Pandemic and Prejudice: How COVID-19 Worsened India’s Existing Inequalities

COVID Pandemic World Map

The COVID-19 pandemic led to significant, uneven drops in life expectancy across India in 2020, particularly affecting younger people, women, and marginalized groups.

In 2020, life expectancy in India saw substantial and disparate declines due to the COVID-19 pandemic, with an estimated 1.19 million excess deaths, significantly higher than official figures.

The study utilized high-quality data from over 765,000 individuals to analyze life expectancy changes by sex and social group, revealing greater impacts on younger populations, women, and marginalized groups.

The international study reveals that life expectancy in India suffered large and unequal declines during the COVID-19 pandemic. Co-authored by the University of Oxford’s Department of Sociology and the Leverhulme Centre for Demographic Science’s Dr. Aashish Gupta and Professor Ridhi Kashyap, the study was published today (July 19) in the journal Science Advances.

Overall, mortality across India was 17% higher in 2020 compared to 2019, implying 1.19 million excess deaths in India. This extrapolated estimate is about eight times higher than the official number of COVID-19 deaths in India, and 1.5 times higher than the World Health Organization’s estimates.

Ridhi Kashyap, Professor of Demography and Computational Social Science at the University of Oxford said, “Our findings challenge the view that 2020 was not significant in terms of the mortality impacts and severity of the COVID-19 pandemic in India. While a mortality surge caused by the Delta variant in 2021 received more attention, our study reveals significant and unequal mortality increases even earlier on in the pandemic.”

Socio-Demographic Analysis: Life Expectancy Changes by Social Groups

Using high-quality survey data from 765,180 individuals, the study estimated changes in life expectancy at birth, by sex and social group between 2019 and 2020 in India – a country where one-third of global pandemic excess deaths are thought to have occurred.

The study found large mortality impacts from the COVID-19 pandemic in 2020 on younger age groups, women, and marginalized social groups. Marginalized social groups within India experienced greater life expectancy declines than the most privileged social groups.

Dr. Aashish Gupta, Marie Sklodowska-Curie Fellow at the University of Oxford said, “Marginalized groups already had lower life expectancy, and the pandemic further increased the gap between the most privileged Indian social groups, and the most marginalized social groups in India.”

Gender and Age Disparities: A Closer Look at Life Expectancy Loss

While high-caste Hindu groups experienced a life expectancy decline of 1.3 years, the loss for Muslims was 5.4 years and 4.1 years for Scheduled Tribes. These marginalized caste and religious groups already faced large disadvantages in life expectancy – disparities that were only exacerbated by the pandemic.

The study also found larger losses among females compared to males among almost all Indian social groups and classes. Women in India experienced life expectancy declines of 3.1 years – one year more than men who experienced life expectancy losses of 2.1 years. This pattern could be explained by gender inequalities in healthcare and allocation of resources within households. It also contrasts with the pattern found in high-income countries where excess mortality was higher among men than women during the COVID-19 pandemic.

While life expectancy declines in high-income countries were primarily driven by mortality increases in over 60s, mortality increased in almost all age groups in India most prominently in the youngest and older age groups. Excess mortality in the youngest ages could be explained by children in certain areas being more susceptible to COVID-19 and by indirect effects of the pandemic and subsequent lockdowns, including deteriorating economic conditions and disruptions to public health services.

Conclusions and Policy Implications

Professor Ridhi Kashyap said, “Using unique demographic and health survey data, our study highlights the importance of focussing on inequality when measuring mortality and shows that pandemics can worsen, rather than equalize, existing disparities. This was particularly noticeable on the role that COVID-19 had in further exacerbating the health impacts of pre-pandemic gender disparities.”

This study shows the potential for accurately estimating mortality – even for short periods – using retrospective mortality information collected in a relatively poor context. It also emphasizes the need for policies that address the underlying social determinants of health to mitigate the impact of future health crises.

Reference: “Large and unequal life expectancy declines during the COVID-19 pandemic in India in 2020” 19 July 2024, Science Advances.
DOI: 10.1126/sciadv.adk2070

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