India is a young country, or so we keep hearing, with a median age of 27 and adding over 25 million new babies every year, educating, skilling and finding employment for over 1 million young Indians entering the workforce every year is an urgent national priority. We spend so much time on the youth, but unwittingly ignore the other demographic shift that will place a burden on our healthcare system: the burgeoning of the ageing population. Geriatric population. Geriatric population of India. Healthcare burden due to geriatrics.
Currently, the growth rate of the older population (1.9 %) is significantly higher than that of the total population (1.2 %). In the near future, the difference between the two rates is expected to become even larger as the baby boom generation starts reaching older ages in several parts of the world. With stabilizing (and declining) populations, the number of workers supporting retirees has reduced dramatically in most countries. The number of working age people supporting one retired person has halved in Japan in 20 years and in Germany over the last 40. Not only are there more elderly people, but they are living longer and consuming more healthcare. In the US, seniors constitute 13% of the population but account for 34% of all health expenses. This, even though the aging population will constitute less than 25% of the total population.
One may wonder how this is relevant to India, a country with a young population. I was recently speaking with an eminent academic and he said the same to me – we don’t have to worry about problems of the aged since we are still a country of young people. The numbers, though, tell a different story. The 2011 population census counted over 100 million elderly people (over the age of 60) in India and that number has been increasing rapidly. From 8.6% of the total population, the elderly will comprise 12.5% of people by 2030 and 20% of the total population by 2050. A staggering 325 million people elderly people will comprise India’s population in the next 30 years, bigger than many large countries!
While this demographic transition has happened in many other countries, the speed of change we are witnessing in India is unprecedented. The shift to older populations is happening much faster, and on a much wider base so that it’s impact is likely to be magnified several times. The developed economies have had over half a century time to understand the implications of this demographic shift and bring about social changes to manage it well. They are also addressing this challenge as much wealthier economies than the emerging nations. Countries like India are unlikely to have adequate time nor funding to adapt to these changes appropriately.
Caring for the elderly population poses different challenges, they are a different demographic and have a unique combination of social and healthcare needs. Most are retired from active professional lives, but will live for several decades with conditions like diabetes, cardiovascular and rheumatoid diseases. The lack of formal work and increasing urbanisation may contribute to a sense of isolation and a proliferation of mental health conditions. Our hospitals are primarily designed for acute interventions and not for chronic, sustained community based care. We have extremely poor options for home healthcare as well as a dearth of geriatric, palliative and integrated care providers in the country. These factors will significantly increase the long-term healthcare cost of caring for the elderly.
This is an added burden on a country still trying to rein in maternal and infant mortality as well as the impact of infectious diseases like tuberculosis. While it is credible the Indian government has recognised the problem and we have a National Program for elderly healthcare, spend on elderly healthcare remains a fraction of total health expenditure. A lot more needs to be done in order to provide the elderly the holistic care they are likely to need in the future.
The biggest shift though needs to happen in attitudes. Very often, when I speak of the elderly population, most people conjure up images of their parents or grandparents.To truly improve health for the burgeoning future ageing population of India, we must recognise the people we are talking about is ourselves.Click To Tweet
Many of us will be part of India’s elderly in the next few decades so any intervention for “their” health is really an intervention into “our” health. While we must plan for better facilities and funding, the best way to insure the health of India’s future elderly is to invest in our own wellness today.
Dr Aakash Ganju is a healthcare consultant and entrepreneur, focused on increasing transparency, access, and convenience to health providers and consumers. He is the CEO of Avegen and lives in Mumbai, India.
Also published on Medium.