
• Declining familial support, economic insecurity, social isolation, elder abuse lead to a host of psychological illnesses(Ingle and Nath 2008)
• Lack of social security and inadequate facilities for health
care, rehabilitation, and recreation
• Pension and social security are restricted to government employees or organised sector employee (Kartikeyan, Pedhambkar and Jape 1999)
• Whereas, 30% of the aged male and close to 75% of the aged females were economically dependend
Challenges faced by the elderly in India
• 72 per cent of elderly people in India still live in a joint
family, despite a majority of them are subject to suffer from
psychological stress (Bose 1997)
• Geriatric facilities available in tertiary care centres which are
concentrated in urban localities
• More number of females – inefficient government programs
• Health insurance
Discussion
• The risk of non-communicable are on rise among the adults
and elderly from higher economic strata
• There should be higher number of geriatric care centres at
rural places
• A multi-disciplinary team specifically trained to meet the
needs of the geriatric population need to be created
• The uneven expenditure for major illnesses among elderly
from various economic groups calls for the government’s
intervention to help the poor to get treatment for these
ailments
• Promoting the youth to take up nutritious diet and enhanced
physical activities could be a long term solution