Published Jan 29, 2026 | 12:27 PM ⚊ Updated Jan 29, 2026 | 12:27 PM
Kerala is planning to position itself as a global destination for graceful and dignified ageing. (South First)
Synopsis: By encouraging a “silver economy” and recognising older persons as mentors and contributors, Kerala is hoping to turn a demographic challenge into a social and economic opportunity — even as rising disease burdens demanded urgent and sustained public health interventions.
Kerala’s much-admired social development story is entering a difficult new phase, marked by rising deaths from lifestyle diseases and a rapidly ageing population that is reshaping the state’s economic and social priorities.
The Economic Review 2025 tabled in the State Legislative Assembly on Wednesday, 28 January, painted a sobering picture: while Kerala continues to score high on human development indicators, its public health system and social policy framework were being tested by changing disease patterns and demographic realities.
According to the Annual Vital Statistics Report 2023, a total of 1,46,696 deaths were reported in the state. Of these, 59.92 percent were males and 40.06 percent females.
While Kerala’s birth rate has steadily declined over the decades, mortality has risen, driven largely by non-communicable diseases, signalling a shift away from traditional public health concerns towards chronic, long-term illnesses.
Cardiovascular diseases remained the single largest cause of death in Kerala.
Heart attack and other heart diseases accounted for 45.82 percent of all reported deaths, followed by cancer at 16.28 percent and asthma at 12.9 percent.
The gender divide is stark. Deaths due to heart disease included 40,565 males and 26,656 females, while cancer claimed the lives of 13,867 males and 10,029 females.
The Health Department has identified a critical gap in early response to cardiac emergencies.
Sudden and unexpected deaths following collapse have underscored the importance of timely Cardiopulmonary Resuscitation (CPR).
Under the ‘Hridayapoorvam’ initiative, more than 26,864 people across the state have already been trained in CPR.
Officials stressed that cardiovascular diseases continued to be the leading cause of premature mortality, with one in five people dying early from CVD.
Evidence suggested that up to 80 percent of heart disease and stroke cases are preventable through timely awareness and preventive action.
Cancer, meanwhile, has been emerging as a major public health challenge due to socio-demographic changes and a high prevalence of risk factors.
With a population of 3.34 crore, Kerala was expected to record over 66,000 new cancer cases annually.
The cumulative lifetime risk of developing cancer before the age of 74 stood at one in seven for men and one in nine for women.
Data from the hospital-based cancer registry of the Malabar Cancer Centre–Post Graduate Institute of Oncology Sciences and Research (MCC-PGIOSR), based on a ten-year trend in northern Kerala, showed worrying patterns.
Among males, lung cancer (20.8 percent) topped the list, followed by cancers of the mouth, stomach, tongue and larynx.
Among females, breast cancer accounted for 30.6 percent of cases, followed by cervix, ovary, mouth and lung cancers.
Alarmingly, over half of the patients were diagnosed at advanced stages (Stage III and IV), while only 26.2 percent were detected early.
Lung cancer cases in both men and women showed a steady increase between 2010 and 2020.
While non-communicable diseases dominate Kerala’s health burden, vector-borne diseases have not disappeared, the Economic Review highlighted.
Malaria continued to pose challenges, particularly due to large-scale migration from endemic states, rapid urbanisation, climate-related changes and uncontrolled construction activity.
Though annual cases typically remained below 500, the situation has worsened recently.
In 2024, 952 malaria cases and six deaths were reported. In 2025, up to August, 788 cases and two deaths were recorded.
Kasaragod district remained particularly vulnerable because of its proximity to highly endemic districts of Karnataka, while the movement of fishermen along the western coast posed an ongoing risk.
Japanese Encephalitis (JE), another mosquito-borne disease, remained a latent threat due to Kerala’s extensive paddy fields and migratory bird habitats.
However, vaccination has proved effective.
In 2024, ten JE cases and four deaths were reported; no cases have been recorded so far in 2025.
Beyond health indicators, Kerala’s demographic transformation may be its most profound challenge.
The Economic Review warned that the state was ageing faster than any other in the country. The elderly population (60 years and above) has been projected to reach 8.4 million by 2036.
Older women already outnumbered men, and this imbalance would widen further. Among those aged 80 and above, the sex ratio has reached 1,416 women per 1,000 men.
The old-age dependency ratio (OADR) — a key indicator of economic pressure — has been rising sharply.
Kerala’s OADR was 19.6 percent in 2011 and has been projected to climb to 34.3 percent by 2031, significantly higher than the national average.
Female dependency ratios were found consistently higher than male figures, reflecting the feminisation of ageing and increased vulnerability to poverty and social isolation.
In response, the Review pointed out, the state has been recalibrating its policy approach.
Plans were underway to launch a Vayojana Web Portal as a single-window system to survey the elderly population, monitor welfare schemes such as Sayamprabha Homes, ensure compliance with the Maintenance and Welfare of Parents and Senior Citizens Act, and digitise departmental services.
A collaborative initiative with the State Planning Board and the National Institute of Speech and Hearing has also been launched to provide home-based geriatric care through training, counselling and therapeutic services.
Kerala’s strategy, the Review pointed out, has been pegged on promoting healthy and active ageing, gender-sensitive welfare measures, ageing in place through decentralised care, and formalising the care economy.
By encouraging a “silver economy” and recognising older persons as mentors and contributors, the state was hoping to turn a demographic challenge into a social and economic opportunity — even as rising disease burdens demanded urgent and sustained public health interventions.
Earlier, in his Policy Address to the Assembly on 20 January, Governor Rajendra Vishwanath Arlekar framed Kerala’s demographic transition not merely as a challenge, but as a strategic opportunity.
The state, he said, was aiming to turn demographic change into a “unique advantage” by building a new Silver Economy, positioning Kerala as a global destination for graceful and dignified ageing.
By leveraging its strengths in healthcare, social development and community-based welfare, the government has plans to attract both domestic and international retirees, while simultaneously creating new employment opportunities.
Taken together, the trends outlined in the Economic Review pointed to a decisive shift in Kerala’s development trajectory.
The gains of the past—high life expectancy, low fertility and near-universal access to healthcare—have been producing a new set of pressures shaped by chronic disease, longevity and rising care needs.
(Edited by Majnu Babu).
