Ageing Women and Health Inequities

The India Ageing Report 2023 highlights that India’s elderly population (60+) will comprise over 20% of the population by 2050, with women living longer but spending more years in poor health.

The Gendered Dimensions of Ageing in India

Demographic Transition and Gender Tilt

• By 2050, more than one-fifth of India’s population will be above 60 years.
• Women live on average 7 years longer than men, creating a demographic tilt towards more elderly women.
• However, elderly women spend 25% more time in poor health compared to men.

Social and Economic Determinants of Health

• Financial Insecurity: A 2011 UNFPA study found that 60% of elderly women have no personal income, and <20% can pay their medical bills.
• Economic Dependence: Elderly women are more dependent on family members than men, influencing health-seeking behaviour.
• Digital Divide: Older women have lower access to digital devices and health-related information.
• Patriarchal Control: Spouses/adult children often decide when or whether elderly women seek medical care.

Healthcare Access Challenges

• Lack of gender-sensitive health facilities; low female health provider availability.
• Absence of regular uro-gynaecological care post-reproductive age.
• Under-diagnosis and delayed treatment of cancers (breast, cervical, ovarian, uterine).
• Higher risk of osteoporosis, arthritis, and fractures, leading to disability.
• Elderly women face greater neglect in mental health care; only 1 in 10 seek help for depression (HelpAge India).

Disease Burden and Gender Gap

• Non-Communicable Diseases (NCDs): Hypertension, diabetes, cardiovascular diseases, and cancer are more severe among elderly women due to post-menopausal changes.
• Neurodegenerative Disorders: Alzheimer’s and dementia are more common among women due to longer lifespan and isolation.
• Healthcare Spending Bias: Across all socio-economic groups, expenditure on women’s health remains lower than on men.

Positive Coping and Resilience Factors

• Community Networks: Elderly women remain embedded in families and social groups, which helps against loneliness.
• Active Engagements: Yoga, walking groups, hobbies, and cultural participation improve mental and physical health.
• Education: Educated women avail more outpatient care and preventive health services.

Way Forward

• Gender-Sensitive Healthcare: Policies must integrate elderly women’s distinct health needs (including non-reproductive care).
• Financial Inclusion: Strengthen pension coverage, social security, and health insurance for elderly women.
• Preventive Health Measures: Routine screenings for cancers, osteoporosis, diabetes, and mental health must be expanded.
• Community-Based Care Models: Develop elderly care centres focusing on women’s wellness and counselling.
• Bridging Digital Divide: Enhance access to telemedicine and digital health literacy among elderly women.
• Capacity Building: Train healthcare providers in geriatric and gender-sensitive care delivery.