Evidence map›Paper›PMID 41409690›Full record

ArticleFrontiers in public health2025

Outliving and outlasting: explaining sex inequities in healthy life expectancy through the lens of multimorbidity and within morbidities in older populations in India.

Ajay Kumar

Abstract read
In one paragraph

Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

Ajay KumarDepartment of Biostatistics and Epidemiology, International Institute for Population Sciences (IIPS), Mumbai, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Life expectancy (LE) at birth in India has increased substantially over the past century, initially driven by reductions in infant and childhood mortality and later supported by declining mortality in older population. Despite these gains, sex gaps in LE have widened, and healthy life expectancy (HLE) has declined, largely due to escalating non-communicable diseases (NCDs) and, more recently, a growing burden of multimorbidity among older adults. Data: Using the Sample Registration System (SRS) and nationally representative Longitudinal Ageing Study in India (LASI) Wave 1, we assessed sex-specific patterns in healthy lifespan inequality (HLI), decomposed disparities in HLE, and quantified inequality arising from mortality and the prevalence of multimorbidity/complex multimorbidity. Results: Females have a marginal advantage in HLE (30.59 years) compared to males (29.15 years) and have higher multimorbidity-free life expectancy (25.50 years vs. 23.30 years). However, they also live longer with multimorbidity (6.09 years vs. 5.85 years) and spend significantly more time with complex multimorbidity (10.77 years vs. 8.93 years). Mortality differentials remain the dominant contributor to sex-specific HLE gaps. Disease- and multimorbidity-specific patterns reveal a survival-morbidity paradox: women live longer than men but accumulate a greater burden of diseases and conditions. Moreover, cardiovascular and musculoskeletal diseases account for significant losses in disease-free life expectancy (DFLE) among women, while men experience steeper declines due to respiratory diseases. Conclusion: As India undergoes demographic ageing and an epidemiological shift toward chronic disease dominance, reducing sex disparities in HLE requires targeted public health strategies. Prioritizing prevention, early detection, and integrated management of multimorbidity particularly complex multimorbidity among older women will be essential to narrow the growing gap and promote healthier ageing.

Indexed as

Health Status DisparitiesLife ExpectancyMultimorbidityAdultAgedAged, 80 and overFemaleHumansIndiaLongitudinal StudiesMaleMiddle AgedSex Factorschronic diseasescomplex multimorbidityhealthy life expectancyhealthy lifespan inequalityIndiamultimorbiditysex disparities

Identifiers

PMID41409690
PMCPMC12706656

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.