India’s ageing population puts new pressure on healthcare and families

India is entering a major demographic shift, with the country expected to have around 347 million people aged 60 and above by 2050. That would mean one in five Indians will be over the age of 60, according to a new study released by Transform Rural India (TRI). Nearly seven in 10 older adults are also expected to live in rural areas.

The findings point to a growing healthcare challenge for India. The country has traditionally benefited from a large working-age population, but the number of working-age adults available to support each older person is falling. The study said the figure is projected to decline from 8.4 in 2001 to an average of 5.2 by 2026.

The white paper, titled “Demographic Transition, Evolving Families and the Future of the Care Ecosystem in Rural India”, says India is ageing at a lower income level than many developed countries did when they went through a similar demographic change. This could make the transition more difficult because families, communities and public healthcare systems may have fewer financial resources to deal with rising care needs.

The pressure is already being felt inside Indian households. Nearly 94 per cent of care for older people is still provided within families, according to the study. However, family structures are changing as households become smaller, younger people move to cities for work and people live longer. This leaves fewer family members available to care for older relatives.

Women are carrying much of this unpaid care work. The study found that women spend around 305 minutes a day on unpaid care work, compared with 56 minutes for men. It also noted that heatwaves and floods can increase the amount of unpaid work that women have to perform.

The health burden is also changing. Around two-thirds of deaths in India are now linked to non-communicable diseases such as diabetes, cardiovascular diseases and cancer, the study said. More people are also living for longer with chronic illnesses and disabilities. This means healthcare cannot focus only on treating short-term illnesses or providing hospital-based treatment.

TRI has proposed a “neighbourhood of care” model to respond to this challenge. Instead of relying mainly on hospitals, the model would connect existing rural institutions such as Gram Panchayats, self-help groups, ASHAs, Anganwadi centres and Ayushman Arogya Mandirs. The aim is to bring basic support and care closer to people’s homes.

The study also sees the growing care requirement as an employment opportunity. It estimates that investing 2 per cent of India’s GDP in the care economy could create around 11 million jobs, many of them for rural women.

For ordinary families, the message is clear. India will need more than hospitals and medicines as its population gets older. It will need stronger community healthcare, better support for caregivers, improved financial security and systems that allow older people to live independently and with dignity.

India has spent decades improving survival and life expectancy. The next challenge will be making sure people can live healthier and better lives for longer.