Ageing, activities of daily living disabilities and the need for public health initiatives: Some evidence from a household survey in Delhi

India is fast becoming a graying society as a result of its upcoming prospect to achieve an accelerating growth in the size of its ageing population. Two causal factors are: (a) a varying but persistent fertility-mortality decline across the country, and (b) added lifespan with increased survival chances, especially at the later end of the life cycle. Those changes, and in particular the added life years, have, however, been mired in the high prevalence of chronic diseases, affecting over half of the country’s population aged 60 and over (NSS 52nd round, 1995-1996). Such a situation - coupled with large-scale poverty and the poor financial status of the older persons (Alam, 2004) - is likely to pose many serious issues for the country. One of the more critical may indeed be the higher incidence of frailty, senescence, functional incapacitation and dependence of older men and women in activities of daily living (ADL) – raising questions for the caregivers, especially the families. With large-scale migration, declining family size and growing participation of women in economic activities, this traditional support mechanism is apparently on the verge of losing its sheen. Somewhat inexplicably, this aspect has been almost completely missed in the analytical literature on health and ageing in India. The analysis presented below is therefore a modest attempt to fill some of this void by looking into the following.