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Has Disability Risen among the Elderly in India?
An analysis of disability among the elderly and its covariates during the period 2005–12 is provided using data from the two rounds of the nationally representative India Human Development Survey, conducted in 2005 and 2012. The increase in life expectancy has not translated into a healthier life, as prevalence of disabilities, their severity, and their association with non-communicable diseases have risen. Given the lack of access to assistive devices, specialised medical services, rehabilitation, and stigma attached to disability, the temptation to offer simplistic but largely medical solutions must be resisted. Instead, a multidimensional strategy is needed that helps the elderly overcome physical and socio-economic barriers as well as address the issues related to prevention and treatment of their underlying health conditions.
The authors are grateful to Raj Bhatia for his meticulous help with the statistical analysis, Manorama Gaiha for her advice on medical aspects, N Chandramohan for several illuminating discussions, and K L Krishna, Maya Prabhu, Lola Nayar, and Varsha S Kulkarni for their Socratic inquiries. The authors are also thankful to the anonymous reviewer for their constructive suggestions.
A billion people worldwide, or 15% of the world’s population, live with disabilities (Groce and Mont 2017). Disability is part of the human condition, and almost everyone will be temporarily or permanently impaired at some point in life, and those who survive into old age will experience increasing difficulties in functioning. Disability is neither a purely medical nor a purely social phenomenon. Rather, it is an outcome of their interplay. Non-communicable diseases (NCDs) such as asthma, cancer, cardiovascular disease, and stroke are associated with impairments that get aggravated by stigma and discrimination in access to educational and medical services and employment. “Higher disability rates among older people reflect an accumulation of health risks across a lifespan of disease, injury, and chronic illness” (WHO and World Bank 2011). The co-occurrence of NCDs and disabilities poses a considerably higher risk of mortality.
Disability encompasses impairments resulting from congenital disorders, diseases, accidents, or ageing. With increasing age, several physiological changes occur, and the risk of NCDs rises. By age 60, the major burdens of disability and death stem from age-related losses in hearing, seeing and moving, as well as from the NCDs, especially in low- and middle-income countries (WHO 2015). Furthermore,
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