Grey wave rising as South India’s population ages fast

SRS 2021 data reveals Kerala has the highest proportion of elderly citizens in India, with 14.4 percent of its population aged 60 or above—over one in every seven residents

Published May 13, 2025 | 7:13 AMUpdated May 13, 2025 | 7:13 AM

Grey wave rising as South India’s population ages fast

Synopsis: India’s southern states are seeing a demographic shift marked by an aging population, fewer youth, and a resilient workforce. SRS 2021 data reveals Kerala leads the nation, with 14.4 percent of its population aged 60 or above—highlighting a growing elderly demographic that could significantly influence regional economic and social policies in the years ahead

India’s demographic landscape is undergoing a quiet but consequential transformation. This shift is most visible in the southern states, where rising numbers of elderly citizens, a shrinking proportion of youth, and a still-strong working-age population are creating a unique demographic profile—one that could shape the region’s economic and social future.

Newly released data from the Sample Registration System (SRS) 2021, published by the Office of the Registrar General and Census Commissioner under the Ministry of Home Affairs, shows that Kerala has emerged as the state with the highest proportion of elderly citizens in India. According to the figures, 14.4 percent of Kerala’s population is aged 60 or older, meaning that more than one in every seven people in the state is elderly, also highest in the country.

Tamil Nadu follows closely, with 12.9 percent of its population in the same age bracket—well above the national average of 9 percent.

Other southern states present a more mixed picture. Andhra Pradesh reports that 10 percent of its population is aged 60 or above. Karnataka stands at 9.2 percent, and Telangana has the lowest among the southern states, at 8.8 percent. Though lower than Kerala and Tamil Nadu, these figures still reflect a broader trend of aging in the region.

Outside the South, states like Himachal Pradesh (12.3 percent), Odisha (11.2 percent), and Punjab (10.7 percent) also have relatively high proportions of elderly citizens. In contrast, northern and eastern states such as Bihar (6.9 percent), Uttar Pradesh (7.6 percent), Assam (7 percent), Jharkhand (7.3 percent), and West Bengal (9.3 percent) continue to have much younger populations.

This regional divergence in age structure points to a deeper demographic transition. The aging trend in the South reflects developments seen in higher-income countries, driven by sustained declines in fertility rates, increases in life expectancy, and better access to healthcare.

Youth population shrinks

Alongside the rise in elderly populations, South India is witnessing a sharp decline in its youngest age group—a trend that further complicates the region’s demographic outlook.

According to the same SRS 2021 dataset, the proportion of children aged 0–14 has dropped significantly in key southern states. Tamil Nadu reports that just 19.2 percent of its population falls within this age bracket, which is lowest in country. Andhra Pradesh is close behind at 19.7 percent, and Kerala stands at 20.3 percent, Telangana and Karnataka show better numbers with 20.7 percent and 22.4 percent, respectively. However, the national average is 24.8.

These figures are markedly lower than those in states like Bihar, where 32.5 percent of the population is under the age of 14. Jharkhand and Uttar Pradesh, too, report youth populations exceeding 30 percent. The disparity points to a sustained and accelerating decline in birth rates across the southern states.

The trend is even more pronounced when focusing on the 0–4 age group. Tamil Nadu and Punjab report the lowest proportion of children in this age group, at just 6 percent. Kerala, Telangana, and Delhi each report 6.4 percent, while Andhra Pradesh (6.2 percent) and Karnataka (7.3 percent) are marginally higher. In contrast, Bihar (11.2 percent) and Jharkhand (9.1 percent) still maintain comparatively larger shares of very young children.

This shift has long-term implications. Fewer young people today mean fewer working-age adults tomorrow, and eventually, a larger share of the population that is dependent on state support. The situation has drawn comparisons with countries like Japan and Italy, where demographic decline has led to prolonged economic and social challenges.

Also Read: South India’s fertility decline is sharper than earlier estimates

Working population: A temporary demographic dividend

At first glance, the working-age population in South India appears to offer a buffer against the pressures of aging. Telangana and Andhra Pradesh report notably high proportions of people in the 15–59 age group, at 70.5 percent and 70.2 percent respectively. Karnataka (68.4 percent) and Tamil Nadu (68 percent) also maintain strong numbers in this demographic.

This robust workforce composition seems encouraging. It suggests that, for now, these states still have the manpower needed to drive economic activity and sustain public services. But the stability is temporary, they will grow old, just like Japan and China are struggling.

These figures reflect the tail end of a demographic dividend—an economic boost that comes when a large working-age population supports relatively fewer dependents. However, as fertility continues to decline and the elderly population grows, the proportion of workers will shrink, and the dependency ratio will rise.

Demographic transition is unfolding

Dr Kiran Madhala, Convener of the Regional Centre for Medical Education (NMC), Telangana, frames India’s shifting population structure not as a surprise, but as part of a predictable global pattern — the demographic transition. “The answers,” he says, “are everywhere around us.”

He points to declining fertility rates across South India and attributes this not to a singular cause, but to a convergence of modern lifestyle choices and environmental stressors. “We are witnessing delayed marriages, increased urbanisation, rising levels of stress, exposure to pollution, and poor dietary habits — all of which are contributing to a notable drop in birth rates.”

The numbers support his concern. According to WHO estimates, India’s infertility rate has reached 12 percent, and Dr Madhala warns that the reproductive capacity of Indian couples has decreased by nearly 80 percent across just two generations.

In this context, the state’s response becomes crucial. Dr Madhala notes the Telangana government’s proactive stance, highlighting its investment in public-sector infertility treatment, including services at major institutions like Gandhi Hospital. “This signals a serious governmental recognition that fertility is not just a private medical concern but a public health issue with long-term social implications.”

But fertility decline is only one side of the demographic shift. The other, he emphasises, is the aging population — a trend increasingly visible in states like Kerala and Tamil Nadu, and slowly emerging across the rest of the country. “We are living longer due to advancements in diagnostics, therapeutics, and preventive healthcare. This is a global phenomenon, and India is no exception. Life expectancy has risen significantly, and with it, the number of people living into their 70s and 80s.”

This shift brings new pressures to the healthcare system. While India has traditionally focused on maternal and child health — with much-needed investments in paediatric hospitals — Dr Madhala suggests the time has come for a recalibration. “The foundation has already been laid. Now, it’s no longer about multiplying general paediatric centres, but about deepening their capabilities.”

He argues that in an era of declining birth rates, the quality of paediatric care becomes paramount. “We must now invest in paediatric subspecialties such as neonatology, pulmonology, gastroenterology, and developmental medicine. These are critical to improving survival and life outcomes for the fewer children we do have. Historically, high child mortality in India was linked not to the absence of hospitals, but to the lack of highly specialised care — especially in the public sector. Even private hospitals lag in this area.”

Also Read: Massive underreporting of COVID19 deaths? 

Economic, social, and healthcare challenges

The rapidly aging population will bring a major demographic shift, significantly impacting healthcare, social security, and economic policies.

“The government must effectively prepare for the challenges that come with an aging population in these states. There are many ways to do so, and it is imperative to start now. Kerala has already begun this process, though there is still much more to be done. We can learn not only from Kerala but also from Japan and other countries that have addressed similar challenges,” Population Foundation of India Executive Director Poonam Muttreja had told South First.

She added that while concerns exist about a declining working-age population, India still has enough young people to benefit from the demographic dividend. However, as the population ages, it is crucial to ensure meaningful employment opportunities for older adults.

According to Dr Kiran Madhala, the real healthcare challenge today is not paediatric care but the growing elderly population. Geriatric care must be prioritised, and recognising this, the National Medical Commission (NMC) has introduced MD in Geriatric Medicine as a postgraduate course. Institutions like Gandhi Medical College in Hyderabad now offer dedicated MD seats for geriatrics, reflecting the urgency of the issue.

“If the NMC is introducing such programmes, it signals that aging is a major challenge for future generations. India’s 70+ population is now a key factor in national planning. Currently, there are 2.7 crore (27 million) elderly individuals, and this number is rising,” he said.

Elder care crisis

This unprecedented rise in the elderly population will create an increased demand for healthcare services, elderly care facilities, and pension schemes, requiring government intervention in long-term care policies and financial support systems. Since women generally live longer than men, this trend highlights a growing need for policies addressing elderly female healthcare, pension security, and social support systems. Many older women may be widowed, financially dependent, or without sufficient support, further increasing the demand for elderly care services.

India urgently needs structured elderly care services, including social security schemes, pensions, and specialised nutrition programmes. However, a critical gap remains – the country lacks a proper nursing care system for the elderly, unlike developed nations. Instead, small, unregulated old-age homes are emerging, but these are insufficient.

“Another growing concern is that many children are moving abroad, leaving their elderly parents behind, often without proper support. This increases cases of elder neglect and financial fraud. Many elderly individuals, due to age-related issues, become vulnerable to exploitation – whether by domestic helpers, fraudsters, or criminals,” Dr Madhala warned.

Muttreja emphasised that while 60 is the current retirement age, it is essential to create opportunities for an aging workforce. Additionally, there is a lack of adequate caregiving for the elderly. Investment in elder care infrastructure, social security for older people, and healthcare is critical.

“Most medical expenses occur in old age, so building strong healthcare systems now will reduce the burden later. If we have been successful in family planning, we can also implement good governance and health policies to address non-communicable diseases (NCDs), ensuring that people age without suffering from multiple illnesses that require costly treatments,” said Muttreja.

(Edited by Ananya Rao)

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