Health status and concerns in India

Even after more than seven decades of independence, health in India remains a luxury and only the rich can afford it. Access to healthcare in India is predominantly urban biased resulting in asymmetric distribution of healthcare facilities between rural and urban India. Urban residents have the privilege of choosing between public and private providers, the rural residents are left with fewer choices. Despite progress in improving access to health care, inequalities by socioeconomic status, geography and gender continue to persist. A very disturbing fact is that private households are burdened by high out-of-pocket expenditure accounting for more than three-quarter of health spending in India. Health expenditures are responsible for more than half of Indian households falling into poverty. Many of the health inequalities result from a broad set of social, economic, and political conditions. The inverse care law, whereby those with the greatest need for health care have the greatest difficulty in accessing health services and least likely to have their health needs met, is highly applicable in India. Health status in India are improving. Life Expectancy at birth improved from 59.7 years in 1990 to 70.3 years in 2016 for females and from 58.3 years to 66.9 years for males. However, there are continuing inequalities between states, with a range of 66.8 years in Uttar Pradesh to 78.7 years in Kerala for females, and from 63.6 years in Assam to 73.8 years in Kerala for males. The under-5 mortality rate has reduced substantially from 1990 in all states, but there was a four-fold difference in this rate between the highest in Assam and Uttar Pradesh as compared with the lowest in Kerala in 2016, highlighting the vast health inequalities between the states. India’s health system is facing dual challenges. Although the absolute disease burden from diseases such as diarrhea, lower respiratory infections, tuberculosis, and neonatal disorders is being reduced, it remains high. At the same time, the contribution to health loss of non-communicable conditions such as heart disease, stroke, diabetes is rising. The present paper analyses the secondary data obtained from reports of the Indian Council of Medical Research, National Rural Health Statistics and various reports of the National Rural Health Mission and the Department of Health and family Welfare. Suitable statistical tools are used to analyse India’s health scenario and the concerns thereof.