Daijiworld Media Network - New Delhi
New Delhi, Aug 9: One in five Indians is projected to be over the age of 60 by 2050, with nearly seven in 10 older adults expected to live in rural India, according to a study released by Transform Rural India (TRI) on Friday.
The white paper, titled 'Demographic Transition, Evolving Families and the Future of the Care Ecosystem in Rural India', said India is ageing before becoming wealthy, unlike several developed nations that became affluent before their populations grew older.
The number of working-age adults available to support each older person is projected to decline from 8.4 in 2001 to an average of 5.2 by 2026, the study said.
The report, released in connection with TRI's India Rural Colloquy, estimated that by 2050 around 347 million Indians will be aged over 60, with nearly 70 per cent of older adults living in rural areas.
Drawing on data from the National Family Health Survey, the Longitudinal Ageing Study in India, Census projections, Time Use Surveys and other national datasets, the study said India's traditional family-based care model was coming under increasing pressure as families become smaller, younger people migrate for work and life expectancy increases.
Nearly 94 per cent of care for older people is still provided within households, leaving fewer family members to meet increasingly complex care requirements, it said.
Women spend around 305 minutes a day on unpaid care work compared with 56 minutes for men, according to the study. It said the unequal distribution of unpaid care was among the biggest barriers to increasing women's participation in the workforce.
Climate change is further worsening the situation, with heatwaves and floods adding significantly to women's unpaid care responsibilities, the report said.
Around two-thirds of all deaths in India are now attributed to non-communicable diseases such as diabetes, cardiovascular diseases and cancer. A growing share of the country's disease burden also comes from years lived with disability rather than premature deaths, it said.
The white paper said India's healthcare system had largely been designed around episodic interventions such as childbirth, immunisation and treatment of acute illnesses.
"The next phase of healthcare is about supporting people living with chronic illnesses, disabilities and the challenges of ageing -- something hospitals alone cannot do," it said.
TRI recommended a 'neighbourhood of care' model that would connect existing rural institutions, including Gram Panchayats, self-help groups, ASHA workers, Anganwadi centres and Ayushman Arogya Mandirs, into a coordinated community care network.
The model aims to make integrated care available within walking distance of every household. The white paper said rural India does not need to build new care infrastructure but should connect and strengthen the institutions it already has.
The report also described the care sector as a potential source of employment, estimating that investment equivalent to 2 per cent of India's GDP in the care economy could generate around 11 million jobs, largely for rural women.
"India has made remarkable progress in helping people survive. The next challenge is ensuring they can live well for longer. Our demographic transition requires us to redesign care delivery itself -- beyond facility-based care, it will require to facilitate as shared community function and improving sustainable living conditions," said Shyamal Santra, practice director at Transform Rural India.
"The institutions needed to make this possible already exist across rural India. By connecting them through a common care mandate, an eco-system needs to be built that supports families, caregivers, strengthens local governance and prepares villages for the decades ahead," Santra added.