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

Background

Population Ageing – What does it mean??

Source: United Nations 2015

• Invisible but gradual increase of elderly population in

India

• Challenges??

– Out of labour force

– Deteriorated health

– Weakening social ties

– More number of women

•

Background

Population Ageing: The Global

Scenario

Ageing by World Region

Source: United Nations 2015

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

Thank You