THE CONTEXT: Life Expectancy at Birth is a statistical measure of the average time an organism is expected to live, based on the year of its birth, its current age and other demographic factors, including gender. This statistic (in terms of the Index of Representation in Longevity (IRL) and the Index of Socio-economic Inequality in Longevity (ISIL)) is vital, especially for an emerging economy like India, as the future growth prospects rest on the status of the democracy. The following article attempts to analyze the aspect of socio-economic inequities regarding longevity in India.
ABOUT LIFE EXPECTANCY AND ELDERLY POPULATION IN INDIA
- Life expectancy in India has increased from 49.7 years in 1970-75 to 68.7 years in 2012-16, as per the National Health Profile 2019. For the same period, the life expectancy for females is 70.2 years and 67.4 years for males.
- Life expectancy in India has risen from 50 (1970-75) to almost 70 years (2014-18); as a result, the number of elders (>60 years of age) is already 137 million and is expected to increase by 40% to 195 million in 2031, and 300 million by 2050.
- According to Census 2011, India has 104 million older people (60+years), constituting 8.6% of the total population. Amongst the elderly (60+), females outnumber males.
- Both the share and size of the elderly population are increasing over time. From 5.6% in 1961, the proportion increased to 8.6% in 2011. The proportion has increased to 10.1% in 2021 and is further likely to increase to 13.1% in 2031. For males, it was marginally lower at 8.2%, while for females, it was 9.0%.
- Government of India’s National Policy on Older Persons 1999, Maintenance and Welfare of Parents and Senior Citizens Act, 2007 and National Policy for Senior Citizens 2011 provide the legal framework for supporting the needs of seniors.
- The National Programme for Health Care of Elderly and Health and Wellness Centres under the Ayushman Bharat programme provide dedicated healthcare to the elderly in primary health care settings.
Recently, an EPW (Economic and Political Weekly) backed research analyzed the Index of Representation in Longevity (IRL) and Index of Socio-economic Inequality in Longevity (ISIL) to gain insights on the status of life expectancy and longevity. Its key focus was the elderly population in India.
THE CONCEPT OF LONGEVITY
- The concept that is generally used when it comes to measuring the length of individual lives in any society is longevity. Though it is often used as a synonym for life expectancy at a given age, it is also used to refer only to the long-lived members of a population.
- If increasing longevity is a desirable objective of any society, then achieving socio-economic equality in it is another one. However, the first step towards striving for equality in longevity in any society is to measure the existing socio-economic inequalities associated with it.
- Further, if inequality in longevity is high, the decrease in life expectancy among those of lower socio-economic status can outweigh the increase in life expectancy among those of a higher socio-economic status. For example, even if people live longer in the southern states of India owing to better performance in socio-economic indicators, it couldn’t compensate for the deteriorating status of the same age group in northern states.
INDEX OF REPRESENTATION IN LONGEVITY (IRL) AND INDEX OF SOCIO-ECONOMIC INEQUALITY IN LONGEVITY (ISIL)
INDEX OF REPRESENTATION IN LONGEVITY
- The IRL is a representational measure similar to the “Distributional Fairness Index” proposed by Villemez and Rowe (1975) and the “Group-specific Index of Relative Disadvantage” proposed by Jayaraj and Subramanian (2006).
- Index of Representation in Longevity: In simple terms, in the IRL, it is comparing the proportion of the 65 years plus population of a socio-economic group in the overall 65+ population of the country to the overall proportion of the population of the same socio-economic group in the overall population of the country.
- Intuitively, any group-specific measure of inequality in longevity must be some function of how large the group’s share in total longevity (65+) is in relation to the group’s share in total population.
INDEX OF SOCIO-ECONOMIC INEQUALITY IN LONGEVITY
- The ISIL, particularly well-suited for dichotomous outcomes, is a form of dissimilarity index based on the measure of the inequality of opportunities advanced by Barros et al (2009).
- Index of Socio-economic Inequality in Longevity: As in the case of the previous index, if an individual’s age is more than 65 years then they will be considered a long-living individual. The ISIL has been estimated for groups based on each characteristic (for example, groups based on caste, groups based on religion, etc.).
- The ISIL is a simple summary and representational measure of group disparities, which is expressed as a normalized, weighted sum of the absolute deviations of group-specific average longevity from the overall (whole population) average longevity.
- The ISIL can be interpreted as the number of longevity opportunities that need to be rearranged from the better-off groups to the worse-off groups (in which average longevity is lower than the population average) to have equal average longevity in all groups.
STATUS OF INDEX OF SOCIO-ECONOMIC INEQUALITY IN LONGEVITY (ISIL) IN INDIA-BASED EPW STUDY
DIMENSION
EXPLANATION
PRESENCE (NUMBERS)
- In 2004, in rural areas, 19%, 7%, 43%, and 31% of the elderly population belonged to the SC, ST, OBC, and OC (Other Caste), respectively.
- The corresponding figures for urban areas were 14%, 2%, 38%, and 46%, respectively.
- In 2012, there was some increase in the percentage of SCs and some decrease in the percentage of OCs in rural areas.
PRESENCE (RELIGION)
- In terms of religion, the percentages of Hindu and Muslim elders have almost remained unchanged in rural as well as urban areas during the study period. There has been some mild decrease in the proportion of elderly Christians in rural areas during the same period.
OCCUPATIONAL STATUS
- Rural Areas: in terms of occupation in rural areas, there was a decrease in the proportion of elderly among cultivators, agricultural labourers, businesspersons, and salaried individuals from 2004 to 2012. There was an increase in the proportion of elderly among the non-agricultural labourers, petty traders, and pensioners during the same period.
- Urban Areas: a decrease is observed in the proportion of elders involved in agricultural labour, self-employed in business, and salaried jobs during the study period, whereas an increase was observed in the proportion of elders involved in non-agricultural labour, petty trade, and pension (and rent) during the same period.
REGIONAL PRESENCE
- In rural as well as urban areas, the percentage of the elderly population was highest in the southern region and lowest in the northeastern region.
- The highest proportion of elders in the southern region is in line with the fact that the southern region comprises states that are among the most developed as far as economic and demographic indicators are concerned.
- Also, the aspect of longevity is more enhanced in southern states owing to better performance in aspects like health, clean environment, and other components of standards of living.
GROUP-SPECIFIC PROPORTION OF ELDERLY (65+ YEARS):
- Among the caste groups, the OCs have the highest proportion of elderly amongst themselves throughout as OCs comprise the socially and economically most advanced castes of India.
- The STs lay at the bottom of the pack as they are among the most disadvantaged as far as social and economic development is concerned.
- The elderly populace of the Muslim community (the majority in the minority), was the most disadvantaged, as their social, demographic and economic development was found to be at the level of the SCs and the STs in India.
- Among the occupation categories, the proportion of the elderly was highest among the pensioners.
INDEX OF REPRESENTATION IN LONGEVITY (RIL)
CONTEXT
EXPLANATION
CASTE GROUPS
- OCs are over-represented in both 2004 and 2012 in rural as well as urban areas.
- The OBCs are marginally over-represented and slightly under-represented in rural and urban areas, respectively, in 2004 as well as 2012.
- The SCs and the STs are severely under-represented (with the STs the worst off) in almost all cases (be it rural or urban) with the representation of the STs decreasing at the all-India level, which is the least among all the caste categories.
RELIGION
- Maximum representation in longevity is of the Christians at the all-India level.
- Muslims are seriously under-represented in longevity.
OCCUPATION
- Overall pensioners, cultivators and “other occupation” categories had an over-representation in longevity.
- The agricultural and non-agricultural labourers and petty traders were under-represented throughout. The lowest under-representation is seen in the case of non-agricultural labourers.
REGIONAL LEVEL
- Representation of longevity was highest in the south followed by the west and the north.
- There was an under-representation in the case of the central, east, and north-east, with the north-east being most severely under-represented.
KEY OUTCOMES (OVERALL)
- The caste-based or religion-based or occupation-based variation in longevity is relatively higher than economic class-based variation.
- About 15% of longevity opportunities need to be shifted from the better-off groups (where average longevity is higher than the average longevity for the whole population) to the worse-off groups such as non-agricultural labour, etc. (where average longevity is lower than the average longevity for the whole population) to bring equality in longevity in society at the all-India level.
- Barring the case of economic class and geographic regions, the socio-economic inequality in longevity, based on all other characteristics, was higher in urban areas compared to that rural areas.
- One of the most glaring socio-economic inequalities in longevity is observed in the case of geographic regions, where the demographically, economically, and socially advanced regions of the south and the west have an over-representation in longevity, whereas the demographically, economically and socially disadvantaged regions of the central, east and northeast have an under-representation in longevity.
ELDERLY POPULATION: CONCERNS AND POTENTIAL
- An increase in longevity and decline of joint family and breakdown in social fabric pushes seniors into loneliness and neglect.
- While one perspective looks at them as dependents, a rather different view would look at them as a potential asset, a massive resource of experienced, knowledgeable people. Integrating the elderly into the lives of communities can make a substantial contribution to improving social conditions.
- Elderly people carry immense experience in their personal and professional life which society, at large, needs to channel for a better tomorrow. Including elderly people as active contributors in the economy will prepare India for the future when a major portion of its population will be aged.
- The silver economy is the system of production, distribution and consumption of goods and services aimed at using the purchasing potential of older and ageing people and satisfying their consumption, living and health needs. The SAGE(Seniorcare Aging Growth Engine) initiative and the SACRED (Senior Able Citizens for Re-Employment in Dignity) are some of the initiatives launched specifically to promote the silver economy.
THE WAY FORWARD:
- Policymakers need to take a cue from projects like the US’s national health initiative, “Healthy People 2000,” which seeks to increase longevity among Americans of all ages, and the UK’s “Longevity Science Advisory Panel” to provide a better chance of understanding the past and the present, for better forecasting in improvements in longevity.
- The government should also address the rampant socio-economic inequalities in the healthcare services in India which lead to different mortality rates across different groups in India, which, in turn, might lead to substantial socio-economic inequalities in longevity in India.
THE CONCLUSION: The Constitutional values along with SDGs (Goal 10) call for equality in every aspect of society. For any ideal society, how long a person lives, should not depend on factors such as caste and religion. The government should pay attention to the idea of longevity (and inequality in longevity) itself and bring it to the forefront of the public health debate in India.
QUESTIONS TO PONDER
- Examine how the inequalities in longevity are present within multiple dimensions in India.
- What measures could be taken to convert the seeming ‘burden’ of the elderly populace into ‘opportunity’? Discuss in the Indian context.
