Chapter 3 DEMOGRAPHY OF ELDERLY POPULATION IN...

Chapter 3

DEMOGRAPHY OF ELDERLY POPULATION IN INDIA

The ageing of a population is an obvious consequence of the

process of demographic transition. Being ahead in this process, the

developed regions of the world have experienced its consequences and

the developing world is well on its way to facing a similar scene.

Developing countries have more elderly persons in absolute terms

because of their large population base. A recent emphasis on studies

pertaining to the elderly in the developing world is due to their increasing

numbers and deteriorating conditions. While their increasing number is

attributed to demographic transition, their deteriorating condition is

considered as the end result of the fast eroding traditional family system

in the wake of rapid modernization and urbanization. As neither of the

circumstances is avoidable, the reason seems to be the lack of adequate

preparedness. However, the available studies have addressed multiple

dimensions of the situation of the elderly by projecting their future size

and composition, assessing their needs and difficulties with regard to

health, social adjustment in old age etc.

The projected increase in both the absolute and relative size of

the elderly population in many Third world countries is a subject of

growing concern for social policy (World Bank 2001, United Nations

2002). These increases are the result of changing fertility and mortality

regimes over the last 40 years. Reduction in mortality means a longer

life span for individuals. Population ageing involves a shift from high

mortality/high fertility to low mortality/low fertility and consequently

an increased proportion of older people in the total population.

Population ageing had far-reaching effects, especially in

developing countries. It was fertility decline that caused shrinkage of

the younger population while the older population increased. In

Europe or developed countries this happened very slowly, since

decline in fertility was spread over a century or so.

43

The changing proportions of the aged have been accompanied

by steady decline in the proportions of children. Over the half century

the proportion of children (0-14 years) dropped worldwide from 34.3

percent in 1950 to 30 percent in 2000. In the MDRs the proportion of

persons aged 60 years and above is slightly higher than the proportion

of children below 15 years of age. Age distribution changes have been

very slow in the LDRs and Asia. Substantial changes are, however

expected to occur in the next 50 years. (United Nations, 2002)

The number of elderly in the developing countries has been

growing at a phenomenal rate. The two major population giants of

Asia are India and China, because they are sharing a significant

proportion of this growing elderly population. The Indian aged

population is currently the second largest in the world to that of china

with 100 million of the aged. The absolute number of the over 60

population in India will increase from 77 million 2001 to 137 million

by 2021. Hence, there arises a need to understand the socio-economic

as well as demographic dynamics of the elderly population in general

(Irudaya Rajan, Sharma and Mishra, 2003). In the present chapter, we

have analysed the different aspects of ageing in India using NSSO

surveys for different years, Census of India, Sample registration

system etc.

POPULATION AGEING IN INDIA

The UN defines a country as “Ageing” or “Greying Nation” where

the proportion of people over 60 reaches 7 percent to total population.

By 2011 India has exceeded that proportion (8.0 percent) and is

expected to reach 12.6 percent in 2025. In order to study the

implications of an ageing population in India, the changing Indian

demographic configuration needs to be highlighted first. Here, we have

analysed the following for this purpose.

44

Size and Growth of Elderly Population

In India, as a result of the change in the age composition of the

population over time, there has been a progressive increase in both

the number and proportion of aged people. The Indian population has

increased from 361 million in 1951 to 1.027 billion in 2001 and

further to 1.21 billion in 2011. Simultaneously, the number of older

people has increased from 19 million (i.e. 4 percent of total

population) to 77 million and further to roughly 93 million (i.e. 7.5

percent of the total) during the same time span (Registrar General of

India, SRS Statistical Report 2011).

Table 3.1 shows that percentage share of elderly population in

total population by sex in India. According to Census of India, there

has been a steady rise in the share of elderly population (aged 60

years or above) in the total population over the decades. The

proportion of elderly people in the population of India rose from 5.6

percent in 1961 to 7.5 percent in 2001. According to SRS statistical

report, in 2011 it rose further to 8.0 percent.

Table 3.1 Percentage share of elderly population

(aged 60 years and above) in total population by sex in India

Years Male Female Total Rural Urban

1961 5.5 5.8 5.6 5.8 4.7

1971 5.9 6.0 6.0 6.2 5.0

1981 6.4 6.6 6.5 6.8 5.4

1991 6.7 6.8 6.8 7.1 5.7

2001 7.1 7.8 7.5 7.7 6.7

2011 7.7 8.4 8.0 8.1 7.9

2004-05 6.9 7.5 7.2 7.3 7.0

2007-08 7.3 7.7 7.5 7.6 7.2

Source: Census of India for 1961-2001, NSSO Survey 2004-05 and 2007-08, SRS (Sample Registration System) Statistical Report 2011

45

For males the rise was more modest from 5.5 percent to 7.1

percent, while for females there had been a steep rise from 5.8 percent to

7.8 percent during five decadal Censuses from 1961 to 2001. In 2011,

the elderly population accounted for 8.0 percent of total population. For

males it was marginally lower at 7.7 percent while for females it was 8.4

percent. According to NSSO surveys, the proportion of elderly in the

population of India rose from 7.2 percent in 2004-05 to 7.5 percent in

2007-08. The proportion of elderly males rose from 6.9 percent in 2004-

05 to 7.3 percent in 2007-08, while on the other hand the proportion of

elderly female rose from 7.5 percent to 7.7 percent during the

corresponding period (Figure 3.1). In rural areas the proportion of elderly

population rose from 5.8 percent in 1961 to 8.1 percent in 2011 and on

the other hand in urban areas it rose from 4.7 percent to 7.9 percent

during the corresponding period. According to NSSO surveys the

proportion of elderly population in rural areas was 7.3 percent during

2004-05 and increased up to 7.6 percent in 2007-08. While on the other

hand in urban areas the proportion of elderly population rose from 7.0

percent to 7.2 percent during the corresponding period. It has been

observed that the percentage share of elderly to total population

remained higher in rural areas than in urban areas.

Distribution of population of India by broad age groups has

been depicted in Table 3.2.

Table 3.2 Percent distribution of population by broad age groups, India Since 1951

Years Age Groups

0-14 15-59 60+ Total

1951 38.4 56.1 5.5 100.0

1961 41.1 53.3 5.6 100.0

1971 42.0 52.0 6.0 100.0

1981 39.7 53.9 6.4 100.0

1991 37.6 55.7 6.7 100.0

2001 35.3 56.9 7.5 100.0

2011 29.5 62.5 8.0 100.0

Source: Census of India for 1951-2001, SRS (Sample Registration System) Statistical Report 2011

47

Dividing the total population into three major age groups (i.e.

age in years 0-14, 15-59 and 60 and above) it has been observed

that the proportion of population in the younger age-groups (0-14

years) has dropped sharply after 1971, and accordingly the

proportion of population in the working-age-group (15-59 years) and

the aged (60 years and above) has shown a tendency to increase.

The proportion of population in the 0-14 age group which was 41.1

percent in 1971 dropped to about 35.3 percent in 2001 and further

to 29.5 in 2011 (SRS Statistical Report, 2011). While the proportion

of elderly population (60 years and above) which was about 5.5

percent during 1971 rose sharply to 7.5 percent in 2001. According

to SRS, Statistical Report, it further rose to 8.0 in 2011. In other

words, the process of ageing of population has already begun in

India (Figure 3.2).

In India, as a result of the change in the age composition of

the population over time, there has been a progressive increase, in

the number and proportion of aged people. Table 3.3 shows

distribution of elderly population to total population in India by

age-groups during the period 1961-2001.

In absolute terms elderly population (60+) increased from

mere 25 million in 1961 to 43 million in 1981 and further to 77

million in 2001 (i.e. more than thrice). The proportion of the

population who are aged 60 or over has been increasing

consistently over the last century, particularly after 1951. The

proportion of elderly persons in the total population of India rose

from 5.6 percent in 1961 to 6.49 percent in 1981 and further to

7.5 percent in 2001.

49

Table 3.3 Numbers and Proportion of Elderly in the Indian Population by Age-Groups, 1961-2001

Number (in millions) Percentage (%)

1961 1971 1981 1991 2001 1961 1971 1981 1991 2001

60+ 25 33 43 57 77 5.6 6 6.49 6.76 7.5

70+ 9 11 15 21 29 2 2.1 2.33 2.51 2.9

80+ 2 3 4 6 8 0.6 0.6 0.62 0.76 0.8

90+ 0.5 0.7 0.7 1 n.a. 0.1 0.1 0.1 0.2 n.a.

100+ 0.01 0.01 0.01 0.01 n.a. 0.02 0.02 0.02 0.02 n.a.

Source: Census of India for the period 1961-2001

This was true to other age cohorts too. The elderly

population aged 70 and above was 29 million in 2001 while it was

only 9 million in 1961 and 21 million in 1991. Beside the

proportion of elderly above 70 in the total population increased

from 2 percent in 1961 to 2.9 percent in 2001.

The elderly population aged 80 years and above was 2 million

in 1961 and rose up to 8 million in year 2001. The proportion of

elderly with age 80 years and above rose from 0.6 percent in 1961

to 0.8 percent in 2001. The absolute share of the elderly, with age

90 years and above, rose from 0.5 million in 1961 to 1 million in

1991. Their proportion became double during the corresponding

period (from 0.1 percent in 1961 to 0.2 percent in 1991) (Figure

3.3).

50

The gender-wise distribution of aged (60+) in total population for

different states has also been shown in Table 3.4. Two interesting

observations have been observed, first regarding inter-state variation

in size distribution of the elderly population, it has been observed that

the share of aged population in most of the states exceed than all-

India level (8.0 percent). This was particularly true for Kerala,

Himachal Pradesh, Maharashtra, Punjab, Tamil Nadu, Orissa and

Karnataka. Among the states the proportion of elderly in total

population was more than 8 percent in Maharashtra, Tamil Nadu,

Punjab, Himachal Pradesh. In Kerala the proportion of elderly in total

population of the state was highest (12.6 percent) in year 2011.

Secondly, regarding feminization of the elderly population it has been

found that elderly female outnumbered elderly male in almost every

state except Bihar, Haryana, Punjab and Uttar Pradesh.

Table 3.4 Size of elderly population (aged 60+) and their share in total population in major states of India in 2011

All India and selected major states

Proportion of elderly in total population of State

Male Female Total

Andhra Pradesh 8.3 9.4 8.8

Bihar 7.2 6.7 7.0

Gujarat 7.6 9.0 8.3

Haryana 6.6 7.6 7.1

Himachal Pradesh 10.4 10.3 10.4

Karnataka 7.9 8.9 8.4

Kerala 11.8 13.3 12.6

Madhya Pradesh 6.8 7.4 7.1

Maharashtra 8.8 9.7 9.3

Orissa 9.1 9.5 9.3

Punjab 9.1 10.0 9.5

Rajasthan 6.6 7.9 7.2

Tamil Nadu 10.2 10.9 10.5

Uttar Pradesh 6.6 7.1 6.8

West Bengal 8.2 8.2 8.2

All India 7.7 8.4 8.0

Source: SRS Bulletin (Sample Registration System) October, 2012, Registrar General of India, New Delhi

52

In India, as a result of the change in the age composition of the


the number and proportion of aged people. The proportion of the

population aged 60 years or more has been increasing over the last

century, particularly after 1951. The decadal growth rate of India’s

elderly population and of the general population, for the period 1951

to 2001 has been depicted in Table 3.5. It shows once again that the

aged population in India has grown very steadily since 1951 at a

much faster rate as compared to that of general population all

through during 1951 to 2001 and more so during the period 1961 to

1981. A decadal growth rate of 23.9 percent recorded for the elderly

population during 1951-1961, increased to more than 33 percent

during the decades 1961-71 and 1971-81 as against around 25

percent decadal growth in general population during the period.

During period 1981-1991 decadal growth rate of elderly population

declined to 29.7 percent and further to 25.2 percent during 1991-

2001 as against 23.87 percent growth in general population during

period 1981-1991 and 21.54 percent during 1991-2001 (Figure 3.4).

Table 3.5 Decadal Growth in elderly population vis-à-vis that of general population in India

Period Percentage change in general population

Percentage change in elderly population

1951-1961 + 21.64 + 23.9

1961-1971 +24.80 +33.7

1971-1981 +24.66 +33.0

1981-1991 +23.87 +29.7

1991-2001 +21.54 +25.2

Source: Census of India for 1951-2001

However, since then there has been a steady decline in the

decadal growth rate of aged population although it has outpaced the

growth of general population.

53

The Trend in the Sex Ratio of the Elderly Population

The progressive increase in the proportion of females to males in

the elderly population is also evident in the trend in the sex ratio of

elderly population aged 60 years or over. Table 3.6 depicts the Trend

in Sex Ratio (females per 1000 males) for elderly and the general

population according to Census of India. The sex ratio among elderly

people was as high as 1028 in 1951 but subsequently dropped to

about 938 in 1971, but has finally increased again to about 972 in

2001 (Figure 3.5). It has been found that there was relatively higher

ratio of females to males in elderly population than in the general

population for all the years since independence.

Table 3.6 Trend in Sex ratio (Number of Females per 1000 males) for elderly and the general population.

Years Sex Ratio of Elderly

population Sex Ratio of General

population

1951 1028 946

1961 1000 941

1971 938 930

1981 960 934

1991 930 927

2001 972 933

Source: Census of India for 1951-2001

Table 3.7 depicts the Trend in Sex Ratio for elderly according to

different NSS estimates. The NSS estimates showed a rising trend in sex

ratio for elderly during the period 1993-94 to 1995-96 but declined

between 1995-96 and 2004. Sex ratio was 984 during 1993-94 and

increased upto 1023 during 1995-96 and further declined to 999 in 2004.

Table 3.7 Trend in Sex ratio (Number of Females per 1000 males) for elderly (NSS Surveys)

Period Sex Ratio of Elderly population

NSS 43rd Round (1987-88) 983

NSS 50th Round (1993-94) 984

NSS 52nd Round (1995-96) 1023

NSS 60th Round (Jan.-June, 2004) 999

Source: Various rounds of NSS Surveys.

55

FACTORS RESPONSIBLE FOR AGIENG OF POPULATION IN INDIA

The changes in the age structure which occurred in the

developing countries, leading to the ageing of the population, are

primarily because of the long term downward trend in the birth rates

in these economically advanced countries. Secondly, there is

substantial improvement in life expectancy throughout the world. This

is particularly due to a reduction in child mortality which reflects

improvement in public health and medical advances in the prevention

of many fatal infectious diseases in childhood. Since the mortality

level of the developed countries was already low and the expectation of

life at birth was very high, further improvement in mortality condition

in these countries affected the older age groups and led to a further

ageing of the population. On the other hand, the age structure of the

developing countries has remained virtually unchanged because their

birth rates have remained more or less at high levels, though their

death rates have been declining since the 1950s. These developing

countries have also started experiencing the fall in their birth rates

since the last two to three decades. The relatively faster decline in

birth rates than in the death rates in the developing countries like

India is however a recent phenomenon.

Total Fertility Rate, Crude Birth Rate and Crude Death Rate

Fertility decline has been the primary determinant of population

ageing (United Nations 2002). Table 3.8 depicts the crude birth rate

and total fertility by residence in India. Total Fertility Rate declined

from 4.5 percent in 1981 to 2.4 percent in 2011. Rural-urban

differences have been observed in fertility rates. Rural areas have

shown higher fertility rates as compared to that of urban areas for all

the years.

57

Table 3.8 Crude Birth Rate (CBR), Crude Death Rate (CDR) and Total Fertility Rate (TFR) by residence over time in India

Year Crude Birth Rate (CBR)

Crude Death Rate (CDR)

Total Fertility Rate (TFR)

Rural Urban Total Rural Urban Total Rural Urban Total

1981 35.6 27.0 33.9 13.7 7.8 12.5 4.8 3.3 4.5

1982 35.5 27.6 33.8 13.1 7.4 11.9 4.9 3.4 4.5

1983 35.3 28.3 33.7 13.1 7.9 11.9 4.9 3.4 4.5

1984 35.3 29.4 33.9 13.8 8.6 12.6 4.8 3.5 4.5

1985 34.3 28.1 32.9 13.0 7.8 11.8 4.6 3.3 4.3

1986 34.2 27.1 32.6 12.2 7.6 11.1 4.5 3.1 4.2

1987 33.7 27.4 32.2 12.0 7.4 10.9 4.4 3.2 4.1

1988 33.1 26.3 31.5 12.0 7.7 11.0 4.3 3.1 4.0

1989 32.2 25.2 30.6 11.1 7.2 10.3 4.2 2.8 3.9

1990 31.7 24.7 30.2 10.5 6.8 9.7 4.1 2.8 3.8

1991 30.9 24.3 29.5 10.6 7.1 9.8 3.9 2.7 3.6

1992 30.9 23.1 29.2 10.9 7.0 10.1 3.9 2.6 3.6

1993 30.4 23.7 28.7 10.6 5.8 9.3 3.8 2.8 3.5

1994 30.5 23.1 28.7 10.1 6.7 9.3 3.8 2.7 3.5

1995 30.0 22.7 28.3 9.8 6.6 9.0 3.9 2.6 3.5

1996 29.3 21.6 27.5 9.7 6.5 9.0 3.7 2.4 3.4

1997 28.9 21.5 27.2 9.6 6.5 8.9 3.6 2.4 3.3

1998 28.0 21.1 26.5 9.7 6.6 9.0 3.5 2.4 3.2

1999 27.6 20.8 26.1 9.4 6.3 8.7 3.5 2.3 3.2

2000 27.6 20.7 25.8 9.3 6.3 8.5 3.5 2.3 3.2

2001 27.1 20.3 25.4 9.1 6.3 8.4 3.4 2.3 3.1

2002 26.6 20.0 25.0 8.7 6.1 8.1 3.3 2.2 3.0

2003 26.4 19.8 24.8 8.7 6.0 8.0 3.2 2.2 3.0

2004 25.9 19.0 24.1 8.2 5.8 7.5 3.3 2.1 2.9

2005 25.6 19.1 23.8 8.1 6.0 7.6 3.2 2.1 2.9

2006 25.2 18.8 23.5 8.1 6.0 7.5 3.1 2.0 2.8

2007 24.7 18.6 23.1 8.0 6.0 7.4 3.0 2.0 2.7

2008 24.4 18.5 22.8 8.0 5.9 7.4 2.9 2.0 2.6

2009 24.1 18.3 22.5 7.8 5.8 7.3 2.9 2.0 2.6

2010 23.7 18.0 22.1 7.7 5.8 7.2 2.8 1.9 2.5

2011 23.3 17.6 21.8 7.6 5.7 7.1 2.7 1.9 2.4

Note: Estimates of vital rates at the National Level upto 1995 do not include Mizoram as the SRS was not operational in Mizoram till 1995.

Source: SRS, Registrar General, Vol. 46 No. 1 January 2012, India & SRS-2010 (April, 2012), SRS Statistical Report 2011

Crude Death Rate (CDR) is another important measure as it, in

58

combination with the crude birth rate determines population growth

rate. It is the number of deaths in a year per 1000 population of the mid-

year population. It registered a decline from 12.5 deaths per 1000

population in 1981 to 7.1 deaths per 1000 population in 2011 i.e. a

decline of 43.2 per cent. The maximum decline in CDR was observed

during the first period 1981-90. On comparing the CDR in rural and

urban areas, it has been found that though the CDR declined in both

rural and urban areas but still a big difference existed between them

(Table 3.8). The CDR decline was higher in rural areas as compared to

the urban areas. Better control of famines, better management of natural

disasters, better medical facilities, improvement in public health and

sanitation, decline of major killer diseases like cholera, tuberculosis etc,

better control of epidemics, spread of education and immunization

programmes have helped to bring down the crude death rate in India.

Life Expectancy

With the rapid advancement in medical science and technology

it has now become easier to control various dreaded diseases which

were the cause of high mortality earlier. This has resulted in a steady

increase in the expected length of life or life expectancy at birth or life

expectancy at age 0. Due to various biological factors, generally

women live longer than men but still because of some social factors

adverse to women, India is one of the few countries of the world where

life expectancy at birth was slightly in favour of males till about 1980.

However, because of improvement in the various socio-economic

conditions since then, women’s life expectancy is now higher than

men’s in India as observed in most of the other countries of the world.

It can be interpreted as the ageing transition is a structural shift

in the age composition from a conical shaped age pyramid with a wide

base and rapidly narrowing off towards its apex, characterising high

fertility and mortality conditions in pre-transitional stages, towards a

barrel shaped age pyramid resting on a relatively shortened base and

59

slowly tapering off towards its apex, characterising low fertility and

mortality conditions in the advanced stages of demographic

advancement (Gulati 1989).

Table 3.9 Life expectancy at selected ages by sex over time in India

At age

(years)

Period Male Female Total

0 1970-75

1976-80

1981-85

1986-90

1991-95

1996-00

2001-05

2002-06

50.5

52.5

55.4

57.7

59.7

61.0

62.3

62.6

49.0

52.1

55.7

58.1

60.9

62.7

63.9

64.2

49.7

52.3

55.5

57.7

60.3

61.9

63.2

63.4

60 1970-75

1976-80

1981-85

1986-90

1991-95

1996-00

2001-05

2002-06

13.4

14.1

14.6

14.7

15.3

15.8

16.4

16.7

14.3

15.9

16.4

16.1

17.1

17.8

18.7

18.9

13.8

15.0

15.4

15.4

16.2

16.9

17.7

17.9

70 1970-75

1976-80

1981-85

1986-90

1991-95

1996-00

2001-05

2002-06

8.6

9.6

9.7

9.4

10.0

10.4

10.9

10.9

9.2

10.9

11.0

10.1

11.0

11.7

12.3

12.4

8.9

10.2

10.2

9.9

10.6

11.1

11.7

11.8

Source: Sample Registration System (SRS) Office of the Registrar General, India.

60

Table 3.9 gives the figures for life expectancy at selected ages by

sex over time in India. Life expectancy at birth rose steadily and by

1990 had reached 60 years (61 for females and 60 for males). The life

expectancy at birth for females has been rising continuously. Earlier

in 1970-75 it was 49 years for females and 51 years for males and

during 2002-06, it was 64 years for females and 63 years for males. It

has been found that life expectancy was higher among urban people

than among the rural people. In 2002-06 it was 69 years in urban

areas and 62 years in rural areas (Figure 3.6).

Life expectancy at higher ages like 60 years, 70 and above

calculates the average remaining length of life for those who have

already attained the specified age. Life expectancy at age 60 was found

to be about 14 years for the period 1970-75 which increased to 18

years, for the period 2002-06. For males it rose from 13 years to 17

years and for females from 14 years to 19 years during the

corresponding period. At age 70, life expectancy in India was found to

be less than 12 years (11 for males and 12 for females) during the

period 2002-06.

Table 3.10 shows the expectation of life at birth and at age 60

for major states of India by sex for the period 1996-00 and 1997-01.

Among the major states of India, while the expectation at birth was

highest in Kerala (70.8 for males and 76.2 for females) for the period

1997-01 followed by Punjab (67.2 for males and 69.3 for females), but

if we look at life expectation at age 60 Punjab stood at top (20.2 for

males and 21.2 for females). In terms of male expectation of life at age

60 for the period 1997-01, Punjab was followed by Haryana (19.0)

whereas in female life expectancy at 60, Kerala (20.6) followed Punjab.

Demographically disadvantaged states such as Bihar, Madhya

Pradesh and Orissa had lowest life expectancy at birth but for Bihar,

life expectancy at age 60 was higher than Maharashtra, Tamil Nadu

and Gujarat.

62

Table 3.10 Expectation of life at birth and at age 60 for major states of India by sex, 1996-00 & 1997-01

States 1996-00 1997-01

At birth At age 60 At birth At age 60

Male Female Male Female Male Female Male Female

Andhra Pradesh 61.7 64.3 15.9 16.8 61.9 64.4 15.9 16.9

Bihar 60.9 59.1 16.4 16.6 61.1 59.3 16.7 16.9

Gujarat 62.1 64.0 15.2 16.8 62.3 64.2 15.3 16.8

Haryana 64.4 65.1 19.0 19.5 64.6 65.2 19.0 19.6

Himachal Pradesh 65.4 66.0 17.5 17.1 65.5 66.1 17.7 17.3

Karnataka 62.5 65.8 15.9 17.7 62.6 66.0 16.0 18.0

Kerala 70.7 76.1 18.6 20.5 70.8 76.2 18.8 20.6

Madhya Pradesh 56.6 56.3 14.8 15.3 56.7 56.4 14.9 15.6

Maharashtra 64.7 67.2 16.5 17.4 64.8 67.3 16.7 17.5

Orissa 57.8 58.0 15.4 15.3 58.0 58.2 15.6 15.5

Punjab 67.1 69.2 20.2 21.3 67.2 69.3 20.2 21.2

Rajasthan 60.1 61.1 15.3 17.1 60.3 61.3 15.4 17.2

Tamil Nadu 63.9 65.9 15.8 16.2 64.1 66.1 15.9 16.5

Uttar Pradesh 59.1 57.9 15.1 16.3 59.2 58.1 15.2 16.5

West Bengal 63.0 64.5 15.7 16.9 63.2 64.6 16.0 17.0

Source: Sample Registration System (SRS) Office of the Registrar General, India.

An important feature of population ageing is therefore the

greater longevity of women than men, a differential which has

increased during the latter half of the twentieth century. The

63

female/male discrepancy in life expectation increased during 1991-2001

and is expected to continue. The reason for this differential decline was

not yet very clear, particularly in view of the fact that status of women

was very low which was reflected in the neglect of their health and well-

being at all ages in the developing counties like India. However, the

improvement in life expectancy was particularly due to a reduction in

child mortality which reflected improvements in public health and

medical advances in the prevention of many fatal infectious diseases in

childhood. Increase in the life expectancy of older people reflected

improvement in the quality of life in the later part of the twentieth

century and to a limited extent some of the achievements of medical

science, although we are not yet successful in combating some of the

illnesses that are major causes of death among the elderly such as heart

attacks, lung cancer, stroke and circulatory diseases. These are major

causes of death for both men and women in the older ages, but they do

not become as important for women until later in the age curve. Thus

these factors differentially affect the sexes within the same age cohort

and contribute to the increasing longevity of women to men.

Age-Specific Death Rate

The age specific death rates in the older age groups by sex give

an idea about the health status of the elderly persons, in the Indian

society. Table 3.11 depicts Age-specific death rate (per 1000) of elderly

population by sex in India. The age specific death rate gives the

number of deaths, during a given time period, of persons of a

particular age group per 1000 persons in that age group.

There was sharp rise in age-specific death rate with age from 20

(per 1000) for persons in the age group 60-64 years to 74 among those

aged 75-79 years and 168 for persons aged 85+. Also for all the broad

age-groups, the rates for males were invariably more than that

forfemales. This progressive advantage in favour of women in the

elderly population is primarily due to the increasingly lower mortality

64

rates of women at middle to late ages compared with men (Figure 3.7).

Table 3.11 Age-specific death rate (per 1000) of elderly population by sex and residence in India, 2011

Age group Male Female Total

60-64 23.8 16.1 20.1

65-69 40.1 26.7 33.2

70-74 58.1 42.5 49.9

75-79 81.5 66.4 73.6

80-84 115.9 95.1 104.8

85+ 183.6 154.8 167.6

Source: SRS (Sample Registration System) Statistical Report 2011

Table 3.12 shows the Age-specific death rate (per 1000) for

broad age-groups of elderly population in states of India. Among

states the age-specific death rate among elderly was relatively lower in

Himachal Pradesh, Kerala, Punjab and highest in Andhra Pradesh,

Bihar, Maharashtra, Orissa, Madhya Pradesh etc.

Table 3.12 Age-Specific death rate (per 1000) for broad age-groups

of elderly population in states of India 2011

State Broad age groups (years) for elderly population

60-64 65-69 70-74 75-79 80-84 85+

Andhra Pradesh 22.8 34.3 53.3 68.1 90.7 125.2

Bihar 20.4 33.9 56.8 73.6 106.9 168.8

Gujarat 18.7 29.8 50.5 54.8 98.3 150.4

Haryana 19.2 32.3 47.0 59.7 70.3 198.9

Himachal Pradesh 14.5 28.6 37.8 66.7 105.8 116.2

Karnataka 18.8 31.8 44.8 83.0 108.1 169.0

Kerala 15.1 21.2 36.0 67.1 97.6 202.7

Madhya Pradesh 24.6 35.6 71.7 87.0 146.3 159.3

Maharashtra 20.5 28.4 45.2 73.1 98.4 159.1

Orissa 22.0 32.2 50.6 74.2 115.5 186.5

Punjab 16.5 22.7 39.8 58.8 91.2 169.3

Rajasthan 17.1 29.1 45.9 62.8 101.2 187.2

Tamil Nadu 19.0 31.8 48.3 69.6 97.2 155.6

Uttar Pradesh 22.4 41.4 48.7 23.1 124.2 167.2

West Bengal 19.3 32.0 48.6 70.3 101.9 172.4

India 20.1 33.2 49.9 73.6 104.8 167.6

Source: SRS (Sample Registration System) Statistical Report 2011

65

Thus the improvement in life expectancy and decline in age-

specific death rate among the elderly are particularly due to the

improvements in public health and medical advances in the prevention

of many fatal infectious diseases and both are the major causes for the

increase in elderly population. Increases in the life expectancy of older

people reflect some of the achievements of medical science.

SOCIO-ECONOMIC AND HEALTH CONDITION OF ELDERLY IN INDIA

Old age is the later part of life, which is characterised by

deterioration in physical capacities. The deterioration brings changes

in the person’s active participation in different areas of life, role

playing and role performance and from economic self sufficiency to

dependence. As a person moves along the life cycle to the higher age

group a general change occurs in his or her living environment. This is

mainly because as the age goes up the ability of the individual to

convert their endowments into output declines. The elderly person

looses out their life time amenities as they passes through a lean

period of their life (Bagchi, 2003).

Socio-Economic Condition of Elderly

This section examines the socio-economic conditions of the

elderly population in India. The socio-economic conditions of elderly in

India, covering marital status, literacy level, dependency ratio, living

arrangements, and economic status have been discussed as below:

Marital status

Marital status of the elderly assumes special significance in the

context of care in old age as it is known that those who are married

fair better in all economic and social aspects than those who are

single. A major concern related to the increasing proportion of the

elderly women, especially widows in the population. Two reasons are

given for the marked gender disparities in widowhood in India (i)

longer life span of women compared to that of men and (ii) the general

67

tendency in India for women to marry men older than themselves

(Gulati and Irudaya Rajan 1999). Also widowed men are much more

likely to remarry and thus restore their earlier status. Though the

relationship between the well being of the elderly and their marital

status cannot be spelt out precisely, any change in the marital status

of the elderly deserves careful examination.

Table 3.13: Marital Status of the elderly in India (in percentages)

Marital Status Rural Urban

Male Female Total Male Female Total

Never married 1.65 0.55 1.10 1.74 1.19 1.46

Currently married 78.57 39.06 58.96 82.27 38.64 59.97

Widowed 19.43 59.85 39.49 15.85 59.71 38.27

Divorced/Separated 0.36 0.54 0.45 0.14 0.47 0.31

Source: NSSO 60th round (Jan-Jun, 2004)

Table 3.13 shows that widowhood and living without spouse is

one of the real challenges for the elderly in India. About 40 percent of

the elderly spent their life without spouses. This incidence of

widowhood was around 60 percent among females in both rural as

well as urban areas. On the other hand, incidence of widowhood

among males was only 15.85 in urban areas and 19.43 percent in

rural areas. This is mainly because the life expectancy is relatively

higher among females compared to that of males.

Table 3.14 shows the marital status of the elderly in Indian

states. Here we take a logistic position that those unmarried,

separated and widowed are of same category with almost identical

position in the society, as long as quality of life is concerned. The

widowhood seems to be chronic problem among the elderly in India

especially among elderly women. Almost in all states more than sixty

percent of women were living without spouse despite significant

spatial difference that exists in India while prevalence of widowhood

68

among men was as low as twenty percent in most of Indian states. The

trend of high incidence of loss of spouse was making life insecure for

the elderly especially that of women in India in their life (Figure 3.8).

Table 3.14: The marital status of the elderly in Indian states (Percentage of unmarried/widowed among aged)

All India and selected major states Male Female

Andhra Pradesh 18.55 70.54

Bihar 21.84 49.20

Gujarat 22.79 61.62

Haryana 19.67 41.17

Himachal Pradesh 22.27 63.37

Karnataka 16.73 73.58

Kerala 14.29 66.16

Madhya Pradesh 22.69 56.42

Maharashtra 15.65 58.91

Orissa 13.12 59.94

Punjab 21.95 46.03

Rajasthan 21.72 57.64

Tamil Nadu 18.24 68.79

Uttar Pradesh 29.42 54.61

West Bengal 17.31 71.27

All India 20.55 61.05

Source: NSSO 60th round (Jan-June, 2004)

69

Literacy Level

Education, in its broadest sense is a means of transference of

knowledge and information among the members of a society, which in

turn helps develop secular and individualistic ideas. Education

increases the ability of an individual to think rationally and logically.

It is an important determinant of various demographic decisions of

individuals. It has been found that the levels of birth rate, death rate

and infant mortality rate are higher in the states where female literacy

rates are lower. The formal education system is not only helps the

individual acquire skills in reading, writing and calculating to be able

to meet the requirements of the employment sector in later life, but

equally importantly enables the development of rationality. Despite

the spread of education over time, however, its benefits have not

reached the elderly population. There is a huge gap between the

literacy level of the elderly males and females as well as of general

overall population.

Table 3.15: Percentage of literates among elderly persons in India

Years Rural Urban Total

Male Female Total Male Female Total Male Female Total

Census

1991

34 18 21 66 3 49 41 13 27

Census

2001

45 13 29 75 42 58 53 20 36

NSSO

Survey

2007-08

44 13 28 77 44 61 52 21 36

Source: Census of India 1991, 2001 & NSSO Survey 2007-08

Table 3.15 tells us about the percent of literates among elderly

in India. It has been found that percentage of literate elderly males

was 41 in 1991 and on the other side among their female

counterparts, it was only 13 percent. In 2001, it was 53 percent for

males and 20 percent for females. The proportion of literates among

elderly persons has increased from 27 percent in 1991 to 36 percent

in 2001 (Figure 3.9).

71

According to NSSO Survey for 2007-08 only 52 percent of

elderly males and 21 percent of elderly females (aged 60 years or

above) were literate. It has been observed that the literacy rate among

both elderly males and females have improved over time in both rural

and urban areas and the literacy rate among males was more than

their female counterparts.

Old Age Dependency Ratio

The total dependency ratio is often used as an indicator of

the economic potential, the principal argument being that a low

dependency implies more workers and the need to divert fewer

resources to dependent populations. It has also been argued that

the shift in the age composition of the population (in favour of

ageing of population) is likely to damage the economy. As older

people consume a higher proportion of the national budget for

health, social services and social security, these become somewhat

self-evident aspects, particularly in the developed countries. For

example, for the USA it is estimated that per capita costs for

elderly persons are approximately three times those incurred by

youth. Comparable figures for the developing world indicate that

the costs of elderly people are 1.5 times higher than for young

people (Johnson, 1993).

The old-age dependency ratio measures the responsibility of

the aged to the working-age population. In India, generally,

persons aged 15 to 59 years are supposed to form the population

of working ages and at age 60, people generally retire or withdraw

themselves from work. Thus old age dependency ratio is obtained

by dividing the population aged 60 or more by the population of

working ages.

73

Table 3.16: Old age dependency ratio by sex and Residence, India 1961-2001

Year Male Female Total Rural Urban

1961 10.9 10.9 10.9 11.4 8.7

1971 11.4 11.6 11.5 12.2 8.9

1981* 11.8 12.2 12.0 13.0 9.2

1991** 12.2 12.2 12.2 13.2 9.7

2001# 12.4 13.8 13.1 14.1 10.8

Source: Census of India 1961-2001

* Excludes figures for Assam in 1981 where the Census was not conducted

** Excludes Jammu & Kashmir where the Census 1991 was not conducted

# Excludes 3 sub-divisions of Senapati district of Manipur

Table 3.16 shows the old-age dependency ratio by sex in India.

The movement of the ratio overtime indicates an ever-rising trend in

this ratio which rose from 10.9 percent in 1961 to 12.0 percent in

1981 and further to 13.1 percent in 2001. Among the males, old-age

dependency ratio was 10.9 percent in 1961 and rose to 11.8 percent

in 1981 and further to 12.4 percent in 2001. On the other side among

the females, it was 10.9 percent and rose to 12.2 percent in 1981 and

further to 13.8 percent in 2001. It has been found that the female old-

age dependency ratio as well as the gap between female and male old-

age dependency ratio are rising over time (Figure 3.10). This is a

matter of great concern. It has been observed that there was a

considerable difference between the dependency ratio of rural and

urban areas. In rural areas, it rose from 11.4 percent in 1961 to 14.1

percent in 2001 while in the urban areas it rose from 8.7 percent in

1961 to 10.8 percent in 2001. This is due to the fact that the working

age population was highly concentrated in the urban areas.

74

Living arrangements among elderly

The conventional living pattern of the elderly has drastically

changed, following the reduction in fertility and the increase in life

expectancy particularly at older ages. In India, the traditional practice

has been for people to live together with children in old age. Living

with children need not necessarily with the intention of receiving care

and support, but often the rest of the family also benefit from the

arrangements for example, when the younger women of the household

go to work, their children are often taken care of by the grandparents.

In fact, the United Nations (2003) in its announcement of theme for

international day for older persons depicts healthy older persons as a

resource for their families, societies and the economy of their

respective countries.

Living arrangement is an important component in dealing the

welfare of any specific group. The elderly persons, being less able to be

independent, need the care and support of others in several respects.

Taking care of the elderly refers mainly to the emotional support; on

the other hand support given to the elderly refers to the financial and

material support. The former type of support is expected from the

families or intimate relatives; whereas the latter is supposed to be a

joint effort of the immediate family and society. The care and support

enjoyed by the elderly is linked to their residence in other words the

living arrangements.

The distribution per 1000 of aged persons by type of living

arrangements for each sex in rural and urban India has been shown

in Table 3.17. The results of NSS 60th Round show that about 4 to 5

percent were living with other relations and non-relations, about 57

percent of the aged were living with their spouses and another 32

percent were living without their spouses and with their children.

Moreover, 4 to 5 percent were still living alone.

76

Table 3.17: Distribution per 1000 of aged persons by type of living arrangement for each sex (India)

Rural Urban

Living Arrangements


Living alone 28 (25)

76 (61)

53 (43)

21 (30)

65 (60)

43 (45)

With spouse only

162 (137)

87 (77)

125 (107)

133 (103)

75 (57)

104 (80)

With spouse, children and grand children

597 (613)

284 (313)

442 (462)

649 (648)

294 (297)

468 (469)

With spouse (2+3)

759 (750)

371 (390)

567 (569)

782 (751)

369 (354)

572 (549)

With children 168 (179)

475 (481)

320 (331)

154 (178)

482 (512)

322 (349)

With other relations and

non relations

27 (38)

56 (59)

42 (48)

29 (35)

67 (65)

49 (51)

Total (include n.r.)

1000 1000 1000 1000 1000 1000

Note: Figures in Parentheses give the corresponding estimates obtained from

NSSO 52nd round (1995-96)


However figures reflects that the living arrangements of the aged

has not changed much between 1995-96 and 2004, as the proportion

of the aged living alone remained almost the same. During this period,

the proportion of the aged who lived with their spouses only had

however, risen in urban areas as well as in rural areas. The proportion

of aged persons especially females living with their children reflect the

gradual breakdown of the extended or joint family system in India in

both rural and urban areas.

77

Economic Condition

Inadequate financial resources are mentioned as one of the

major problems of the Indian elderly. The financial inadequacy seems

to be of higher degree among the elderly women compared to their

male counterparts. Another major problem is related to the loss of

economic independence with the increase in age. The elderly continue

to work though their working hours decrease with increasing age.

Financial problems are more common among widows and among the

elderly who live in nuclear families. Economic insecurity is considered

to be the sole concern of the elderly in barely sustainable households

in India. The major sources of worry for the elderly are stress and

economic dependence. For understanding their economic dependence

it is important to analyse gainful employment among elderly.

The financial and economic well being of the elderly is closely

linked to their level of education and past work status. Under usual

circumstances, most of the elderly in the formal sector would have

retired from the labour force. However, given the Indian situation

where the unorganized sector accounts for a larger share of the work

force and where rural labour is predominantly in agriculture or allied

activities, there is no question of formal retirement for the elderly. In

fact, being economically active is probably a positive feature of the

aged population in India since it helps to keep at bay many of the age

related health problems that arise from a feeling of being unwanted,

isolated and useless.

Table 3.18: Status of gainful employment among the elderly (in percentages)

Status of

gainful

employment

Rural Urban Total

Male Female Total Male Female Total Male Female Total

economically active

59.3 16.7 38.2 33.0 8.0 20.0 53.1 14.6 33.8

economically

non active

40.7 83.3 61.8 67.0 92.0 79.8 46.9 85.4 66.2


78

Table 3.18 shows the status of gainful employment among the elderly

sex-wise. It is clear from this table that majority were not productively

employed in the work force. In India only 33.8 percent were engaged

in the productive work while it was significantly higher in the case of

males 53.1 percent and only 14.6 percent in case of females. The

difference was mainly due to the fact that an elderly woman generally

engages in the household duties that are out of the purview of

economic activities. The elderly in the rural areas were more engaged

in the economic activity (38.2 percent) than their urban counterparts

(20.0 percent) as they are forced to work by the conditions of the

deprivation in which they live (Figure 3.11).

Table 3.19 depicts the status of gainful employment among the

elderly in Indian states. The state wise estimates of economically gainful

workers among the elderly almost show a similar pattern as observed in

the national scenario. There was a significant fell in work participation in

higher age groups. At all India level figures shows that in the case of

males it fall down from 53.1 percent to 15.28 percent as the age group

from 60-79 category to the eighty plus years of the category. In the case

of females the figure fell further down from 14.6 percent to 2.43 percent

in these two age groups. In Punjab state, in the case of males

corresponding figures were 50.42 percent and 10.55 percent respectively

in these two age groups. In case of females the figures were 5.62 percent

and zero percent respectively in these two age groups. Moreover these

figures were below all India level for both male and female.

One of the critical issue raised in the high levels of work

participation is that for poor elderly there is only one retirement, not

from work, but from the world” (Irudaya Rajan, Mishra, and Sharma

1999). The high levels of work participation among the elderly shows

that majority of them are working to avoid the economic and social

crisis, that, they faced both within and outside family set up. In most

of the cases they are compelled by the situation of their life that put

them in the labor force in the later years of life.

80

Table 3.19: Status of gainful employment among the elderly in Indian states (in percentages)

All India and selected

major states

60-79 80+

Male Female Male Female

Andhra Pradesh 49.88 17.54 5.68 3.83

Bihar 70.78 13.74 27.71 0.00

Gujarat 54.88 15.07 9.01 1.90

Haryana 44.11 6.26 2.99 0.00

Himachal Pradesh 68.65 34.74 34.90 18.00

Karnataka 57.36 18.32 18.23 0.60

Kerala 44.25 11.94 12.59 2.55

Madhya Pradesh 63.64 24.08 8.29 0.63

Maharashtra 49.71 21.80 13.71 0.50

Orissa 57.01 10.14 20.05 0.00

Punjab 50.42 5.62 10.55 0.00

Rajasthan 58.72 13.38 11.05 1.39

Tamil Nadu 51.50 24.49 14.56 1.01

Uttar Pradesh 67.71 11.55 22.47 4.47

West Bengal 49.74 6.10 13.78 3.92

All India 53.1 14.6 15.28 2.43


Further the problems of day-to-day maintenance of livelihood of

the elderly can be revealed by looking at their economic dependence/

81

independence. Table 3.20 reveals the state of economic independence

(i.e. day-to-day maintenance of livelihood) for each sex of the elderly in

rural and urban sectors of India.

Table 3.20: Distribution per 1000 of aged persons by state of Economic Independence of each sex in India

State of

Economic Independence

Rural Urban


Not dependent on others

513 (485)

139 (121)

327 (301)

555 (515)

170 (115)

359 (311)

Partially dependent on

others

152 (180)

124 (146)

138 (163)

134 (169)

95 (110)

114 (139)

Fully dependent on others

320 (313)

720 (706)

519 (511)

301 (297)

721 (757)

516 (532)

Total (include n.r.) 1000 1000 1000 1000 1000 1000

Note: Figures in Parentheses give the corresponding estimates obtained from NSSO 52nd round (1995-96)


According to NSS 60th round 65 percent of the aged had to

depend on others for their daily maintenance in both rural and urban

areas. The situation of elderly females was worse. Among the elderly

females about 85 percent were economically dependent either fully or

partially. Males were in much better condition than females.

Compared to estimates obtained from NSS 52nd round (1995-96), the

economic condition of the aged persons has improved in general and

also both among male and female in rural as well as urban areas. The

economic condition of elderly has improved more in the urban sector

compared to that of the rural sector.

Table 3.21 shows the assessment of the level of poverty among

Indian elderly according to sex, by major states of India. All the

elderly were categorized here in three categories: not dependent,

partially dependent and fully dependent; we presume that fully

dependent the elderly need economic help in old age as they are

below the poverty line.

82

Table 3.21: Dependency status among the elderly by sex and place of residence in India (state wise)

All India and selected major states

Male Female Total

Andhra Pradesh 44.8 62.2 53.6

Bihar 36.8 56.5 46.2

Gujarat 45.9 60.7 53.5

Haryana 52.8 58.2 55.7

Himachal Pradesh 35.6 39.3 37.4

Karnataka 51.6 62.4 57.3

Kerala 53.4 61.4 57.8

Madhya Pradesh 43.3 53.9 48.6

Maharashtra 46.3 57.3 51.9

Orissa 47.5 64.1 55.6

Punjab 53.2 68.8 60.8

Rajasthan 43.2 56.9 50.6

Tamil Nadu 41.2 57.1 48.8

Uttar Pradesh 41.6 57.8 49.5

West Bengal 48.3 65.8 56.9

All India 45.2 60.6 52.8


It has been observed, a large proportion of the elderly were

economically dependent on others for their livelihood in most of the

states. It is therefore, pertinent to know about the persons who are

providing economic support to these elderly. Table 3.22 depicts the

distribution per 1000 of economically dependent aged persons by

category of persons supporting the aged for each sex in India.

According to NSSO 60th round, a majority (about 76 to 78 percent)

had to depend on their children and a sizable proportion (13 to 15

percent) on their spouses for their economic support. Only 3 percent

were supported by their grandchildren and the rest (6 percent) had to

depend on ‘others’, including non-relations.

83

Table 3.22: Distribution per 1000 of economically dependent aged persons by category of persons supporting the aged

for each sex in India

Category of persons

supporting

Rural Urban


Spouse 70

(113)

159

(159)

127

(142)

60

(105)

192

(182)

148

(156)

Own children 850

(766)

746

(717)

784

(735)

865

(792)

710

(695)

762

(728)

Grand children 22

(50)

31

(52)

28

(52)

18

(54)

30

(56)

26

(55)

Others 57

(71)

63

(72)

61

(71)

57

(49)

68

(67)

64

(61)

Total

(include n.r.)

1000 1000 1000 1000 1000 1000

Note: Figures in Parentheses give the corresponding estimates obtained from NSSO 52nd round (1995-96)


Between the years 1995-96 and 2004, the distribution of the

aged who were economically dependent changed in respect of the

category of persons supporting them for their livelihood. The pattern

of change is not similar for males and females, but is so for the elderly

living in the rural and urban areas. In the inter-survey periods, the

proportion of the aged males and females depending on their children

for economic support has increased in both rural and urban areas

and more so in the rural areas. On the other hand, the proportion of

those depending on their spouse decreased, in general, among the

males but marginally increased among the aged females in the urban

areas. The proportion in this category however did not show any

change between the periods in the rural areas.

84

Health Condition of Elderly

The process of biological ageing brings with it several

accompanying health problems or diseases. It is obvious that people

become more and more susceptible to chronic diseases, physical

disabilities and mental incapacities in their old age. The decline in the

efficient functioning of the various organ systems of the body

including the immune system renders the elderly particularly

vulnerable to several diseases. As age advances, due to deteriorating

physiological conditions, the body becomes more prone to illness. The

illness of the elderly are multiple and chronic in nature. Some of the

health problems of the elderly can be attributed to social values also.

The idea that old age is an age of ailments and physical problems is

deeply rooted in the Indian mind, and many of the sufferings and

physical troubles within curable limitations are accepted as natural

and inevitable by the elderly.

The perception about one’s health is an important factor in

getting an idea about a person’s actual health condition. A person

may be considered as being in good health if he feels so. Moreover, it

reflects the mental health of that person. Table 3.23 depicts the

distribution of aged persons (per 1000) by own perception about their

health. It has been observed that as high as 55 to 63 percent of the

aged with sickness felt that they were in a good or fair condition of

health. The proportion among the aged without sickness was 77 to 78

percent. Possibly they considered their sickness as a problem of

ageing. Among the aged, the males seemed to be feeling that they had

a better health condition even with sickness compared their female

counterparts. As against this, about 13 to 17 percent of the aged who

were not even sick considered themselves as having a poor state of

health. Rural aged seemed to be feeling that they had a better health

condition even with sickness as compared to the urban aged.

85

Table 3.23: Proportion (per 1000) of aged persons according to their own perception about Health (India)

Own perception about current state of health

Aged persons with sickness

Aged persons without sickness

male female person male female person

Rural

excellent/very good 19 14 17 81 43 62

good/fair 580 525 553 772 770 771

poor 401 460 429 147 187 167

all aged 1000 1000 1000 1000 1000 1000

Urban

excellent/very good 31 19 24 114 72 92

good/fair 641 620 631 775 780 778

poor 327 360 345 111 148 130

all aged 1000 1000 1000 1000 1000 1000

Note: The proportions have been adjusted excluding the ‘not reported cases’.


Table-3.24 shows the prevalence of chronic disease among the

elderly in India. It has been found that heart disease is the major

chronic problem among both elderly male and elderly female.

Prevalence of heart diseases among elderly males and females was

much higher in urban areas than in rural areas. Among elderly males,

most common problem was urinary problem. On the other side more

elderly females reported to suffer from problem of joints.

86

Table 3.24: Number of person aged 60 years and above reporting a chronic disease (per 1000 persons) by sex (India)

Type of chronic disease

Rural Urban

Male Female Person Male Female Person

Whooping Cough 8 6 7 4 2 3

Ulcer 37 54 44 30 24 27

Problem of joints 30 40 34 26 45 35

Hypertension 23 53 36 50 59 54

Heart disease 95 59 80 165 162 164

Urinary Problem 78 28 57 89 33 63

Diabetes 30 52 40 68 36 53

Cancer 18 36 26 25 25 25


Ability to move is an important indicator of physical condition of

health of aged persons. It also indicates their dependence on others

for movement and performing their daily routine. Table 3.25 gives

information regarding the proportion (number per 1000) of the aged

persons who cannot move around and are confined to their home or

who cannot move at all and are confined to bed.

Table 3.25: Proportion (per 1000) of aged persons who cannot move and are confined to bed or home in India

age-groups (years) rural urban

male female person male female person

60-64 27 34 31 33 34 33

64-69 51 50 51 34 63 50

70-74 79 132 105 77 116 97

75-79 117 163 139 113 185 147

80& above 220 326 269 239 323 283

all aged 67 88 77 68 100 84


87

About 8 percent of the aged persons were either confined to

their home or bed. With the increasing age the proportion of aged

persons reporting confinement to their home or bed was found to

increase in both rural and urban areas, being as high as 27 for

persons aged 80 and above. In both rural and urban areas the

incidence of confinement is seen to be higher among female than

among male.

On the whole, we can conclude that due to the ongoing

demographic transition, India faces major age structure changes with

an accelerating growth in the aged (60+) population. The cause of this

change is decline in fertility reinforced by continued decline in

mortality levels. The increase of demographic ageing process in our

country has a series of socio-economic problems as well as health

problems. There are several problems of elderly which are – loneliness,

economic dependency, poor health, malnutrition etc.

The elderly population (60+) increased sharply during 1991-

2001. In India, as a result of the change in the age composition of the


the number and proportion of aged people. The proportion of elderly

female to elderly males has been found higher than in the general

population for all the years since independence. The improvement in

life expectancy and decline in age-specific death rate among the

elderly are particularly due to the improvements in public health and

medical advances in the prevention of many fatal infectious diseases

and both are the major cause for the increase in elderly population.

Widowhood and living without spouse is one of the real challenges for

the elderly in India. Among the elderly people only two categories,

namely those who live with spouse, children and grandchildren and

those who live with children and grandchildren but without spouse,

are predominant among the Indian elderly. In India only one third of

the elderly are engaged in the productive work while it is significantly

88

higher in the case of men than in case of women. Elderly females were

more economically dependent either fully or partially. Males were in

much better condition than females. Since age is associated with

increase in physical illness and disability, ageing becomes an essential

part of the health care delivery system. Therefore in-depth studies

through multidisciplinary assessment on issues like socio-economic

problems, health, and psychological stress and social security needs

of the elderly should be done nationwide.

89

Chapter 3 DEMOGRAPHY OF ELDERLY POPULATION IN...

Documents

Transcript of Chapter 3 DEMOGRAPHY OF ELDERLY POPULATION IN...