Large and unequal life expectancy declines in India during COVID-19

The international study, co-authored by the Department of Sociology and the Leverhulme Centre for Demographic Science’s Dr Aashish Gupta and Professor Ridhi Kashyap, reveals that life expectancy in India suffered large and unequal declines during the COVID-19 pandemic.

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.'

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 marginalised social groups. Marginalised 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, ‘Marginalised groups already had lower life expectancy, and the pandemic further increased the gap between the most privileged Indian social groups, and the most marginalised social groups in India.’

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 marginalised caste and religious groups already faced large disadvantages in life expectancy – disparities which 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 and most prominently in the youngest and older age groups. Excess morality 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.

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 equalise, 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 emphasises the need for policies that address the underlying social determinants of health to mitigate the impact of future health crises.

The full paper, ‘Large and unequal life expectancy declines during the COVID-19 pandemic in India in 2020, can be found in Science Advances.

Editor’s notes

For more information and interviews, please contact the communications teams at the Leverhulme Centre for Demographic Science (LCDS.Media@demography.ox.ac.uk) and at the Department of Sociology (comms@sociology.ox.ac.uk).

More information, including a copy of the paper, can be found online at the Science Advances press package at https://www.eurekalert.org/press/vancepak/

A video interview with Dr Aashish Gupta can be found at https://www.youtube.com/watch?v=hqLrIJNxH74 

About University of Oxford’s Department of Sociology

Oxford Sociology is at the forefront of ground-breaking empirical research which spans the full spectrum of the social world. We apply a diverse range of rigorous methods to real-world issues in order to address the most pressing societal challenges of our times. Our commitment to collaborative research ensures that our researchers have the freedom to transcend disciplinary boundaries, foster international partnerships, and explore innovative research. Some of the themes that our researchers are currently working on include social inequality, demography, political sociology, gender and the family, cybercrime and justice, computational social science, and the COVID-19 Pandemic.

About University of Oxford’s Leverhulme Centre for Demographic Science

Based at Oxford Population Health, the Leverhulme Centre for Demographic Science and Demographic Science Unit are at the forefront of demographic research, disrupting and realigning demography for the benefit of populations around the world. Focussing on inequality, family, biosocial, digital, geospatial, and computational research, our researchers use new types of data, methods and unconventional approaches to tackle the most challenging demographic and population problems of our time.