Outliving and Outlasting: Explaining Sex Inequities in Healthy Life Expectancy Through the Lens of Multimorbidity and Within Morbidities Among Older Adults in India

Ajay Kumar , International Institute for Population Sciences (IIPS)
Suryakant Yadav, Assistant Professor

Over the past century, life expectancy (LE) at birth in India has increased significantly, primarily due to declines in infant and child mortality, followed by reductions in mortality among older adults. However, the gap in LE between male and female has widened significantly, while healthy life expectancy (HLE) has notably declined, particularly due to a rising burden of non-communicable diseases (NCDs) and in recent decades, by multimorbidity among older populations. Utilizing the SRS and Longitudinal Ageing Study in India (LASI) Wave 1 dataset, we examined age-specific healthy lifespan inequality (HLI) between sexes, decomposed healthy life expectancy (HLE) disparities, and further quantified the inequality by mortality and prevalence rate in complex multimorbidity. Findings revealed that female (30.59 years) consistently outlive male (29.15 years) and enjoy more multimorbidity-free years, but they also endure longer periods with multimorbidity. Mortality differentials are the primary drivers of age-specific HLE gaps between male-female. Multimorbidity and disease-specific differences in HLE highlight a paradox where female outlive male but endure longer periods with chronic conditions. Cardiovascular and bone diseases significantly impact female’s DFLE, while male experience sharper declines from lung diseases. Complex multimorbidity disproportionately affects older female, underscoring their higher burden of severe health conditions. In conclusion the findings highlight that with the rapidly ageing population and shifting epidemiology characteristics, public health interventions are pivotal to mitigate the underpinning gap in HLE between older male and female, particularly in the transitioning disparity of complex multimorbidity burden and degenerative diseases susceptibility.

See paper

 Presented in Session 22. Gender, Sex and Health