India to grow old before it grows rich, 20 pc of population to be over 60 by 2050: Study

NEW DELHI: One in five Indians on an average will be over the age of 60, with nearly seven in 10 older adults living in rural India, a study showed on Friday.

The study released by Transform Rural India (TRI) said India is growing old before it grows rich, unlike many developed nations that became wealthy before their populations aged.

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.

Titled 'Demographic Transition, Evolving Families and the Future of the Care Ecosystem in Rural India', the white paper was released in connection with the TRI's India Rural Colloquy (IRC).

"By 2050, one in five Indians -- around 347 million people -- will be over the age of 60, with nearly seven in 10 older adults living in rural India. Unlike many developed nations that became wealthy before their populations aged, India is undergoing this demographic transition at much lower income levels," the study said.

Drawing on data from the National Family Health Survey (NFHS), Longitudinal Ageing Study in India, Census projections, Time Use Surveys and other national datasets, the white paper said India's traditional family-based care model is under increasing strain as families are smaller than before, younger generations are leaving for work and people are living longer.

"Yet nearly 94 per cent of care for older people is still provided within households, leaving fewer family members to meet growing and increasingly complex care needs," it added.

Women spend around 305 minutes every day on unpaid care work, compared with 56 minutes by men, the study said, adding that this unequal distribution of unpaid care remains one of the biggest barriers to improving women's labour force participation.

It also noted that climate change is worsening the situation, with heatwaves and floods adding significantly to women's unpaid work.

Around two-thirds of all deaths in India are now due to non-communicable diseases (NCDs) such as diabetes, cardiovascular diseases and cancer, while a growing share of the disease burden comes from years lived with disability rather than premature death, according to the study.

The white paper said India's healthcare system was largely designed around episodic interventions such as childbirth, immunisation and 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 added.

TRI recommends 'neighbourhood of care' model to link existing rural institutions, including Gram Panchayats, self-help groups, ASHAs, Anganwadi centres and Ayushman Arogya Mandirs, into a single community care network.

The model seeks to make integrated care available within walking distance of every household, with the white paper saying rural India does not need to build new care infrastructure but connect the institutions it already has.

The white paper also positioned care as an economic opportunity, estimating that investing 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, 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.