Unlike most countries in the world, women in India have been affected more by COVID-19 than men.

The COVID-19 pandemic may have affected India more severely than previously estimated, with women, certain social groups and younger people experiencing the most severe declines in life expectancy.

Mortality estimates in India during the coronavirus pandemic have been based on official death records. But the lockdown disrupted this system, and already Under-reporting of women and children’s deaths Even before the pandemic, certain information such as caste and ethnicity was not collected. Sangeeta Vyas At Hunter College in New York.

So Vyas and his colleagues collected information on mortality in India from the National Family Health Survey, a nation-wide survey that asks participants whether anyone in their household has died in the past four years and, if so, to provide data such as date of death, age, and sex (with only male and female options).

The researchers analyzed data from more than 765,000 participants who completed the survey in 2021. They found that deaths in 2020 were about 17% higher than in 2019. If a similar increase occurred across India, it would amount to about 1.2 million excess deaths in 2020. This is eight times the official number of COVID-19 deaths in India in 2020 and 1.5 times the World Health Organization estimate. QuoteAccording to research.

From 2019 to 2020, life expectancy across the entire sample fell by more than 2.5 years. 1.5 Years of Decline During the same period in the United States, changes in life expectancy also varied by sex, age, and social group.

For example, mortality rates fell by about three years for women and just over two years for men. This contrasts with global trends that show that men have experienced a larger increase in mortality than women during the COVID-19 pandemic. “These peculiar patterns in India are likely to be explained, at least in part, by gender inequality,” Vyas says.

preliminary survey In Indian households, women spend less on healthcare compared to men, and the pandemic may have exacerbated these existing disparities, it said. Riddhi Kashyap Oxford University researchers who co-authored the study say strict lockdowns could hinder access to obstetric care and increase obstetric mortality.

Unlike other countries, the decline in life expectancy observed in the study was mainly due to premature deaths: rising mortality rates among women and girls under 20 contributed about one year to the decline in life expectancy in 2020, roughly the same as the number of deaths among women aged 60 to 79.

“We believe the rise in mortality is stemming from indirect effects of the lockdown in India,” Vyas said, which could include disruptions to access to childhood vaccines and treatment for tuberculosis, a leading cause of death in the country.

There were also large differences between social groups: high-caste Hindus saw their life expectancy fall by 1.3 years, while Muslims and people belonging to lower castes saw their life expectancy fall by 5.4 and 2.7 years, respectively.

Public health experts have long been aware of health disparities in India, but the findings highlight the magnitude of those disparities, Vyas said. “Knowing how different populations are affected differently is important for crafting policy responses,” she said.

But the study had limitations. Due to disruptions during the lockdown, survey respondents came from only 14 of India’s 36 states and union territories, making the sample demographically representative of only about a quarter of India’s population. The study also didn’t look at causes of death. “We can only speculate as to why there are these patterns,” Kashyap says. “But we can’t say for sure what’s causing them.”