The COVID-19 pandemic has had a more profound impact on life expectancy in India than previously believed, particularly affecting women, specific social groups, and younger populations.
Previous mortality estimates in India were based on official death records, which were disrupted by lockdown measures that also failed to capture deaths accurately among women and children. According to experts, existing systems do not collect essential demographic data such as caste or ethnicity.
In a groundbreaking study, researchers analyzed death data from the National Family Health Survey, which includes responses from participants on household deaths over the past four years, detailing dates of death, age, and gender. This analysis included over 765,000 individuals from 2021, revealing a significant rise in deaths in 2020—about 17% higher compared to 2019. This indicates nearly 1.2 million excess deaths in 2020, significantly surpassing the official COVID-19 death count and World Health Organization estimates.
Between 2019 and 2020, overall life expectancy at birth in this sample dropped by over 2.5 years, a stark contrast to the 1.5-year decline observed in the United States during the same period. The decline in life expectancy varied by gender, age, and social group. Women experienced a decline of roughly three years in life expectancy, compared to just over two years for men, diverging from global patterns where men faced greater mortality increases during the pandemic. Researchers attribute these trends to pervasive gender inequality in health care spending and access in India.
Prior studies indicate that Indian households allocate fewer healthcare resources to women compared to men, and the pandemic may have exacerbated these existing disparities. Additionally, strict lockdowns disrupted access to essential maternal and child healthcare, heightening risks for mothers and infants.
Notably, the decline in life expectancy was primarily driven by increased mortality among younger individuals. Mortality rates among women and girls under 20 contributed approximately one year to the overall decline, comparable to the impact of deaths in women aged 60 to 79.
Experts suggest that these increased mortality rates likely stem from indirect consequences of lockdown measures, including interrupted access to childhood vaccines and treatments for tuberculosis, which remains a leading cause of death in India.
The findings also revealed significant disparities among social groups: high-caste Hindus experienced a 1.3-year decline in life expectancy, while Muslims and individuals from lower castes saw declines of 5.4 years and 2.7 years, respectively. These results underscore the urgent need to address health inequities in India.
Although the study sheds light on these disparities, it does come with limitations. Due to lockdown disruptions, the survey data was collected from only 14 of India’s 36 states and union territories, representing about one-fourth of the population. The study did not determine specific causes of death, leaving researchers to speculate about these mortality patterns.
