The Sample Registration System’s report from the Registrar General of India marks a critical milestone in the nation’s demographic trajectory. The data for 2024 released this week confirms that India’s total fertility rate (TFR) has stabilised at 1.9, reinforcing its position below the population replacement threshold of 2.1. This macro-level stability signals that India has crossed a structural pivot, transitioning away from historical anxieties of a population ‘explosion’ towards a phase of long-term stabilisation.
However, beneath this national aggregate lies an accelerating demographic divergence between the southern states and the rest of the country. This regional divide is driven by decades of distinct state-level investments in public health infrastructure, female literacy and social development.
The most striking divergence is reflected in the indicators of fertility and natality, where the southern states record parameters comparable to advanced industrial economies. Nationally, the crude birth rate (CBR) stands at 18.3 per 1,000 population, heavily influenced by high-fertility northern states such as Bihar, which records a national high of 26.8. In sharp contrast, the southern regional baseline is dramatically compressed, led by Kerala with an exceptionally low CBR of 11.1.
This chasm is mirrored in the TFR metrics: Kerala and Tamil Nadu exhibit an ultra-low TFR of 1.3. Demographers note that sustained fertility levels below 1.4 inevitably trigger rapid structural contraction, a reality the south is confronting decades ahead of the national timeline. The mortality and healthcare indicators in the SRS report further illustrate this asymmetric development. The national infant mortality rate (IMR) has declined to 24, while Kerala secures a national low IMR of 8. However, a paradox emerges in the CDR, where the national average sits at 6.4, but Kerala records a higher rate of 7.2 due to its older demographic profile.
This demographic contraction has fundamentally altered age distribution patterns. At the national level, the proportion of children aged up to 14 years has receded to 24 percent, while the population aged 60 and above has risen to 9.7 percent. Such greying is highly concentrated in the south. The child cohort has shrunk to just 18 percent in Tamil Nadu, compared to 31.5 percent in Bihar. By 2036, nearly one in four Keralites is expected to be above 60.
One of the most significant features of Kerala’s ageing pattern is the “feminisation of ageing”, where women considerably outnumber men in higher age groups, producing a large number of widowed and solitary elderly women vulnerable to social isolation and insecurity.
In many ways, Kerala is a laboratory of India’s demographic future. The problems Kerala experiences today—eldercare, dementia, loneliness, shrinking family support systems and long-term care—are likely to become major national concerns in the coming decades. Nuclear families, weakening caregiving structures, migration of younger generations abroad and increasing individualisation have fundamentally altered the social experience of ageing. Traditional family-based systems of caregiving are gradually eroding without adequate institutional alternatives emerging in their place.
It is against this background that the decision of the new UDF government in Kerala to create a separate department for senior citizens acquires historic significance. The initiative marks a shift from viewing elderly persons merely as passive welfare beneficiaries toward recognising them as citizens with rights, dignity and continuing social contributions.
The proposed department seeks to embody a vision of “active, dignified and graceful ageing” through a unified policy architecture integrating schemes presently scattered across the social justice, health, and local self-government domains. Greater emphasis is expected on specialised geriatric healthcare infrastructure, including home-based care systems, palliative care, dementia care and digital health monitoring.
The state has also expressed interest in adapting elements of the model for elderly care in Japan, which transformed ageing from a welfare burden into a collective social responsibility through the philosophy of “ageing in place”. Its long-term care insurance system distributes responsibility for elderly care among the state and local governments, communities and families, while supporting home care, rehabilitation, dementia centres, nursing services and support centres. Equally important is Japan’s emphasis on preventive healthcare, emotional well-being, neighbourhood care and social participation.
Technology also plays a central role through telemedicine, robotics, AI-supported monitoring systems, mobility aids, and emergency response devices. Elder-friendly urban planning, barrier-free infrastructure, and accessible public spaces are integral components of the system. Kerala’s proposed department appears inspired by this broader blueprint, combining community integration and technological assistance to ensure dignity, independence and autonomy in old age.
Sociologically and politically, the SRS findings introduce profound tensions into India’s federal structure. For the southern corridor, the paradigm of population control is now obsolete. If implemented imaginatively and sustainably, Kerala’s new department for senior citizens could emerge as a pioneering model for India, demonstrating how an ageing society can be approached not with fear or neglect, but with compassion, institutional imagination and a commitment to graceful ageing.
Antony Palackal | Former Professor and Head, Department of Sociology, University of Kerala
(Views are personal)
