India has been experiencing a demographic transition with decreasing fertility and increasing life expectancy in the last three decades, resulting in a significant increase in the older population across the country. In addition, the country is in the process of an epidemiological shift, with a surge in non-communicable diseases (NCDs), which are particularly prevalent among the elderly. NCDs have added to the burden of existing communicable diseases, resulting in a dual burden of diseases. In the ageing process, there is variation among the different states of the country, with those in the southern region leading the way in comparison to other states. However, all states are in a period of transition, with dropping fertility and rising life expectancy, which will result in a rise in the proportion of older people in each state in the future, but the rate and pace will differ. Therefore, the current study estimates the ageing level using several ageing indices and projected the ageing process in each state of the country.
Findings from the present study showed that there will be a change in the age structure of the population from 2001 to 2031, with an increase in the working-age group (15–59 years) and the older population (60 and above), but a decline in younger population ages 0–14 years. The rate of ageing in the country was slow due to high rate of fertility in the past. But it is predicted to rise (rate of ageing) as the rate of fertility is declining (Usha, 2010). Further, previous studies have expected that by 2030, the younger population will be shifted to an ageing population as a result of altering demographic structures (James, 2011). Although these demographic change has occurred due to improvement in healthcare, rising living standards, and better nutrition. These findings raise an alarm for the challenges of an ageing population across the country. Several researches have indicated that the impact of an ageing population will be significant in the future in terms of economic, health, and social security across the country (Agarwal et al., 2021; Bhattacharya, 2005; Day, Devaki, JK, Kabir, & KS, 2012a; James, 2011; McPake & Mahal, 2017). These issues are becoming grave concern to the country as the nuclear family structure replaces the joint family structure, leading to social and mental health issues among the elderly population (A. K. Bhat & Dhruvarajan, 2001; Golandaj, Goli, & Das, 2013). Moreover, results from the projected ageing indices display a remarkable surge in the median age, index of ageing (aged-child ratio), and old-age dependency ratios in India. All these indices, however, are increasing at diverse rates in different states. Meanwhile, the strongest indicator of population ageing has been the median age, which splits the population into two equal parts, half older and half younger. By 2031, Kerala is expected to have the highest median age, while Uttar Pradesh will have the lowest; nevertheless, Uttar Pradesh's projected increase will be more than the other states. During the period between 2011 and 2031, Kerala would have the highest expected increase in the index of ageing among southern states, followed by Maharashtra among western states, West Bengal among eastern states, and Punjab among northern ones. Furthermore, Kerala will have the highest increase in the old-age dependency ratio during the period between 2011 and 2031. It was claimed that Kerala had already achieved a significant level of ageing in the year 2011 and the remaining states are on their way to reach the same level of ageing as Kerala (P. N. M. Bhat & Rajan, 1990; James, 2011; Rajan, Shajan, & Sunitha, 2020; Ratcliffe, 1983; Zachariah, 2001). However, because of variations in demographic and health indicators, and the fact that different states are at varying stages of economic development and demographic transition, the population will age at varying rates in different states to reach the Kerala level.
The present study projected the year by which different states will achieve Kerala's ageing level of 2011. A few states have already achieved the Kerala level of median age and index of ageing by the year 2020, these states are Tamil Nadu, Punjab, Andhra Pradesh, and Himachal Pradesh. Further, by or before 2025, Karnataka, Maharashtra, Telangana, Odisha, and West Bengal will reach Kerala's median age of 2011. According to data, it has been observed that these states have the highest proportion of elderly people after Kerala, owing to their advanced level of mortality, fertility, and demographic changes as compared to their counterparts (Bose, 2013; Sekher, Raju, & Sivakumar, 2001; Spoorenberg, 2010). Moreover, these states are economically and socially developed and are having a significant level of education, especially among women. They also have early adoption of family planning, and awareness about the modern contraception methods which have been contributing to a sharp decline in fertility in these states(Basu & Sidh, 2008; Jejeebhoy, Santhya, & Zavier, 2014; Mathew et al., 2009; Murthy, 2014; P. Singh, Singh, Singh, & Pandey, 2020). Consequently, the overall population of these states has decreased significantly and is anticipated to continue to decline. Similar patterns for dependency ratios across the states in the country can be observed in the present study. The dependency ratio is a significant measures that give an idea about the demographic dividend. Previous studies stated that as the older population increases, old age dependency ratios will rise, posing issues such as limited mobility, social and structural impediments, wage loss, familial dependencies, and declining social involvement (Chanana & Talwar, 1987; Day, Devaki, JK, Kabir, & KS, 2012b; Smith & Majmudar, 2012). Present projected figures suggest that states in advanced demographic transition are expected to achieve Kerala’s level of old age dependency ratio early in the upcoming few years. Consequently, the demographic dividend is on the wane in these states including Kerala much earlier than in the rest of the country. Therefore, these states are needed to prioritise in terms of health care, financial assistance, and social and emotional support.
On the other hand, by the year 2035 and beyond, some northern states, as well as few other states, such as Bihar, Uttar Pradesh, Madhya Pradesh, Jharkhand, and Chhattisgarh, are likely to have Kerala level of median age and index of ageing. These states are reported to have a slow demographic change, because of high fertility and low life expectancy (Greenhalgh, Jeffery, & Jeffery, 1998; Tandon et al., 2018). These states are still facing poor economic and social development that has led to poor healthcare, low female literacy, and infant survival rates (Chowdhury, Taneja, Mazumder, Bhandari, & Strand, 2017; Jatrana, 2003; Patkar, 1995; R. B. Singh et al., 1997; Ram B. Singh, Niaz, Thakur, Janus, & Moshiri, 1998; T. Singh et al., 2016). Even though fertility is declining in these states but at a slow rate, leading to a shift in the age group of 0–6 years into the working ages in upcoming decades. In the meantime, there has been an increase in the working-age population. The future economic potential of the country is locked in these states which are experiencing a slow demographic transition. A panel study has documented a strong and positive association between the age structure transition and economic growth in China and India (D. E. (David E. Bloom, Canning, & Sevilla, 2003; D. E. Bloom, Canning, & Rosenberg, 2011). The shift in demographic structure will help the country's economy thrive, but it will depend on the country's policy environment and governance (James, 2008). In addition, the growing working-age population will create a significant burden in terms of education, employment, and healthcare to ensure the arrival of the window of demographic opportunity. Therefore, projection estimates from the present study suggest that policymakers should make it a priority to take full advantage of demographic bonuses by offering high-quality education, particularly for women, as well as greater job opportunities, especially in states having a larger population. Therefore, there is a need to make approachable efforts towards the increasing ageing population as needed implications of social, medical, and financial at the macro level as well as at the household level. Variations in the process of demographic transition across different states will invite different challenges for providing socioeconomic and health-related opportunities in the future. Access to pensions, healthcare, long-term care, and other care for this segment of the population will improve the quality of life among older adults (Agarwal et al., 2021). However, because of unemployment and low level of education among female, the government expenditure for social welfare schemes and health care expenditure will have a significant concern for the states that are in the advanced stage of demographic transition. The predicted projections from this study will contribute to the existing literature on social welfare programmes and the associated financial outlays to satisfy the increasing demand for old-age dependency and decreasing support base, which will be essential for policy consideration in the coming days.