India’s two-speed demography

Updated: January 16, 2015 2:37:22 AM

Some states are ageing faster than others. This two-speed demography carries opportunities for businesses such as insurance, healthcare and housing

With 66% of its population under the age of 35, India is home to the largest cohort of young people in the world—825 million. The median age
of the country is just 27 years, much below 37 in the US and 46 in Japan. Numbers like these suggest that India has a competitive advantage over China and other Asian countries—a demographic dividend.

But favourable demographics do not imply that India is not ageing at all. According to United Nations Population Division, by 2050, the median age will rise to 37 years, and the number of elderly (over 60 years of age) from 100 million now to 300 million—equivalent to the current population of the US. Old age dependency ratio in India will go up from 13% in 2000 to 32.8% in 2050. Three Indians in the working age population will have to take care of one elderly by 2050 as compared to eight today. India, too, is ageing, albeit slowly. A closer look presents a global scenario within India itself—some states are ageing faster than others, leading to a two-speed demography.


South India will age faster

The total fertility rate (TFR) is defined as the average number of children that would be borne by a woman of a child-bearing age. While the average TFR for India is 2.5, for nine Indian states it is below 2.1. A TFR of 2.1 is considered to be the replacement level (the average number of children born to a woman to ensure that the level of population remains constant). A TFR above 2.1 means that the median age of the population will go down, while that below means that the median age will increase.

The four southern states accounting for 21% of India’s population—Kerala, Tamil Nadu, Andhra Pradesh and Karnataka—have a TFR below 2.1. These numbers are comparable to fast-ageing countries such as Norway, Australia, Sweden, Germany and Canada. States such as Bihar, Uttar Pradesh and Rajasthan have a TFR of above 3, which is also reflected in their young population.

The proportion of people below 30 years of age in the four southern states is only 53%, much lower than India’s 59%. The median age of Kerala is the highest in India at 31, followed by Tamil Nadu at 29, Andhra Pradesh at 27 and Karnataka at 26. The proportion of people above the retirement age—60 years—in southern states is 11%, above the all-India average of 9%. Thus, with the current scenario and low TFR, south India is likely to age faster than the rest of India.

Businesses to come of ‘age’

Unlike others, we feel this ageing population, along with a burden, brings in new opportunities for businesses. Most businesses are still not prepared to tap the growing ‘grey’ market. As a report from BCG put it: “Companies either do not perceive the magnitude of global ageing, or are too consumed by short-term imperatives to act.” The potential business sectors that could benefit from this demographic trend include retirement housing, cosmetics, financial planning, insurance, healthcare, leisure and consumer goods, and many more.

Financial services

Insurance and pension penetration is low compared to the rest of the region, but income security remains the top priority for an ageing population. According to a Crisil report on pension funds, if 70% of private sector retirees are adequately covered by pension schemes by 2030, the corpus available to fund managers would be R276 trillion. Only 8% of the private sector retirees are currently covered by private pension. This bodes well for companies in the financial sector that can offer diversified insurance and pension products. In India, out of pocket healthcare payments account for almost 86% of private expenditure on health, compared with an OECD average of 20%, because financial protection through insurance is limited to a small section of the population. States with low TFR/ageing population might be the ones where insurance services might see a big growth. Given the low level of fertility, people will look for sources to secure their finances in old age.


An ageing population needs a well-developed healthcare system to support it, and healthcare is probably one of the most inadequately provided/supplied sectors in India. According to WHO, the country has just nine hospital beds per 10,000 people, compared with a global average of 30. Government expenditure on healthcare per person is among the lowest in the world at 1.2% of GDP, compared with an average of 7% for OECD countries. Yes, public healthcare services are subsidised, but infrastructure and services are often inadequate, prompting many of those who can afford it to switch to better-equipped private providers.

This creates a significant opportunity for the business to grow not only in primary healthcare but also in wellness and disease management, ancillary products and home healthcare market which is estimated at $1.5 billion, compared to $140 billion globally. Geriatric care is also underdeveloped in India and there is a shortage of geriatric specialists.

Consumer goods and retail

Retailers need to adapt to the needs of ageing consumers, whose consumption is skewed towards food, beverages, and health and medical products. Studies show that small innovations such as easy to open packaging, larger print for prices, lower product placement on shelves and shopping trolleys that are easy to push go a long way towards attracting older customers.

Convenience is also a big factor. Older consumers want to be able to order by phone or online, and they value complimentary carry out services. That is the reason why India’s local kirana shops have been able to survive amidst organised big food retailers.

Online retailing could be a big market for the elderly of the future, who will be better connected, more technology savvy and more internet aware than today’s generation. India’s internet user population is already the third largest in the world and is growing rapidly. Online portals such as and are increasingly tapping food and grocery demand online.

Businesses can also capitalise on new product segments. For example, an elderly-friendly phone by iBall was quickly followed by competing products from bigger companies such as Samsung. Other age-related innovations include hearing aids, non-prescription health products and tele-medicine.


The western concept of old-age homes is culturally frowned upon in India. Yet rapid urbanisation and steady disintegration of the extended family system have fuelled demand for retirement homes. Many new residential projects are not only elderly-friendly in terms of construction but also take care of day-to-day issues such as bill payment, security, round-the-clock medical services and so on. Examples include the Antara senior living complex in Dehradun by Max India, Ashiana in Bhiwadi by Ashiana Housing, and Athashri in Pune by Paranjape. A recent report by Jones Lang LaSalle (India) put current demand for retirement housing at approximately 3 lakh units. This far outstrips the current supply of 10,000-15,000 new homes in the pipeline.

Ageing is an inevitable phenomenon and India is no exception to it. An ageing population is not all burden. Ageing does bring along with it new and lucrative business opportunities and it is up to the private sector to identify them and capitalise on. After all ‘old is gold’.

Prachi Priya & Anuj Agarwal

The authors are corporate economists based in Mumbai

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