This report on CSES Working Paper No. 31 was published in Times of India on 09-09-2021
Kerala needs to focus on challenges emerging from the demographic transition as the strategies adopted by the state now will determine the future course of transition, says a recent study by the Centre for Socio-Economic and Environmental Studies, Kochi.
Given its early onset, demographic transition in Kerala is now at the matured stage with fertility below the replacement level, life expectancy at birth above 75 years, decadal growth rate of population at 5% during 2001-2011 with negative growth in two districts. The demographic advantage has created certain unique challenges for the state that are yet to be visible at the national level.
The study by Baishali Goswami, associated fellow of CSES, aims to synthesize the current trajectory of the transition in the state in light of the existing trends experienced worldwide with regards to advanced mortality and fertility transition.
Despite a long history of mortality transition coupled with an advanced epidemiological transition, Kerala is yet to reach the advanced stage of mortality transition with mortality concentrated in ages 80 years and above, the study pointed out. Kerala successfully prevented infectious and communicable diseases at the early stage of the transition and ensured better longevity for its population. Life expectancy at birth increased from 62 years in 1970-75 to 72 years in 1996-2000 and then to 75 years in 2014-18. Reduction in mortality was mainly concentrated in the early years of life. To sustain this, the state now needs to focus on the health problems of adulthood that are much harder to prevent, in an age-disaggregated manner, says the study.
With mortality transition, Kerala experienced an obvious shift in the disease pattern from communicable to non-communicable diseases (NCD) and emerged as the state experiencing the highest level of epidemiological transition in the country. Between 1990 and 2016, NCD accounts for three-fourths of the total burden of diseases in the state and thus shifted the mortality up to mid-seventies.
Given the global experience, the study highlights that there remains untapped potential in the state to postpone the age-specific mortality from degenerative diseases from the current age group of 70+ further to the advanced age group of 80+.
Kerala, with the highest proportion of elderly among all states in India, has already started recognizing the unique health needs of ‘elderly’ as a group. The study calls for further refinement in strategies targeting intervention to address the intra-group differentials in mortality to postpone the death rates to advanced ages of 80 and above. This also calls foe age-sex disaggregated data across major killer diseases in the advanced age groups.