Demographic Shift and India

Context:
India’s elderly population (those aged 60 and above) is expanding rapidly. In 2023, there are 149 million elderly individuals, making up 10.5% of the total population. By 2050, this figure is projected to reach 347 million, or 20.8% of the population.

Challenges of an Ageing Population

• Increasing Dependency Ratio: India’s old-age dependency ratio, at 15.7 per 100 working-age individuals (as of 2023), places growing financial demands on public resources.
• Healthcare Burden: According to the Longitudinal Ageing Study of India (2017-18), 30% of elderly women and 28% of elderly men suffer from chronic conditions such as diabetes and hypertension, particularly in rural regions.
• Economic Insecurity: The India Ageing Report 2023 indicates that 40% of elderly Indians are in the poorest income bracket, with 18.7% of them having no personal income.
• Inadequate Pension and Insurance Coverage: Less than 20% of elderly Indians are covered by health insurance, which results in significant out-of-pocket expenses for medical care.
• Social Isolation: Due to the migration of younger family members, many elderly individuals, especially in states like Kerala (with 16.5% of its population elderly), face loneliness and depression.
• Labour Force Contraction: In states like Kerala and Tamil Nadu, the rise in the elderly population is leading to a reduction in the active workforce, thereby affecting overall economic productivity.
• Caregiving Pressures: A substantial portion of the elderly, 58% of men and 68% of women, require daily assistance, placing heavy burdens on family caregivers (LASI 2017-18).
• North-South Demographic Divide: Southern states are aging more rapidly due to lower fertility rates and better healthcare, leading to disproportionate pressure on their resources compared to northern states.

Government Initiatives for the Elderly

• National Policy on Older Persons (NPOP), 1999: Aims to safeguard the health, safety, and financial well-being of senior citizens, promoting the family as the primary support system.
• Indira Gandhi National Old Age Pension Scheme (IGNOAPS): Provides monthly pensions to elderly citizens living below the poverty line (BPL), ensuring basic financial security.
• Rashtriya Vayoshri Yojana (RVY): Distributes physical aids, such as mobility devices, to BPL elderly citizens with disabilities related to aging.
• Pradhan Mantri Vaya Vandana Yojana (PMVVY): A pension scheme that guarantees returns, offering financial security post-retirement.
• Varishtha Pension Bima Yojana (VPBY): Provides regular monthly pensions for citizens aged 60 and above, functioning as a form of social security.
• Atal Vayo Abhyuday Yojana (AVYAY): Consolidates elderly welfare programs, emphasizing healthcare access, helplines, and reducing social isolation.
• National Programme for Health Care of the Elderly (NPHCE), 2010: Focuses on the specialized healthcare needs of the elderly, particularly chronic disease management and the establishment of geriatric healthcare units.
• Integrated Programme for Senior Citizens (IPSrC): Offers financial support to NGOs for running old-age homes, daycare centers, and mobile healthcare units for elderly individuals in underserved regions.
• Ayushman Bharat (PM-JAY): Provides free secondary and tertiary healthcare services to senior citizens.

Way Forward

• Encouraging Employment of Older Workers: Offering tax incentives to companies that employ elderly workers could help retain their experience in the workforce.
• Utilizing Experience: Mentorship programs for older adults, similar to Singapore’s “SkillsFuture” initiative, can promote knowledge transfer across generations.
• Flexible Work Arrangements: Establish part-time job opportunities for the elderly without compromising their health. Australia’s “Workplace Gender Equality Agency” promotes such flexibility in employment.
• Investing in Age-Friendly Infrastructure: Develop accessible public spaces and transportation systems to support the elderly.
• Strengthening Healthcare Infrastructure: Boost investments in geriatric care, especially in rural areas, where 79.9% of Community Health Centers are short of specialists.
• Creating Long-term Care Systems: Set up long-term care facilities and home-based care for chronic conditions like dementia. Norway’s model for comprehensive home care can serve as an example.
• Promoting Age-Friendly Environments: Implement urban planning initiatives that enhance the mobility and social engagement of older adults, similar to New Zealand’s “Age-Friendly Cities” project.
• Expanding Social Security: Strengthen pension schemes like PMVVY and IGNOAPS to ensure financial stability for the elderly, following Denmark’s flexible pension system as a model.
• Leveraging Technology: Expand telemedicine services and promote digital literacy among older adults to improve healthcare access.