Gender disparities in health and wellbeing of older population in India

Gender disparities in health and wellbeing of older population in India

Table 1 reveals significant gender differences across various health and well-being indicators in most states and union territories of India. Overall, the prevalence rates of cardiovascular disease (CVD), bone diseases, low vision, oral health problems, mobility restrictions, and functional abilities (ADL, IADL) were higher among older women than older men by more than ten percentage points in the majority of the states and union territories.

Among older women aged 60 and above, the prevalence rate of cardiovascular disease (CVD) exceeds 50% in nine of the 36 Indian states, compared to just two states for older men in the same age group. The highest prevalence rates among older women are found in Goa (64%), Chandigarh (63%), Sikkim (61%), Kerala (58%), and Jammu and Kashmir (57%). In contrast, the highest prevalence rates for older men are lower, with Goa at 56%, Kerala at 55%, Sikkim at 54%, Andaman & Nicobar Islands at 50%, and Chandigarh at 48%. Similarly, the highest prevalence of bone disease among older women is observed in West Bengal (37%), Telangana (36%), Kerala (35%), Jammu & Kashmir (33%), and Andaman & Nicobar Islands (31%). For older men, the highest prevalence rates of bone disease are reported in the lower range in the states of Telangana (30%), West Bengal (29%), Maharashtra (22%), Tamil Nadu (22%), and Jammu and Kashmir (22%).

Older women in the northern Indian states of Haryana (14%), Punjab (14%), Himachal Pradesh (10%), Madhya Pradesh (10%), and Uttar Pradesh reported a higher prevalence of thyroid disorders. Additionally, the gender difference in the prevalence of depression was more pronounced in Bihar (7.4% women vs. 5.4% men), Chandigarh (8.6% vs. 5.8%), Goa (10.4% vs. 6.5%), Punjab (9.9% vs. 6.3%), and Uttar Pradesh (12.1% vs. 8.9%). States such as Chandigarh, Delhi, Puducherry, Tamil Nadu, and Kerala, which have a higher proportion of literate and educated women, demonstrated better cognitive function outcomes. Approximately half of the women aged 45-59 in Mizoram (52%) and one-third in Himachal Pradesh (32%) reported reproductive health problems, with over 20% reporting such problems in Madhya Pradesh, Uttar Pradesh, Uttarakhand, and Punjab. In contrast, older women in Tamil Nadu (10%), Andhra Pradesh (4%), Telangana (6%), and Goa (9%) reported lower prevalence rates of reproductive health problems.

In more than half of the states, the percentage of older women reporting mobility restrictions ranged broadly from 70% to 80%, compared to 50% to 65% among older men. Similarly, older women reporting functional limitations in activities of daily living (IADL) ranged from 50% to 65%, while for older men, it was between 35% and 50%.

These results confirm: a) higher rates of chronic health conditions and lower functional health outcomes among older women than men in most states; b) a higher prevalence of chronic health conditions in states advanced in demographic transition; and c) the geographic patterns of gender-based differences in education likely contribute to the observed disparities in both physical and mental health conditions between older women and men16. This pattern aligns well with well-established literature on gender-based inequalities in socioeconomic and health indicators across Indian states13,19. For instance, states with relatively high Human Development Indicators and stronger healthcare systems, such as Goa, Kerala, Chandigarh, and Puducherry, reported higher rates of diagnosis, treatment, and control of chronic health conditions for both older women and men4. In contrast, Nagaland and Lakshadweep, which have low literacy rates and limited access to healthcare services, showed lower treatment and control rates.

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