Malcolm Adiseshiah Mid-Year Review of the Indian Economy 2016-17 Ageing in India: The Health Issues Debasis Barik November 5, 2016 India International Centre, New Delhi
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
Background Invisible but gradual increase of elderly population in India Challenges?? Out of labour force Deteriorated health Weakening social ties More number of women
Population Ageing: The Global Scenario Ageing by World Region Source: United Nations 2015
Ageing in India: Facts and Figures Assam Delhi Jharkhand Jammu & Kashmir Bihar Rajasthan Uttar Pradesh Chhattisgarh Madhya Pradesh Gujarat West Bengal India Haryana Uttarakhand Karnataka Odisha Andhra Pradesh Maharashtra Himachal Pradesh Punjab Tamil Nadu Kerala 6.7 8.6 12.6 0 2 4 6 8 10 12 14 Percentage of Elderly Population to Total Population Source: Barik et al. 2015
Educational Level Illiterate Up to 5th Secondary Metric Graduate Missing Religion/Caste Forward caste OBC Dalit Adivasi Muslim Other Residence Rural Urban Working No Yes Sex Male Female Age 60 64 years 65 69 year 70 74 year 75 79 year 80 + years Marital Status Unmarried Married Widowed Div./Sep Family Type Single Couple Nuclear Joint Socio-demographic Profile of Indian Elderly 80 70 60 50 40 30 20 10 0 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 80 70 60 57.4 67.9 67.3 50 40 30 20 10 0 17.8 17.4 3.1 4 0.2 25.8 35.3 18.4 6.7 9.9 3.9 32.1 32.7 Source: Based on IHDS 2011-12
Per cent with any of the long term illnesses Ageing and Health The Linkages Prevalence of major morbidities increases with age 45 40 Male Female 35 30 25 20 15 10 5 0 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80+ Age Source: Based on IHDS 2011-12
Causes of DALYs, both sexes, all ages, India 1990 2010 Communicable, new-born, nutritional and maternal Source: The GBD Studies 2013 Non-communicable Injuries
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 16000 14000 Major Morbidities 13380 12000 10000 8000 6000 7749 5560 7988 10584 4000 2000 0 Lowest Second Third Fourth Highest Household Income Quintile 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
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