Does living longer mean living healthier?: Exploring disability free life expectancy in India

During the last century, India has experienced a drastic reduction in mortality and a vast improvement in life expectancy. However, a question is raised regarding quality of life. Have the extra years gained with respect to life expectancy really improved the quality of life in India? Such a question becomes pertinent particularly when one considers the changes in morbidity in the country. No study, to date, has combined mortality and morbidity changes into a single index by to represent the health status in India. This paper is an exploration of quality of life, based on Disability-Free Life Expectancy (DFLE) rates in India. It follows the methodology developed by Sullivan (1971), using three levels of disability rates – perceived morbidity, restricted activity and confined to bed. Mortality data given by SRS and morbidity data given by NSSO are used for the analysis. The study finds higher rates of decline in DFLE in developed states with high life expectancy indicating a considerable decline in the quality of life with improvement in life expectancy. Such reduction is much higher in the older ages. On the other side, females and urbanites experienced considerable decline in the quality of life compared to males and rural people respectively. This indicates that even though females and urban people have more expected years of life, they spend more years in morbidity. An assessment based on the effect of diseases shows that chronic/degenerative diseases cause major losses in DFLE. The study concludes that a mere increase in longevity does not mean a better life, especially in the older ages. It is time for India to have effective interventions to improve the quality of life along with life expectancy.