The longevity puzzle

Life expectancy remains sub-par despite massive govt schemes

News that the average Indian can expect to live about 69.7 years, around two years more than the life expectancy 10 years ago, comes as a damper on the country’s self-image as an emerging power player on the global stage. Of course, when seen across a broader time horizon, India’s life expectancy can be considered to have improved by leaps and bounds from an abysmal 32 years around the time of independence. But 70 years of life expectancy for a 75-year-old nation looks modest when set against the global average of 72.6 years and when compared with neighbouring Bangladesh (which became independent 50 years ago) at 72.1 and Nepal at 70 years. The country’s life expectancy rate is also significantly behind China at 76.9 years. Although life expectancy crosses the global average in the following Indian states and Union Territories — Delhi, Kerala, Jammu and Kashmir, Himachal Pradesh, Punjab, and Maharashtra — none of them surpasses China’s record.

Underlying this poor performance on a key demographic indicator of economic development is the fact that Indian babies, especially girl children, still have a low chance of survival at birth and infancy. The latest abridged sample registration system data shows that the gap between life expectancy at birth and that at ages one or five has improved by only about 20 years over a 45-year period. Even this super-slow progress masks depressingly high metrics in states in north and east India, with Uttar Pradesh and Chhattisgarh sharing the dubious honour of being the worst performers with life expectancy of 65.6 years and 65.3 years, respectively. In the World Population Review’s latest country ranking of infant mortality rate (IMR), India weighed in at number 138 out of 195 countries, with a steep 27.8 deaths per 1,000 live births, again behind Bangladesh at 135 (IMR of 24.3) and Nepal at 132 (23.5). China, with an IMR of just 5.4, ranks 50.
 

The reason for India’s poor showing on life expectancy and the IMR is all too visible in the abysmal access to medical infrastructure for the average Indian, particularly women. The variations become obvious in the wide discrepancies between rural and urban life expectancy, which can vary as much as five to eight years. But this state of affairs is puzzling because since 1975, the Indian government has run a massive programme that was set up to focus on the health and nutrition needs of children under six years of age. A large network of anganwadi centres was set up as an adjunct to this programme, and almost every state offered mid-day meal schemes in their schooling system as a result of it. The Integrated Child Development Services (ICDS) boasts being one of the largest such programmes in the world, and initially claimed improvement in child health and nutrition. But over the years, both budgetary allocations and institutional attention to the implementation of this and related schemes appear to have waned. Some researchers have calculated that the ICDS and mid-day meal scheme budgets have been steadily cut in real terms since 2015-16, resulting in far lower coverage. Others have pointed out that the major beneficiaries of these schemes have been middle and lower-middle class children rather than the poor and marginalised. The latest figures suggest that an urgent course correction is long overdue.