Technological advances in medicine and resulting increase in life expectancy is significantly changing the demographic landscape worldwide including India.
World health organization (WHO) has highlighted the issue of geriatric health over the years, with World health day themes such as “Add life to years (1982)” and “Healthy living: Everyone a winner (1986)”. The theme “Active ageing-makes the difference” (1999-International year of older persons) not only served a wake-up call to the nations of the world to the reality of our increasing elders, but also went on to bust myths about aging. The well-being of senior citizens is mandated in the Constitution of India under Article 41. “The state shall, within the limits of its economic capacity and development, make effective provision for securing the right to public assistance in cases of old age”.
DEMOGRAPHY OF INDIAN AGEING –
According to UN’s World Population ageing report (1990-2050), in the years 2000-2050, the overall population in India will grow by 55% whereas population of people in their 60 years and above will increase by 326% and those in the age group of 80+ by 700%-the fastest growing group.
According to Census 2011, the population of senior citizens in the country is 10.38 crore, which comprises about 8.6% of total population and are projected to grow to 20% by 2050. Changing pattern of morbidity, privatization of health services, social deprivation and exclusion affect the already vulnerable elderly population. Currently, the elderly are provided health services through general healthcare system. Nearly 90% of the elderly reported suffering from at least one disability
(He, Muenchrath and Kowal, 2012). Disability and poor health in old age in India is because of the double burden of communicable and non-communicable diseases (Johnson, et al. 2011).This is unlike ageing population in developed countries where communicable diseases are not a major risk factor. The burden of disease in old age is further worsened by high rates of smoking and other life style factors
(Kowal et al., 2012).The government‘s role in treatment and care of the elderly is limited in India. About 24 to 42 per cent of elderly with chronic conditions and about 41 per cent of elderly with acute morbidities sought treatment in public hospitals (BKPAI,2012).
Even in public hospitals where treatment is free, indirect cost for transportation, bribes, and payment for medicines make treatment un-affordable for many elderly (Balagopal,2009). The problems of elderly women are exacerbated by a lifetime of gender based discrimination, often stemming from deep-rooted cultural and social bias. It is compounded by other forms of discrimination based on class, caste, disability, illiteracy, unemployment and marital status. Patriarchal hierarchy and access to property rights are also discriminatory. Women experience proportionately higher rates of chronic illness and disability in later life than men. Women suffer greater non-communicable diseases and experience lower social and mental health status, especially if they are single and/or widowed.
Even though India was one of the first countries to launch National policy on senior citizens in 1999 and came up with a revised one in 2011 along with a specific ‘National programme for healthcare of elderly in 2011’, still the Indian healthcare delivery system is still not prepared adequately to reach out to this cohort. Given the scarce resources that developing economies have, Indian health systems should work towards developing low cost strategies, harness existing technology and capacity building to care for our vulnerable elderly population.
About the Author: Dr. Divyesh Mundra is a Hospital Administration candidate and a Life Member, CHD Group, India.
Disclaimer: Views expressed are the author’s own and CHD Group is not responsible for the same.