Gender Disparities in Health of Older Adults in India: Assessing the Morbidity-Mortality Paradox through Disability Free Life Expectancy

Sadanand Karun, International Institute for Population Sciences (IIPS)
Lotus McDougal, Center on Gender Equity and Health, UCSD
Abhishek Singh, International Institute for Population Sciences (IIPS)

In many contexts, females live longer than males, but their time spent with disability is also higher. Our study assesses gender disparities in health and the morbidity-mortality paradox among older adults aged 60 and above in India and its states. Utilizing data on death and disability rates, we constructed health expectancies using Sullivan's method. The stepwise-replacement decomposition technique was used to decompose the gender gap in health expectancies into mortality and disability components. We found a gender gap of 1.8 years in life expectancy (LE) at age 60 (Male-LE=17.4 years; Female-LE=19.2 years). The gender gap ranged between 5.1 years in Jammu and Kashmir and -1.1 years in Jharkhand. The disability prevalence was higher among women than men both nationally and in states. The decomposition result indicates that nationally, 98% of the mortality advantage of females was spent in disability. The disability disadvantage of females over mortality advantage was highest in Uttar Pradesh; 93% of additional years of life were spent with disability. However, it was lowest in Rajasthan, where only 9% of additional years were spent in disability. Age-wise decomposition indicates a decrease in mortality effect and an increase in disability effect with increasing age. In conclusion, the morbidity-mortality paradox exists in India and its states.

Keywords: Mortality and Longevity, Population Ageing, Gender Dynamics, Older Adults and Intergenerational Relations

See extended abstract.