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| India ageing: A Concern! | | | Dr. Pragya Khanna | 8/16/2018 10:39:05 PM |
| India will transform gradually from young India to a 'greying' country and by 2050 every 5th Indian will be in 60s as against every 12th at present. India's older population will increase dramatically over the next four decades. Yes! The share of India's population ages 50 and older is projected to climb from 16 percent in 2010 to 34 percent in 2050, according to the United Nations Population Division (UN 2011). By mid-century, India's 60 and older population is expected to encompass 323 million people, a number greater than the total U.S. population in 2012. This profound shift in the share of older Indians, taking place in the context of changing family relationships and severely limited old-age income support, brings with it a variety of social, economic, and health care policy challenges.
Life expectancy at birth in India climbed from 37 years in 1950 to 65 years in 2011, reflecting declines in infant mortality and survival at older ages in response to public health improvements. By 2050, life expectancy at birth is projected to reach 74 years.
Economic development and urbanization have brought lifestyle changes that have led to unhealthy nutrition, physical inactivity, and obesity contributing to the prevalence of a number of ailments. Chatterji and colleagues (2008) report a high rate of smoking (26 percent) and inadequate physical activity (18 percent) among Indians. These behaviours will likely translate into future ill health.
Almost one-half (47 percent) of older Indians have at least one chronic disease such as asthma, angina, arthritis, depression, or diabetes. India's health insurance scheme for the poor only covers those ages 65 and younger, leaving India's elderly population particularly vulnerable. Rising numbers of older people will put new and increasing demands on the health care system.
The 2005-2006 National Family Health Survey in India examined living arrangements by household, which is defined by having separate cooking facilities even if older parents and adult children live in adjacent structures. According to Bloom et al. 2010, the recent surveys confirm this shift in attitudes, with a 40 percentage point decline in the share of adult children who said caring for their elderly parents was their duty, from 91 percent in 1984 to 51 percent in 2001.
According to Tsuyoshi Oyama, Deloitte Japan Economist, "As is already increasingly evident in Japan, the surge in ageing-related opportunities will be evident well beyond health care. Rapid ageing in the Japanese population has changed the needs of people and the way businesses satisfy them. There has been increasing demand in sectors such as nursing, consumer goods for the elderly, age-appropriate housing and social infrastructure, as well as asset management and insurance,".
Among the measures recommended to deal with rising shortages in workforce in the Asian region and pre-empt the adverse effects of an ageing population, the report recommended an increase in the retirement age, incentivising the participation of female workforce, welcoming migrants, and increasing productivity and skill development.
In India, the elderly depend upon the joint family system for care-giving support. However, factors such as industrialization, migration, and urbanization have disrupted the joint family system and resulted in the growth of nuclear families. In the process, the elderly are encountering both economic and emotional problems.
The increasing dependency ratio brings more economic pressure on working population. As the ratio increases there may be an increased burden on the productive part of the population to maintain the means of livelihood of the economically dependent. This results in direct impacts on financial expenditures on things like social security, as well as many indirect consequences.
As per the most recent report jointly brought out by United Nations Population Fund (UNFPA) and Help Age International, the number of elders, who have attained 60 years of age, will shoot up by 360 per cent between 2000 and 2050 and the government should start framing policies now else its consequences are likely to take it by surprise. India has around 100 million elderly at present and the number is expected to increase to 323 million, constituting 20 per cent of the total population, by 2050. The population of the older persons in India is continuously increasing.
The Registrar General of India forecasts the share of older persons (age 60 years and above) in the total population to rise from 6.9% in 2001 to 12.4% in 2026.
As per the Constitutional Provisions for Older Persons the following are some important points:
lWell-being of older persons has been mandated in the Constitution of India. Article 41, a Directive Principle of State Policy, has directed that the State shall, within the limits of its economic capacity and development, make effective provision for securing the right of public assistance in cases of old age.
lThere are other provisions, too, which direct the State to improve the quality of life of its citizens. Right to equality has been guaranteed by the Constitution as a Fundamental Right. These provisions apply equally to older persons.
lSocial security has been made the concurrent responsibility of the Central and State Governments.
lThe Criminal Procedure Code, Hindu Adoption & Maintenance Act and Maintenance and Welfare of Parents and senior Citizen Act deal with the concerns of Senior Citizens in India.
lThe 2007 act explicitly maintains that it should be the duty of the children to maintain their parents. It is applicable to all persons irrespective of their religion. Maintenance covers all basic necessities and requirements of life. There is no restriction / bar on the age of parent. Parent can claim maintenance without any bar of age, except in the case that children is minor. The act also includes the Childless senior citizen. A childless senior citizen can claim maintenance from relative who is legal heir of that senior citizen and who is in possession of or would inherit his property after his death.
In order to address the problems of the older persons, the Ministry of Social Justice and Empowerment (MoSJE) has launched in the year 1999, a National Policy on Older Persons (NPOP). Its main features are as follows:
lOld Age Pension Scheme
lTax Exemption for Senior Citizens
lMake PDS to reach older people
lSubsidy in healthcare, geriatrics care, mental health services, counselling facilities
lGrants, land grant at concessional rates to NGOs and private hospitals to provide economical and specialized care for the older person
lEarmarking 10% of the houses in housing schemes and easy access to loans
lLayout of housing colonies to be sensitive to the needs of the older persons
lQuick disposal of cases of property-transfer, mutation, property-tax etc.
lAssistance for construction/ maintenance of Old-Age Home, Daycare Centers, Multi-service Citizens Center, outreach services, supply of disability related aids and appliances etc.
lSetting up a welfare fund for older persons
In 2010, the National Policy of Older Persons (NPOP) finished 10 years. To review it, Dr. V Mohini Giri committee was set up by the government to assess the present status of various issues concerning senior citizens and implementation of NPOP, 1999. The committee was also asked to draft a new National Policy on Older Persons, keeping in view the emerging trends in demographic, socio-economic, technological and other relevant fields.
Dr. V. Mohini Giri has submitted final draft of National policy on senior citizens 2011 to the Indian ministry of social justice and Empowerment.
lOne of the important recommendations of this committee was that recipients of national honours like Padma awards or gallantry awards in the armed forces or national recognition for arts and culture must be given lifelong healthcare facilities for free on the lines of central government health services.
lThe draft of National policy on senior citizens 2011 calls for the setting up of a department of senior citizens 2011
lIt also recommends for the selling up of a department of senior citizens and also a national council for senior citizens.
lAccording to the policy employment in income generating activities after superannuation will be encouraged.
lThe draft policy also speaks that old-age pension scheme for those living below the poverty line would be expanded to cover all senior citizens.
lRates of monthly pension will be increased to Rs. 1000 per person and revised at intervals to prevent its deflation.
In accordance with the Directive Principles of State Policy, the Government of India introduced in 1995 the National Social Assistance Programme (NSAP) to lay foundation to a National Policy for Social Assistance for the poor. The NSAP aims at ensuring minimum national standard for social assistance in addition to the benefits that state are currently providing or might provide in future.
lAt present NSAP comprise Indira Gandhi National Old Age Pension Scheme (IGNOAPS), National Family Benefit Scheme (NFBS) and Annapurna.
Under IGNOAPS which was launched on 19th November, 2007, Rs. 500 per month per beneficiary is provided by way of central assistance to all persons who are 65 years of higher and belonging to a family living below the poverty line.
Another aspect of concern is the Feminization of the Old Population
lAccording to the World Population Prospects: The 2010 Revision, the current youth bulge in the country is expected to last till 2025. After that, the growth rate of the elderly is likely to take over. This report says that by 2050, women over 60 years would exceed the number of elderly men by 18.4 million, which would result in a unique characteristic of 'feminisation' of the elderly population in India as is being experienced in many provinces of China.
lThe predicament of elderly women is aggravated by a life time of gender-based discrimination. The gendered nature of ageing is such that universally, women tend to live longer than men. In the advanced age of 80 years and above, widowhood dominates the status of women with 71 per cent of women and only 29 per cent of men having lost their spouse.
lSocial mores inhibit women from re-marrying, resulting in an increased likelihood of women ending up alone.
lThe life of a widow is riddled with stringent moral codes, with integral rights relinquished and liberties circumvented. Social bias often results in unjust allocation of resources, neglect, abuse, exploitation, gender-based violence, lack of access to basic services and prevention of ownership of assets. Ageing women are more likely to get excluded from social security schemes due to lower literacy and awareness levels.
The 'Global Report on Ageing' says that India has the responsibility to formulate and implement public policy on population ageing. Issues of poverty, migration, urbanisation, ruralisation and feminisation compound the complexity of this emerging phenomenon.
With increasing longevity and debilitating chronic diseases, many elder citizens will need better access to physical infrastructure in the coming years. Lack of physical infrastructure is a major deterrent to providing comfort to the aged. Many elder citizens need better access to physical infrastructure, both in their own homes and in public spaces. Unattended chronic disease, unaffordable medicines and treatment and malnutrition are part of old age life in India as there is no system of affordable health care. Emphasis on geriatrics in the public health system is limited with few dedicated geriatric services. The other issues of the public health system are lack of infrastructure, limited manpower, and poor quality of care and overcrowding of facilities due to insufficient focus on elderly care.
It is important to understand the social aspects concerning aged in the country as they go through the process of ageing. Increased life expectancy, rapid urbanization and lifestyle changes have led to an emergence of varied problems for the elderly in India. It must be remembered that comprehensive care to the elderly is possible only with the involvement and collaboration of family, community and the Government. India should prepare to meet the growing challenge of caring for its elderly population. All social service institutions in the country need to address the social challenges to elderly care in order to improve their quality of life. There is a need to initiate requisite and more appropriate social welfare programmes to ensure life with dignity for the elderly. In addition, there is also a need to develop an integrated and responsive system to meet the care needs and challenges of elderly in India. |
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