Aug 27, 2024 09:08 PM IST
Evidence suggests that if appropriate investments are made, elders too can contribute to an Atmanirbhar Bharat based on the idea of Sabka Sath, Sabka Vikas, Sabka Vishwas and Sabka Prayas.
As per the Longitudinal Aging Survey in India, more than one out of four people attribute health-related expenses as the number one reason for indebtedness in urban areas. In rural areas, this was a close second after the purchase of agricultural land. These statistics highlight the crippling impact of health care costs for senior citizens who are particularly vulnerable to age-related health issues. From that perspective, the expansion of the Ayushman Bharat scheme to senior citizens 70 years and older marks a significant step towards alleviating the financial burden of health care on the elderly. However, to ensure sustainability, the expansion of the scheme must be complemented with a comprehensive primary health care system that is focused on prevention and health promotion at every age. This will allow people to arrive at an older age healthier and stay healthy longer.
The importance of this approach becomes even more critical when we consider demographic projections. By 2050, India’s elderly population is expected to double, reaching about 319 million. This would mean that one in every five Indians will be over the age of 60. Obviously, this will have a profound implication not only for our health care system, but for society at large. So, how do we adapt to this significant change? What are some of the challenges and opportunities? The World Health Organization recommends interventions under three pillars — health, social security, and participation — to support this transition.
On the health front, the expansion of the package of services under the National Health Mission at the primary level to include palliative care is a step in the right direction. This will need significant investments to transform the system and align it with the needs of an ageing population. That will require a larger share of the Gross Domestic Product (GDP) dedicated to health than what has been currently offered in the budget.
Second, a social security system to create a safety net in a country, where nearly 80% of people work in the informal economy, is needed. The ministry of rural development has schemes for non-contributory financial assistance and food security for elders below the poverty line. However, the amount is meagre, and the schemes remain underutilised. Measures should be taken to facilitate uptake. Moreover, they must be re-examined to reflect present day realities in terms of the assistance provided. An example of a successful social security programme is Bolivia’s Renta Dignidad, a pension scheme for the elderly. Aside from its benefits for the recipient, the programme had a profound impact on child labour and school enrolment among families covered.
Third, investments to promote participation must focus on developing an age-friendly environment and opportunities to engage in paid or voluntary work. The elderly population is not homogenous. Many are in good health and can continue to work while others may engage in voluntary caregiving activities for grandchildren and other family members. This, among other things, allows women to participate in the workforce.
Studies have shown that elders bring with them unique problem-solving skills and social capital. And, as they age, there is an innate desire among them to contribute to society. These combined attributes bring value to individuals and communities. For example, in the United States (US), the Experience Corps is one such programme that engages trained elders to volunteer in schools to support vulnerable children with poor educational outcomes. Studies have shown that the programme benefited both children and elders. It improved learning outcomes for children and elders benefitted from better strength, mobility, and mental health. The programme has been implemented in nearly 23 US cities for over two decades.
While social participation has not been a focus of ageing discourse in India, some initiatives to address this gap have been taken. Under the ministry of social justice and empowerment’s Senior and Able Citizens for Reemployment in Dignity (SACRED) programme, there is an online platform for employment opportunities for the elderly in the private sector. Similarly, the National Education Policy 2020, has introduced the concept of “professors of practice” for appointing experts, including retired professionals, in higher education institutes. While these are promising initiatives, more needs to be done for these to take off. These programmes should be revisited and implemented either alone or through the engagement of relevant stakeholders. Last but not least, ageism, or stereotyping based on age is another factor that needs to be addressed. This will require sensitisation and awareness generation so that elders are seen as valuable members of society. Along with public programmes, the private sector can contribute by reskilling and upskilling elders to create a multigenerational workforce. They can also be incentivised to develop innovative technologies catering to an ageing population.
There is no doubt that tangible steps are also being taken to address ageing in the public sphere. During the 2024 general elections, for the first time, the option for voting from home was available to senior citizens over 85 years of age. The time has come to put the agenda of ageing up front and centre so that a whole-of-government and a whole-of-society approach can be taken to add life to the years. Evidence suggests that if appropriate investments are made, elders too can contribute to an Atmanirbhar Bharat based on the idea of Sabka Sath, Sabka Vikas, Sabka Vishwas and Sabka Prayas.
Abha Jaiswal is a public health expert working with the Sankala Foundation.The views expressed are personal
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