Challenges and Opportunities for Elderly Women's Health in India

The ageing population in India is growing rapidly, with women living longer but often less healthily than men. By 2050, over 20% of India's population will be 60 years or older, with women having a longer average lifespan than men by 2.7 years. Despite this demographic trend, elderly women often face significant health challenges and remain on the periphery of healthcare discussions.

Health-Seeking Behaviours and Challenges

• Social Determinants of Health: Elderly women's health is influenced by socio-cultural, economic, and structural factors. These include education levels, social conditioning, marital status, and financial dependency.
• Barriers to Health-Seeking: The Three-Delays framework identifies barriers: 
  1. Household dynamics that de-prioritise elderly women's health. 
  2. Limited access to healthcare facilities and services. 
  3. Inadequate and untimely care at healthcare facilities.
• Economic and Digital Challenges: Financial insecurity and limited health insurance coverage affect elderly women disproportionately, as does the digital gender gap which impacts access to health information and services.

Common Health Issues

• Chronic Conditions: These include cardiovascular diseases, cancers, and neurodegenerative diseases. Women experience these conditions with different severity due to physiological transitions and caregiving burdens.
• Bone and Muscle Health: Post-menopausal hormonal changes lead to more severe outcomes for non-communicable diseases such as hypertension, diabetes, and cardiovascular illnesses. Osteoporosis and arthritis are prevalent but underdiagnosed.
• Uro-Gynaecological Health: Conditions like uterine prolapse, urinary incontinence, and pelvic floor dysfunction are common yet rarely discussed due to cultural stigma.
• Cancer Awareness and Treatment: Older women are more susceptible to cancers such as breast, cervix, ovaries, and uterus, with late-stage diagnoses being common due to low screening awareness.
• Mental Health: Elderly women face high rates of depression and anxiety, compounded by loneliness and caregiving burdens, yet only 1 in 10 seek mental health support.

Strategies for Improvement

• Inclusive Health Systems: To empower elderly women, health systems must be gender-sensitive, acknowledging their unique life paths and conditions.
• Data and Policy Initiatives: Large-scale, gender-disaggregated data collection and analysis can inform policies and interventions. Programs like the National Programme for Health Care of the Elderly aim to improve care.
• Pension and Financial Reforms: Policies such as the Atal Pension Yojana and state-level schemes should include gender-sensitive criteria and expanded benefits for informal workers.
• Health Insurance Evolution: Insurance schemes need to cover outpatient care, preventive diagnostics, and long-term needs. Programs like Ayushman Bharat should introduce packages for women-specific geriatric care.
• Community and Support Groups: Investing in women-led social support groups and initiatives like the Kudumbashree in Kerala can enhance social engagement and empower elderly women.

Conclusion

It is imperative to centre elderly women in healthcare systems and policies to build a stronger, caring society. This involves understanding their journeys, supporting their health needs, and ensuring they have access to care that is inclusive and considerate of their unique challenges.