EDITORIAL ANALYSIS : The Not Young
Kartavya Desk Staff
Source: Indian Express
• Prelims: Demographic dividend, The Census Act, 1948, Longitudinal Ageing Survey in India (LASI), life expectancy, demographic transition, India Human Development Survey (IHDS) etc
• Mains GS Paper I and II: Government policies and interventions for development of various sectors and issues arising out of them etc
ARTICLE HIGHLIGHTS
• The proportion of older persons in the total population will increase from 6 percent in 2011 to 20.8 percent in 2050.
INSIGHTS ON THE ISSUE
Context
What is the Demographic Transition and Demographic Dividend?
• A demographic shift refers to a change in the composition of a population over time.
• This change can occur due to various factors such as changes in birth and death rates, migration patterns, and changes in social and economic conditions.
• A demographic dividend is a phenomenon that occurs when a country’s population structure shifts from having a high proportion of dependents (children and elderly) to having a higher proportion of working-age adults.
• This change in population structure can result in economic growth and development if the country invests in its human capital and creates conditions for productive employment.
Demographic changes in India:
• In 1941, male life expectancy was about 56 years; only 50% of boys survived to age 28. Today, life expectancy for men is 69 years, and nearly 50% live to see the ripe old age of 75.
• Today, life expectancy for men is 69 years, and nearly 50% live to see the ripe old age of 75.
• Total Fertility Rate fell from 7(five point seven) in 1950 to 2.1(two point one)in 2019.
• With four children: The chance of not having a son was barely 6%, but with two children, it grew to 25%. Social norms and patrilocal kinship patterns combined with lack of financial security reinforce a preference for sons.
• Social norms and patrilocal kinship patterns combined with lack of financial security reinforce a preference for sons.
• The India Human Development Survey (IHDS) found that: 85% of women respondents expected to rely on their sons for old age support 11% expected support from their daughters.
• 85% of women respondents expected to rely on their sons for old age support
• 11% expected support from their daughters.
• Parents who want to ensure that they have at least one son among their one or two child families, resorted to sex-selective abortion, and, in some cases, the neglect of sick daughters.
• The number of girls per 100 boys, ages under five dropped from 96 to 91 between 1950 and 2019.
Demographic distribution:
• Most states in the southern region and select northern states such as Himachal Pradesh and Punjab reported a higher share of elderly population than the national average in 2021. This gap is expected to widen by 2036.
• This gap is expected to widen by 2036.
• East and South Asian societies: rapidity of ageing compared to the experience of Western countries.
• The magnitude of the increase in the proportion of older persons witnessed over a hundred years in the West has occurred in a mere 20-30 years in South and East Asia.
Challenges associated with increasing elderly population(middle and low-middle-income countries)
• Inadequate social protection for the elderly, including pensions, access to health and social-care services.
• Rapid changes in family structures, with the spread of nuclear families,
Steps taken by East Asian countries:
• They have integrated health and social care through financial investments, including a variety of insurance schemes
• They have strengthened these institutions at the community level.
Challenges for India:
• Unlike the East and South East Asian countries, India does not have a universal public pension scheme, health insurance or social-care provisioning
• India has some health insurance and social welfare schemes targeted only at older persons below the poverty line.
• Available macro data and a few micro studies highlight inequalities in the availability, accessibility, affordability and acceptability of the services and support needed by older persons.
• Access to government health insurance like the Ayushman Bharat Programme is seen as being limited to those below the poverty line.
• Government insurance programmes like the Central Government Health Scheme (CGHS) or the Employment State Insurance Scheme (ESIS) cover only government employees and those in the organized sector.
• Older persons face difficulties in claiming insurance due to long processing times, claim deductions and rejections.
What steps need to be taken?
• Assess the supply side in terms of social protection, insurance schemes, and health and social-care institutions.
• Given the fractured landscape of financing and provisioning of the required services. Define the ecosystem of care and then offer a guide to policy planning.
• Define the ecosystem of care and then offer a guide to policy planning.
Different surveys:
• Longitudinal Ageing Survey in India (LASI): Those above 60 years suffer from multiple morbidities due to non-communicable diseases that include diabetes, hypertension and cardiovascular conditions. It highlights the variations in the social determinants of the health and well-being of older persons. Geographical location, class, caste and gender, work and pensions are important determinants for perceived quality of life. A large proportion of older persons, especially those who continue to work and that too in the unorganized sector, are ineligible for pension or other forms of income support.
• It highlights the variations in the social determinants of the health and well-being of older persons.
• Geographical location, class, caste and gender, work and pensions are important determinants for perceived quality of life.
• A large proportion of older persons, especially those who continue to work and that too in the unorganized sector, are ineligible for pension or other forms of income support.
• The Helpage India Report 2024, ‘Ageing in India: Exploring Preparedness and Response to Care Challenges’: It carried out across 10 states and 20 cities It highlights the gaps in access to financial security, health and social care. The cross-sectional survey covered Tier I and Tier II cities. Its findings highlight the poor coverage of social pensions, which were largely skewed to the middle classes in government service. Older persons reportedly felt financially insecure and were dependent on their family members for support.
• It highlights the gaps in access to financial security, health and social care.
• The cross-sectional survey covered Tier I and Tier II cities.
• Its findings highlight the poor coverage of social pensions, which were largely skewed to the middle classes in government service.
• Older persons reportedly felt financially insecure and were dependent on their family members for support.
• Both the LASI survey and the Helpage India Report highlight the burden of multiple morbidities due to one or more Non-Communicable Diseases (NCDs).
Way Forward
• As the disease burden increases with age, the ability to manage activities of daily living reduces. The elderly require both physical and emotional support that is mostly provided by family members. Given the changes in family structure in urban areas, the stress of caregiving falls on women in the household. In households where adult children have migrated for work, older persons often live on their own.
• The elderly require both physical and emotional support that is mostly provided by family members.
• Given the changes in family structure in urban areas, the stress of caregiving falls on women in the household.
• In households where adult children have migrated for work, older persons often live on their own.
• Institutional support outside the realm of family and home-based care, in the form of retirement communities and long-term and end-of-life care, is poorly developed in India in the public, private and non-profit sectors.
• The upper-middle class and the rich are able to access the newly emerging retirement communities that provide a range of services for health and social care. The problem is acute for the lower-middle class and the urban and rural poor.
• The problem is acute for the lower-middle class and the urban and rural poor.
• Public policy must unpackage the multiple axes of inequalities in access to financial security, health and social care of older persons.
• As India becomes an aging society there are significant gaps in access to pensions, health services and social care for older persons that need to be addressed.
• As the country seeks to encash the “demographic dividend” it must pay attention to healthy ageing.
QUESTION FOR PRACTICE
Discuss the main objectives of Population Education and point out the measures to achieve them in India in detail.(UPSC 2021) (200 WORDS, 10 MARKS)
Editorial Analysis – 31 June 2024