India’s Ageing Women: The Silent Health Crisis

Why in the News?

1. The India Ageing Report 2023 by the International Institute for Population Sciences and the UN Population Fund projects that people aged 60+ will comprise over 20% of India’s population by 2050, indicating rapid ageing.
2. The report highlights a gendered health gap, with women living longer than men but spending 25% more time in poor health, according to the McKinsey Health Institute.

Key Highlights

1. Demographic Transition and Gender Gap
   2050. India’s elderly population (60+) is projected to cross 20% by 2050.
   2051. Women live 7 years longer than men on average, creating a demographic tilt.
   2052. However, women experience higher morbidity and disability in old age.
2. Social Determinants and Health-Seeking Behaviour
   1. Women prioritise family wellbeing over their own health, leading to neglect of personal care.
   2. Health-seeking behaviour is shaped by factors like education, social norms, marital status, financial dependency, and digital access.
   3. Elderly women are highly dependent on family for decision-making and mobility; two-thirds are accompanied by family members for care.
3. Economic and Digital Vulnerability
   1. Around 60% of older women have no personal income; less than 20% pay their medical bills
   2. Very few have health insurance coverage.
   3. A wide digital gender gap further restricts access to health services and information.
4. Gendered Health Risks and Diseases
   1. Chronic conditions like cardiovascular diseases, cancers, and neurodegenerative disorders are prevalent but underdiagnosed.
   2. Post-menopause risks: osteoporosis, arthritis, fractures, and nutritional deficiencies.
   3. High burden of breast, cervical, and ovarian cancers among older women; screening drops sharply after reproductive age.
   4. Mental health concerns: only 1 in 10 elderly women with depression seek help.
5. Positive Trends and Coping Strategies
   1. Many elderly women engage in community activities, yoga, hobbies, which improve mental and physical health.
   2. Educated women have better access to healthcare, showing the role of schooling in health empowerment.
   3. Social connections remain strong, acting as a protective factor against loneliness.

Major Initiatives & Schemes by the Government of India for Elderly Women

1. Financial Security and Pension Schemes
   1. Indira Gandhi National Old Age Pension Scheme (IGNOAPS)
      1. Provides a monthly pension to elderly persons (60+ years) belonging to Below Poverty Line (BPL) households.
      2. Women aged 60–79 get ₹200/month (central share); 80+ get ₹500/month. States often add to this.
   2. Pradhan Mantri Vaya Vandana Yojana (PMVVY)
      1. A pension scheme for senior citizens (60+) with an assured return of 8% per annum.
      2. Special focus on women investors for financial security.
   3. Atal Pension Yojana (APY)
      1. Provides defined pension after 60 years. Women subscribers get incentives for enrollment.
   4. Health and Nutrition
      1. National Programme for Health Care of the Elderly (NPHCE)
         1. Comprehensive geriatric health care through primary, secondary, and tertiary health facilities.
         2. Includes special outreach for elderly women with chronic illnesses and mental health issues.
      2. Ayushman Bharat – PM-JAY
         1. Provides cashless secondary and tertiary health care for poor senior citizens, including elderly women.
      3. Integrated Programme for Older Persons (IPOP)
         1. Grants to NGOs for running old-age homes, day-care centres, and health care facilities for elderly, prioritizing widows and single women.
      4. Poshan Abhiyaan
         1. Though mainly for children and pregnant women, some states have extended nutritional support to elderly women, especially widows.
      5. Social Security & Welfare
         1. Maintenance and Welfare of Parents and Senior Citizens Act, 2007
            1. Legal right for elderly (including women) to claim maintenance from children or heirs.
            2. Provisions for old-age homes and protection against neglect.
         2. Rashtriya Vayoshri Yojana
            1. Provides physical aids and assistive living devices (hearing aids, walking sticks, wheelchairs) to senior citizens belonging to BPL category, especially women.
         3. Senior Citizens’ Savings Scheme (SCSS)
            1. A government-backed savings instrument offering higher interest rates for senior citizens, benefiting elderly women who invest.
         4. Safety and Empowerment
            1. One Stop Centres (OSCs) under the Women and Child Development Ministry
               1. Provide support to elderly women facing abuse or violence.
            2. HelpAge India collaboration with Government
               1. Helplines, counseling, and support for elderly women in distress.
            3. Digital and Legal Support
               1. Digital Literacy Campaigns under PMGDISHA
                  1. Aims to reduce the digital divide among elderly women, enabling them to access telemedicine and online pension services.
               2. Senior Citizen Cell in Police Departments
                  1. Special cells for safety and grievance redressal, benefiting elderly women living alone.

Implications

1. For Public Health Policy
   1. Growing elderly population demands inclusive and gender-sensitive health systems.
   2. Need for lifelong preventive healthcare for women, not just maternal care.
2. For Social Structure
   1. Patriarchal norms and decision-making patterns restrict women’s autonomy in health-seeking.
   2. High dependency on family increases social vulnerability for older women.
3. For Economic Security
   1. Low personal income and inadequate insurance coverage heighten financial insecurity, delaying treatment.
   2. Higher health costs in later years increase economic burden on households.
4. For Healthcare Infrastructure
   1. Lack of female health providers, gender-sensitive facilities, and geriatric specialists limits accessibility.
   2. Inadequate screening for cancers and osteoporosis worsens late-stage diagnoses.
5. For Mental Well-being
   1. Rising cognitive decline, dementia, and depression among elderly women needs focused mental health programs.
   2. Social isolation post widowhood increases psychological vulnerability.

Challenges and Way Forward

Conclusion

India’s ageing women face a double burden — longer lives with prolonged illness and structural disadvantages. Bridging this health gap requires gender-sensitive policies, economic empowerment, improved screening, and accessible healthcare systems. Healthy ageing for women is not only a health issue but also a social and economic imperative for inclusive development.