The 20-Year Question
What's Stealing India's Healthy Years?
India is home to the world’s . On paper, it’s a demographic advantage. In reality, we’re watching that potential erode quietly, steadily, through the lens of poor health.
Look beyond , and the cracks begin to show.
A Tale of Two Metrics: HALE and DALY
Life expectancy in India has crossed 70 years, but this number masks a deeper issue. (Health-Adjusted Life Expectancy) at birth puts India at just ~60 years.
The story deepens with age. HALE at age 60 in India drops to just about 11 years, meaning after 60, most people can only expect 11 relatively healthy years, with chronic illness, disability, or reduced function setting in thereafter.
In contrast, countries like Japan and Singapore have HALEs of 74–76 years at birth, and people aged 60 there can still expect to live over 20 healthy years.
That means the average Indian is losing out on ~20 years of good health.
But even HALE doesn’t tell the full story. Here's where DALY (Disability-Adjusted Life Years) comes in.
measures the total number of years lost to illness, injury, or early death.
DALY = YLL (Years of Life Lost) + YLD (Years Lived with Disability)
It accounts for:
Premature mortality
Time lived with chronic disease, pain, or mental illness
In short, DALY reveals what’s stealing our healthy years.
India’s DALY Burden is Alarming
DALYs per 100,000 (2021)
~33,000
~11,300
~13,000
(Source: Global Burden of Disease Study 2021, released in 2024)
India’s disease burden is 2.5 to 3 times higher than global healthspan leaders. And it’s not just the elderly. The rise is being driven by non-communicable diseases (NCDs) that affect working-age adults:
Heart disease
Diabetes and kidney disorders
Chronic respiratory diseases
Depression, anxiety, and other mental health conditions
Musculoskeletal disorders (e.g., back pain, arthritis)
Summary: Three Metrics, One Story
Life Expectancy
How long people live
HALE
How long they stay healthy
DALY
What’s being lost and why
We don’t just need longer lives, we need healthier ones. And to get there, we need to focus on the causes behind the DALY numbers.
The Implications for Work
This growing burden shows up at work every day:
Employees logging in with migraines, fatigue, and poor concentration
Missed deadlines and decision fatigue from cognitive strain
Medical leaves for preventable conditions that were never screened or managed
Low uptake of care benefits due to fragmented systems and stigma
The net result shows a workforce that’s present, but not fully productive. And the worst part is that this loss doesn’t show up in headcount or P&L lines, but in slow-moving attrition, rising claims, poor engagement, and declining output.
Where the System Breaks Down
1. A Health System Built for Crisis, Not Continuity
India’s healthcare model is reactive by design. Preventive care is rarely emphasized, with little infrastructure for early screening or continuity of care. Out-of-pocket costs push many to delay treatment, and there’s no widespread public health culture around annual check-ups, lifestyle management, or mental health.
2. A Workplace Model That Mistakes Insurance for Health
Most companies stop at group insurance, treating it like a safety net, not a strategy. But insurance alone doesn’t improve healthspan. It doesn’t:
Drive early intervention
Support long-term condition management
Close gaps in daily behaviors that impact energy, mood, or cognition
Wellness programs, where they exist, are often generic, underfunded, or disconnected from actual needs.
Why the 20-Year Gap Matters
That 15–20 year gap is no longer a public health concern; it's a business risk.
If employees spend their most experienced years battling chronic conditions that are preventable, it will lead to talent attrition, innovation slowdown, and an increase in healthcare costs.
Countries that lead in healthspan have invested for decades in:
Robust primary care systems
Early detection and habit-based prevention
Strong workplace-linked health models and incentives for healthy behavior
The Way Forward
To close this gap, we must move from a model of “sick care” to “healthspan care”, one that spans both policy and the workplace.
Rethink benefits beyond insurance, into daily health engagement, not just claims.
Strengthen the primary care backbone
Offer access to preventive services, mental health support, and primary care continuity based on employee requirements, and not based on a checklist.
Incentivize digital and preventive care models
Make health visible and measurable, not just in utilization, but in long-term outcomes like DALYs avoided or HALEs extended.
Integrate workplace wellness into national health goals
In Closing
The question isn’t just how long Indians are living, but how well they’re living, especially during their working years.
This report, the Workforce Health Index, makes it clear: India’s demographic dividend is not guaranteed.
Without systemic reform and workplace-led intervention, we risk turning dividends into a demographic liability.
Because every year lost to illness is more than a statistic, it’s a missed opportunity for a healthier, more resilient, and more productive nation.
Sources
Global Burden of Disease Study 2021 (Published 2024), Institute for Health Metrics and Evaluation (IHME), ghdx.healthdata.org
WHO Global Health Observatory, who.int
Our World in Data – DALY metrics, ourworldindata.org
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