Developmental problems of ageing: Case study of Meghalaya

 

Dr. Markynti Swer

 

ABSTRACT:

Meghalaya recently has been adding significantly to its aged population. The distinctive aspect of this largely tribal society is its continuation of a social order, which is matrilineal. The women enjoy a much higher social status particularly based on a system of inheritance along female line and matri-local marriage institution. It may therefore be exceedingly interesting to examine the issue of the aged section and care of the aged in such a society that distinguishes itself from the rest not only in North-East but also from rest of the country.

 

 

INTRODUCTION:

Meghalaya Plateau has been purposively chosen to undertake this important aspect of ageing. Strictly from demographic perspective, the people living in this plateau have not been ageing as the fertility rate continues to decline and the life expectancy has not remarkably improved. As a result of little demographic shifts during the past four decades, nearly all-demographic indicators show little shift to an aging society. The issues addressed in this analysis include the living arrangements of the aged, their economic status, care giving, poverty and health among the aged and the kind of social support they receive.

 

As per details from Census 2011¹, Meghalaya has a population size of 29.64 Lakh, an increase from figure of 23.19 Lakh in 2001 census. Total population of Meghalaya as per 2011 census is 2,964,007 of which male and female are 1,492,668 and 1,471,339 respectively.  Around 85 percent of the population belongs to largely matrilineal scheduled tribes namely the Khasis-Jaintias and the Garos. When most states of India are busy shunning the girl child by committing female foeticide, participating in bride burning, demanding dowry or in short persecuting the female sex, the people of Meghalaya celebrate the birth of a girl child and accord special status to them.

 

During the period from 1901-1991, the population of the state increased from a meager 3,04525 to 17,60640 with a growth rate as high as 292.28 percent. During the decade 1991-2001, the population of Meghalaya recorded a growth of 30.6 percent. The population is distributed in 418,850 households living in 6026 villages and 16 towns. Ironically though, the sex ratio of the population of the state is characterized by a deficit of women in the year 2001 as evident from a ratio of 972 females per 1000 males. As per 2001 census records 42.3 percent of the state’s population comprises of children in the age group 0-14 years.

 

 

Table 1: Meghalaya: Age Composition, 1971, 2001

Source: Census of India, Meghalaya, 1971, 2001²

 

Table 2 Meghalaya: Growth in Different Age-groups: 1971 and 2001

Source: Census of India, Meghalaya 1971 and 2001³

 

Population of the age group 15-59 years constitutes 53.0 percent and elderly population (60 years and above) accounts for 4.6 percent of the state’s population.

 

Table 1 shows the changes in age composition of the population of Meghalaya during 1971 and 2001. Significantly, the table shows little change in the proportion of aged despite significant rise in the number of the aged. In fact the proportion of the aged in 2001 is marginally lower.

 

In 1971, Meghalaya had total population of 1,005,881 out of which the Young population (0-14 yrs.) accounted for 43.55 percent Adult (15-59yrs.) 51.74 percent and the old/aged (60 yrs. and above) constituted only 4.59 percent. About 42 percent of the ‘Young’ population consisted of males and 44 percent by females. The adult or working population constituted the highest in numbers. The old, indeed, accounted for a meager 4.59 percent. 4.94 percent males and 4.23 females belonged to the aged category.

 

Different age groups have grown differently in the period 1971 and 2001 with reference to their varied size. The table 2 has the details.

 

The number of the aged population increased from 41,077 in the year 1971 to 64,665 in 2001, which shows a percentage increase of 157.47.  The young group has seen an increase of 122.58 percent while that of the adult has been 134.6%. It is evident that the aged population has been growing at a faster rate than the other two groups and the sheer size of the aged is substantial in a population that is still going through high fertility rate.

 

Table 3. Elderly Population in Meghalaya, 2001

Age Group	Percentage
60-64	1.69
65-69	1.15
70-74	0.81
75-79	0.42
80+	0.48

Source: Census of India, 2001⁴

 

Table 3 shows distribution of the aged category in different age cohorts. The ‘young old’ (between 60 to 70 years of age), account for 2.84 per cent of the total population. The ‘old old’ (70 to 80 years of age) constitute 1.23 percent while the very old (above 80 years of age constitute only 0.48 percent of the total population of the state.

 

MATERIAL AND METHODS:

Data on these aspects have been collected through intensive field work conducted in four villages representing four highly differentiated communities belonging to the three major cultural groups namely the Khasi, Jaintia and the Garos. Since the Khasis, the most numerous community are highly differentiated among themselves, two villages have been selected representing two different Khasi community. In addition, an urban locality in Shillong belonging to one of the Khasi communities has also been included in the selected areas as a sample purposively selected for the study.

 

 

Fig 1. Age group of the aged (60+) in selected culture groups

 

Data and information collected are analyzed using simple bar diagram and pie diagram to get insights and assess the various issues of aged such as living arrangement, health etc.

 

RESULTS:

Demographic profile of the aged in selected villages

As population grows over time, the age structure also changes, raising the absolute numbers of the elderly persons, as well as their proportion in the population

 

Figure 1. reveals the distribution of the aged above 60 years in different aged groups in five different cultural regions of Meghalaya. The population in the selected Garo village and the Bhoi village in Ri-Bhoi has the highest percentage of the aged with 60.2 percent and 50.5 percent respectively in 60-65 age group popularly referred as young old compared to the Pnar in Jaintia, Khyriam in Khasi Hills and Khyriam in Shillong city in the same age cohort of the old.. On the other hand aged over 90 years of age is far more numerous in Khyriam in Khasi Hills and Khyriam in Shillong city. The proportion of aged above 80 years is very less in all the areas except Khyriam in Shillong city with 13.3 percent and Pnar in Jaintia Hills with 12.2 percent. In Pnar village of Jaintia Hills, aged females vastly outnumber their male counterparts in the age group of 65+ (66 percent of women and 34 percent of men). This is in sharp contrast to the Garo village where aged males are much more than the aged females. In Bhoi and Khyriam village as well as among the khyriam population in Shillong city the sex ratio of the aged shows surplus of females in all aged groups.

 

The contrasts in Garo and Khasi villages with regard to distribution of different aged groups and sex ratio among the aged is clearly brought out from the data collected from the field.

 

Living Arrangement:

Living arrangement for the elderly was not an issue a few decades ago in most developing countries, including India, because the elders are taken cared for by the family. However, issues concerning household structure and support for older persons in developing countries are becoming increasingly important. Along with an ageing population these countries are also experiencing socio-economic and demographic changes. Since last few decades there has been a rise in economic growth, literacy levels, urbanization and modernization, women bearing fewer children and people living longer and healthier lives. All this brought about significant changes in India. The effects of these trends on families, households, kin networks and subsequent support for older persons are complex and not well documented. It is generally accepted that the size and complexity of the households decrease along with industrialization and urbanization. In traditional rural societies families are often more extended than in modern urbanized societies where the independent nuclear family is predominant. In the process, extended kinship ties weaken and the nuclear family becomes an independent unit. This weakening of ties with family members reduces social interaction and financial and physical support for the older generation. Separate living arrangements are required for them as countries develop. Therefore in this context, the living arrangement issues of the elderly need attention because their welfare depends on it.⁵

 

Living arrangements are generally studied as a dichotomous outcome - whether living alone or with others. Data from western countries shows that more than 60 per cent of the elderly aged 65 and above live either alone or with the spouse.⁶

 

Data from developing countries however shows a much smaller number of elderly living alone. However, a general agreement among researchers is that there is an increasing trend of the elderly persons living alone or with the spouse even in India. These days, due to a change in family structure, the family members do not give the elderly adequate care and attention. Though the younger generation takes care of their elders, in spite of several economic and social problems, it is their living conditions and the quality of care, which differ widely from society to society.⁷

 

The transition to widowhood is one of the most stressful events in human life and experiences a disruption in relationship networks.⁸ Widows and widowers experience life in different ways. After the death of a husband, in Garo and Khasi system, women have to be dependent on daughters and have to live in a daughter’s family. Given this backdrop of rapid demographic and family changes, it is important to explore the current nature of living arrangements in five areas of Meghalaya in 2012.

 

Fig.2. Living Arrangement in five different communities of Meghalaya

Figure 2 reveals the living arrangement of the aged population in five sample areas in Meghalaya and across four different communities living in different culture regions and in an urban setting. In Pnar village 30.5 percent aged lived with spouse and children or grandchildren. As much as 69.5 percent of the aged are either widow or widower, these aged and live along with sons or daughters and depend on them physically and financially. But the prevalence of living separate or alone is nil or negligible.

 

In the Garo village, a majority of 51.2 percent of the aged lived with spouse and children or grandchildren. This proportion in the Bhoi village was 46.5 percent of which, 49 percent were widower or widow. Around 2.5 percent of the aged lived alone. Around 2 percent of the aged who were unmarried lived with relatives. In Khyriam village only 20.4 percent aged lived with spouse and children or grandchildren of whom 79.6 percent were either widower or widow. Among the Khyriams in Shillong city, 66.6 percent of the aged lived with children and grand children. Among all the areas, only Khyriam in Shillong city have the highest percentage of unmarried among the aged who lived with sisters, niece and nephew (13.3 percent). This reveals that the custom and tradition within the matrilineal society is still significant where the sister, niece and nephew still look after their maternal uncles and aunties.

 

In all the five areas the aged who are left behind by the spouse and who stays with family, are treated good by them, they could get enough food, enough warm clothes, never get beaten and always sleep in the bed not in the floor or corner, and these aged people do accept financial assistance from the children. This reveals the co residence and kinship organization still prevalent in the different parts of Meghalaya society irrespective of cultural differences. Though the region was influenced by westernization than modernization the bond within the family is still strong.

 

 

Fig.3. Care of elderly within the family

 

Those who are left behind by the spouse and who stay with the family, figure 3 reveals that in Pnar culture, sons take more care of the aged parents than their daughters. This must be due to their culture where unlike in Khasis, the sons after marriage, still has to live with the mother and has to take care of the parent. In Bhoi culture both sons and daughters customarily take care of the aged parents as 38.6 percent aged reported were taken care by both. The proportion is much higher in Garo Hills at 51.5 percent. In Khyriam community both in the village and in the city, the family members who take care of the aged left by the spouse is not as simple as in other 3 areas. Here the grandsons, granddaughters, niece, nephew and daughters-in-law take part in caring the aged, though the highest percentage share is by the daughters with 48 percent. These are the areas in Khasi hills that have a distinct culture in which the youngest sister is supposed to look after the aged who are unmarried or divorced or who are left by the spouse.

 

Economic Status

To deal with economic hardship, most of the elders engage in various earning activities, mainly in agriculture. Since agriculture is laborious and physically challenging, additional support is sought to reduce the burden. Sons, daughters, and relatives support them according to their capacities and needs. When older people are unable to perform any economic activity, their children and close family members support them financially. If immediate family members are not available or do not have resources to support, neighbors step in with financial support or material aid. Villagers’ Fund, an emergency community fund, supports poor older people of Khasi community. Similarly, church offers the economic support to the Khasi and Garo older people who face economic hardship.⁹

 

It is generally believed that the elderly are a burden on the family and the nation, as they do not contribute to the national income. This is not always true.

 

The income of the elderly is one of the important determinants of their economic status.  Literacy status is important as far as their earning capacity is concerned. Surprisingly the entire aged population surveyed in Pnar village of Jaintia Hills is illiterate. In Garo village however a majority of 57 percent of the aged is illiterate while 11 percent had done their primary and 11 percent had done their matriculation, 13 percent had done their middle schooling and 4 percent up to higher secondary. In Bhoi village only 18 percent of aged is illiterate, 29 percent studied up to primary, 42 percent up to middle and 11 percent completed higher secondary.

 

However in Khyriam of Khasi Hills, 47 percent of aged reported to be are illiterate, 36 percent studied up to up to primary, 13 percent up to secondary, and 4 percent had completed higher secondary.

 

It is to be noted here that the main occupation of the head of the households in Pnar region is either farming their own land or doing business in the form of shopkeepers and sellers in different weekly market of Jaintia Hills. There are also a few labourers or drivers in coal mines. The average income of households is Rs. 4800 per month.

 

Fig. 4. Economic Status of the Aged

The highest proportion of the aged who were economically active and not dependent on the family members was found in the Bhoi village. Most of the head of households are working in their own field, some are shopkeepers, few are teachers and majorities are agricultural labourers. The average income of households is Rs 5500 per month. The most dependent aged were found among the aged in Pnar village in Jaintia Hills (figure 4). Only 17.4 percent aged were reportedly economically active and independent. In the Garo village, the main occupation of the head of household is farming their own land with 71 percent, the rest of the families are engaged in business and wage earner. Around 44.2 percent are economically active and 55.8 percent are dependent. The average income of the households is Rs 5500 per month.

 

However in Khyriam community 71 percent of the heads of the household are working as agricultural labourers, 20 percent have their own land for cultivation and 9 percent are government servants. It is to be noted that 64 percent of the aged are dependent on others and 36 percent are still active and participate in income earning of the family. The average income of households is Rs 5700 per month.

 

The situation is significantly different among the Khyriam community living in the urban environment of Shillong. About 13.3 percent of the aged are retired government servants with social security of pension available to them. 82.2 percent of them however depend on family members and only 4.4 percent is still economically active. This data reveals wide difference across rural and urban areas. Khyriam locality in Shillong being an urban area reveals that few of the aged in their past could avail the opportunity of education, and could also get the opportunities in job markets, not like in other four different villages where the aged are illiterate.

 

Poverty

Among the elderly worldwide, poverty appears in the form of social and economic insecurity, health hazards, loneliness, illiteracy and dependency. Retirement lead to poverty in many cases, especially in a country like India where even in full adulthood, many people were eking out a living. Those who have saved a little in younger days as a provision for the future also experienced poverty in old age due continuing inflation, expenditure on medicines, marriages and deaths. Even in a rich country like United States of America, the problem of poverty in old age prevailed. Fostering the negative attitudes of the old, financial problems often existed. For instance semi skilled and unskilled people were unwilling to retire due to poverty.¹⁰

 

In India today people depend on sons or children in old age as they did in United States in 1800 when a couple needed four children to be 95 percent certain that a male child would survive until the parents old age.¹¹

 

Mental illness is another aspect of old age, which might need attention. The incidence of mental illness among old people is reported to be much higher than among the young. The causes are complex, multiple and complicated by organic brain involvement. Failure in social and personal adaptation, cultural break down, and losses and bereavements lead to the disintegration of personal lives. Acceptance of old age within the community, attitudes of children and grand children, and religious beliefs and acceptance of deaths as well as disease all play their role in the changing frames. Treatment from family members and key relations affect the course and treatment of the mentally ill. There are no data on these problems in India. Ibid

 

In Meghalaya, the areas under study reveals that there is little social isolation, no emotional loneliness or desolation in old age as it has happen in most of the Indian society. But poverty persists in all the rural areas under the study. Most of the aged interviewed particularly those who are dependent on sons or daughters; always feel indebted to their sons or daughters for they have looked after them, physically and financially.

 

Health

Ageing is accompanied by biological changes increasing risks of illness, disability and probability of dying. The elderly population is more at health risks than the younger age population though some elderly may enjoy good health. Greater proportion of the elderly suffers from severe impairment and disability. While incidences of communicable diseases are becoming less and less, incidence of degenerative diseases are becoming more numerous especially among the older people. Public health services in most developing countries are ill equipped to deal with old age degenerative diseases largely due to limited resources at their disposal. Moreover such facilities are largely confined to urban areas leaving the vast majority of the older people living in the rural areas with little public health care facility directed to the old cohorts. Health issues pertaining to the elderly require completely different approaches and cannot be combined with general health measures.

 

Attitudinal changes are required as far as health issue concerning the elderly. It is common in most less developed countries to accept poor health conditions of the elderly segment as a ‘natural’, ‘normal’ or ‘biological’ manifestation with old age. This attitude needs to be changed as the aged can lead a normal healthy life through medical intervention, awareness and public health measures generally sensitive to old age health problems as much as it has been to young age health problems.

 

The individual ageing process, from a medical perspective, is often associated with disease and disability. This association has been challenged on the grounds that there are many older persons who do not suffer chronic illness or disability, and many claiming to be in good health despite the presence of chronic illness.^{12, 13}   ‘Of all the problems associated with an ageing population, healthcare demands top priority’.¹⁴ Meghalaya, is one of the smallest states in India. The population is predominantly rural with a major chunk belonging to the Scheduled Tribes. Considering the two and half decades since the state was carved out of Assam little has been achieved with half the population continuing to live below the poverty line. It is common to see many a women in the rural areas having as many as 8-10 children. Repeated and frequent pregnancies have been detrimental to the health of women. There is a deep-rooted belief in having large families.¹⁵

 

According to the study hospitals/dispensaries are very near to all the sample areas. Figure 5 reveals health condition of the aged. Among all the sample areas the aged in Garo community seems to be healthier than aged of other villages going by their self-perception regarding health. When asked ‘do you consider yourself healthy’, 77.5 percent of the Garo elderly persons considered themselves healthy. On the other hand aged in Pnar community reported more health problems as nearly 90 percent of the aged reported themselves as not healthy. However, around 42.5 percent elderly among rural Khyriam people felt quite healthy. Such proportion of the aged among the Bhoi community was much less with 86.5 percent aged consider being not healthy. However, the Khyriam people living in Shillong and leading an urban life had more aged considering themselves as healthy as 75.6 percent aged felt as such.

 

Fig. 5. Perceived Health condition of the aged

 

Fig.6. Aged taken treatment in different hospital in selected culture groups

 

A very large percentage (69.5 percent) of the aged in Pnar village needed help for walking as they were unable to go to places without help and unable to travel unless special arrangement is made. They were also unable to perform any housework or go for shopping for grocery and cannot prepare meals for themselves. However about 30 percent aged are quite mobile and can go to places without help as well as able to travel and go for shopping for grocery and can also prepare meals for themselves. The 10 percent who considered being healthy are those who are in the age group that does not need any help in walking or in doing any other work.

 

The situation in Garo community chosen for study is quite different, 89.5 percent of the aged who were interviewed is quite mobile, can do their own housework, can go for shopping, and can also prepare their own meals. This is largely a reflection of the age structure of the Garo elderly in the village wherein bulk of them were in 60-70 years of age. Around 78.5 percent of the aged people in Bhoi community is active physically while 21.5 percent can walk and attend to other duties with some help. Proportion of the physically fit aged in Khyriam village was only 56.5 percent with 21.5 percent who needed some help and 22 percent completely unable to travel unless special arrangement is made. The urban Khyriam people had 60.2 percent aged who could do own household work without help. 39.8 percent of them can go to places of walking distance with some help.

 

Figure 6 reveals percentage of the aged who have taken treatment in different hospitals. Most of the aged people in all the villages got treated themselves in government hospitals; the highest percentage of treatment taken in government hospital is in Bhoi, followed by Garo and Pnar.

 

However the situation in Khyriam is different, 50 percent of the aged get treated from private doctors. Khyriam in Shillong city has the highest percentage of aged who sought treatment from private doctors (58.8 percent); 5.9 percent sought treatment in both private and government hospitals, 2.9 percent preferred local medicines and 32.4 percent in government hospitals.

 

When asked why they preferred private doctors than government hospitals, the aged answered that government hospitals do not supply proper medicines.

 

Figure 7 reveals the capabilities of aged to perform everyday activities. According to the study, aged among the Pnars has the highest percentage (48 percent) among all villages that need help regularly but not throughout day and night.

 

Fig.7. Capabilities of aged to perform everyday activities

 

The proportion of such aged persons in the Garo village is negligible. Proportion of the aged that required assistance regularly but not throughout day and night, is 12.5 percent of the aged in Bhoi village and only 4 percent in rural Khyriam village. Nearly all of the aged (96.5 percent) among the aged in the Garo village can perform work without assistanne. Aged proportion that required least assistance was as high as 16.5 percent among the Pnars, 39.5 percent among the Khyriams, 48.5 percent among the Bhois and around 40 percent among the urban Khyriams.

 

Among all the aged who need help regularly, the percentage is extremely high in Khyriam village (16.5 percent) followed by Pnar (12 percent) Bhoi (6.5 percent) and Garo (2 percent). However those who can perform work without assistance but need help with heavy work such as laundry and housekeeping have the highest percentage in Bhoi village with 49 percent, Pnar village with 23.5 percent, Khyriam rural with 22 percent and Garo with 2 percent. In urban Khyriam community in Shillong 40.0 percent of the aged perform activities without assistance. 37.8 percent of aged performs activities without assistance but need some help with heavy work such as laundry and housekeeping. Aged that need help regularly are only 4.4 percent. About 17.8 percent of the aged need help regularly but not throughout day and night.

 

 

Social Support:

Research has shown fairly consistently that social isolation and loneliness are related to negative health outcomes and that social support of various types and from various sources is associated with positive health outcomes.^15a,b,c… Rewarding social relationships are also thought to be a key factor in psychological health, including happiness and subjective well-being.¹⁶

 

Figure 8, 9….. reveals the social support received by the aged from family members. The highest proportion (90.5 percent) of the aged among the Bhoi community reported excellent support received from the members of the family. This was followed by the Pnars with 57.5 percent, Khyriam with 44.5 percent, the Garo with 24.5 percent where the aged received excellent support. Such a support was much less (31.1 percent) in urban areas as reported by the elderly Khyriams living in Shillong.

 

Fig 8. Social support received from family when need to talk to someone or go out (Pnar)

 

Fig 9 Social support received from family when need to talk to someone or go out (Garo)

 

Fig 10 Social support receiving from family when need to talk to someone or go out in (Bhoi)

 

Fig 11 Social support received from family when need to talk to someone or go out (Khyriam)

 

Fig 12 Social support received from family when need to talk to someone or go out in (Khyriam in Shillong city)

 

Extent of support was extremely poor in Garo community with 24.5 percent aged reporting such lack of support. Among the other communities, poor support is to the extent of 20.5 percent amongst Khyriam, 8 percent among Pnars, Khyriam in Shillong city with 6.7 percent. However the aged among the Bhoi did not report any support as being poor.

 

DISCUSSION:

Meghalaya is not experiencing ageing in the strict demographic sense of the term. However, like any other part of the country, the proportion of the aged is increasing at a faster pace than other age group. The notable aspect of Meghalaya is its unique matrilineal tradition that makes the issue of ageing and the care of the aged an interesting study. The other aspect of the population that makes the study interesting is the composition of the population, which is dominantly tribal. A combination of tribal social structure and matrilineal social practice has its significant influence on the ageing population. There are however important ethnic variations within the population as represented by the Garo and Khasi-Jaintia people following different matrilineal practices. The Khasis themselves are also divided into several sub-groups having their peculiar practices. Moreover, the process of urbanization too has important bearing on ageing.

 

Given these complexities, the present paper addressed itself to a number of issues pertaining to the aged and ageing problems. The data collected from selected villages and a locality in Shillong reveals the powerful impact of the twin aspects of tribal values and of matriliny in Meghalaya as far as the aged is concerned. It is clear from the analysis that the aged population in the communities studied rarely suffers from the kind of social isolation, loneliness etc. which are becoming more numerous in its occurrence in rest of the country. Informal support systems of family, kinship and community are strong enough to provide social security to its members including the aged. Understandably, the daughters provide the maximum care to the aged, but other members within the family too contribute significantly to taking care of the aged as revealed from the data on living arrangements. There are extremely few cases where an elderly lives alone. Children and grand children, sisters and brothers, nieces-nephew and daughter in laws take part in taking care of the aged. The community structure is still very robust in taking care of cases of destitution. Barring the Garo community, support from family persons has been rated excellent in all the communities. The aged in most cases finds itself not healthy and requires assistance.

 

There are though some changes that are seen in urban setting. The aged finds itself more dependant in an urban setting though enjoys better health.

 

REFERENCES:

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19.     Ernst, J. M., and Cacioppo, J. T. 1999. Lonely hearts: Psychological perspectives on loneliness. Applied and Preventive Psychology, Vol. 81, p1-22.

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Received on 04.08.2016

Modified on 22.09.2016

Accepted on 28.10.2016

© A&V Publication all right reserved

Research J. Humanities and Social Sciences. 7(4): October- December, 2016, 293-304.

DOI:  10.5958/2321-5828.2016.00048.6