South India’s Ageing Population: Healthcare & Social Services | UPSC

Introduction

• South India is currently facing a pressing issue: its population is ageing rapidly while fertility rates continue to decline. Andhra Pradesh’s Chief Minister, N. Chandrababu Naidu, recently announced plans to incentivize families to decrease South India’s Ageing Population have more children, reflecting the growing concern over this demographic shift.
• Southern states, already worried about losing political representation in Parliament due to smaller populations, are bracing for the potential consequences of this trend.

Rising Old-Age Dependency Ratio

• According to the Elderly in India 2021 report by the Ministry of Statistics and Programme Implementation (MOSPI), the old-age dependency ratio — which refers to the number of people aged 60 and above per 100 individuals aged 15-59 — is steadily increasing across the country.
• This ratio rose from 10.9% in 1961 to 14.2% in 2011 and is projected to reach 20.1% by 2031. The trend is particularly pronounced in South India, where fertility rates have declined more rapidly than in the North.

Regional Ageing Projections

• The Ministry of Health and Family Welfare (MoH&FW) has provided the latest projections on South India’s Ageing Population trends, revealing significant regional variations.
• Northern states like Uttar Pradesh and Bihar are expected to maintain a younger population due to higher fertility rates.
• However, Southern states like Kerala and Andhra Pradesh will see a much more significant rise in their elderly populations.
• By 2036, Kerala’s elderly population is projected to make up 25% of its total population, whereas Uttar Pradesh will still have a relatively young demographic, with only 12% of its population aged 60 or older.

Read also: Supreme Court Urges Stronger Laws to End Child Marriages | UPSC

Key Data on Population Growth and Ageing (MoH&FW Report)

• India’s Population Growth: From 2011 to 2036, India’s population is expected to increase by 31.1 crore, with Northern states like Bihar, Uttar Pradesh, Maharashtra, West Bengal, and Madhya Pradesh contributing 17 crore to this growth. In contrast, South India’s Ageing Population will contribute only 2.9 crore (or 9%) to the overall increase.
• Doubling of the Elderly Population: The elderly population (60 years and above) will double from 10 crore in 2011 to 23 crore by 2036, raising their share of the total population from 8.4% to 14.9%.

Concerns Regarding the Ageing Population in Southern States

• Economic Strain: A growing elderly South India’s aging population increases the dependency ratio, leading to fewer working-age individuals supporting a larger number of retirees. This demographic shift puts immense strain on state finances, as public resources are stretched to cover pensions, healthcare, and social services for the elderly.
• Decreasing Labour Productivity: As the working-age population shrinks, Southern states could face labour shortages, negatively impacting overall productivity and slowing economic growth.
• Loss of Political Representation: With lower fertility rates, Southern states risk losing parliamentary representation in future constituency delimitations, as Northern states with larger populations gain more seats. This has raised concerns about a diminishing political voice for the South in national decision-making.
• Increased Healthcare Costs: With an ageing population comes increased healthcare demands. Southern states will need to invest heavily in geriatric care, including hospitals, nursing homes, and specialized healthcare services.
• Inadequate Elderly Care Infrastructure: Many Southern states currently lack sufficient infrastructure to support their ageing population. Assisted living facilities and nursing homes are limited, creating an urgent need for investment in elderly care.

The Importance of Caring for India’s Elderly

• Harnessing Experience: The elderly possess a wealth of personal and professional experience that can benefit society. Tapping into this knowledge through proper care and social engagement can be a valuable asset.
• Generational Continuity: Elderly individuals play a vital role in providing generational continuity, especially in joint families. Their presence ensures the transmission of values, traditions, and life lessons to younger generations.
• Promoting Social Harmony: The elderly, with their deep cultural experiences, act as a buffer against intolerance and societal unrest. Their presence contributes to social harmony and stability.
• Moral Responsibility: Caring for the elderly is not just an economic or social obligation; it is a moral one. Society must reciprocate for the contributions they have made throughout their lives, ensuring that they receive the support they deserve in their later years.

Challenges Faced by the Elderly Population in India

• Social Neglect: Globalization, Western education, and the rise of nuclear families have contributed to the social neglect of the elderly, leaving many isolated and unsupported.
• Abuse and Exploitation: Elderly individuals often face various forms of abuse, including emotional, financial, and sometimes physical harm, further exacerbating their vulnerability.
• Caste and Age Intersection: Lower-caste elderly people often have no choice but to continue working for survival, while upper-caste elders may experience a sense of ‘worthlessness’ due to the lack of suitable jobs.
• Feminization of Ageing: Elderly women, particularly widows, face heightened challenges due to societal biases. These include exploitation, neglect, lack of access to basic services, and exclusion from asset ownership.
• Financial Instability: A large portion of India’s elderly population falls outside the pension safety net, and those receiving pensions often find them inadequate for maintaining a decent standard of living.
• Health Issues: The 2021 Longitudinal Ageing Study in India (LASI) revealed that one in five elderly individuals in India suffers from mental health issues, and 75% live with at least one chronic disease. The rising prevalence of non-communicable diseases also increases the financial burden on elderly individuals.

Read also: Supreme Court Ruling on Section 6A of Citizenship Act | UPSC

Way Forward

• Shift Focus from Pro-Natalist Policies: Financial incentives for larger families have had limited success worldwide. Instead, Southern states should look to the Scandinavian model, which emphasizes strong family support systems, gender equality, and comprehensive childcare provisions.
• Promote Internal Migration: Facilitating the migration of working-age individuals from Northern states to Southern states could help balance the demographic shift. This approach has been used successfully in countries like the US, where pro-immigration policies have sustained economic growth.
• Formalize the Caregiving Economy: According to a NITI Aayog report, home-based healthcare could reduce hospital costs by 20% and unnecessary hospital visits by 65%. Recognizing caregiving as formal work and improving working conditions for caregivers will be essential in addressing the growing elderly population.
• Draft Comprehensive Home-Based Care Policies: Southern states need to implement policies that formalize the caregiving sector. These should include clear training programs for caregivers, creating a registry for professionals, and establishing accountability mechanisms.
• Adopt Switzerland’s Time Bank Model: Under Switzerland’s time bank system, individuals ‘bank’ time by caring for elderly people. They can later redeem this time when they themselves need care. South India could adopt this innovative model to manage the rising elderly population sustainably.