South Asia

Increasing longevity implies a rising burden of degenerative disease that characterizes an elderly population, but health care systems across most of South Asia are designed to cope with infectious disease control and maternal/child health issues that face a younger population. Preventive or palliative care for chronic conditions among elders is lacking. The concept of ‘‘healthy aging’’ has yet to be widely accepted. Individuals expect to ‘‘suffer various aches and pains’’ as they grow older, and may not seek treatment for even quite serious conditions. Health practitioners also tend to view chronic conditions as a natural consequence of aging rather than as diseases to be prevented or treated.

Above age thirty-five, Indian men have significantly shorter life expectancies than women, and the age-specific death rates are about twice those for women above thirty-five (review in Basu). High levels of adult male mortality may be partly attributed to tuberculosis and to aggravating lifestyle factors, such as tobacco and alcohol consumption. Increasing rates of cardiovascular disease can also be attributed to lifestyle factors. For women, increasing rates of cervical and breast cancer are noted. Indian women develop osteoporosis (and consequent hip fractures, therefore experiencing premature death) ten to fifteen years earlier than their counterparts elsewhere. Indian men also have a higher risk of hip fracture than do other men (Gupta).