In India, COVID-19 has hit women harder than men, unlike most parts of the world.

The COVID-19 pandemic may have had a more severe impact on India than previously estimated, with life expectancy falling most severely among women, certain social groups and the younger generation.

During the COVID-19 pandemic in India, previous mortality estimates relied on official death records. However, the lockdown disrupted this system, and already Unreported deaths of women and children This was the case even before the pandemic. They say they don’t collect specific information like caste or ethnicity. Sangita Byas At Hunter College in New York.

So Vyas and her colleagues collected information on deaths in India from the National Family Health Survey, a nationwide survey that asks participants if anyone in their family has died in the past four years, and if so, provides data such as date of death, age, and sex. It includes options only for male and female.

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 had occurred nationwide, that would represent about 1.2 million excess deaths in 2020. That’s eight times India’s official COVID-19 death toll for 2020 and 1.5 times the World Health Organization’s figure. calculationAccording to research,

Between 2019 and 2020, overall life expectancy at birth in our sample decreased by more than 2.5 years. 1.5 year decline In the United States over the same period, life expectancy changes varied by gender, age, and social group.

For example, women lost about three years, while men lost just over two years. This contrasts with global trends that have shown a greater increase in mortality among men than among women during the COVID-19 pandemic. “This unique pattern in India could be explained, at least in part, by gender inequality,” says Vyas.

Preliminary study Indian households say the pandemic may have exacerbated existing inequalities, as women spend less on health care than men. Ridi Kashyap She, who worked as a co-author at the University of Oxford, said strict lockdowns were likely to increase maternal mortality by reducing access to maternal health care.

Unlike other countries, the decline in life expectancy observed in this study was mainly due to deaths among the younger demographic. The increase in deaths among women and girls under 20 contributed about a year to the decline in life expectancy in 2020, which is about the same as the deaths of women aged 60–79.

“We think the increase in mortality is due to the indirect impact of the lockdown in India,” says Vyas. That impact could include disruption to childhood vaccines and treatment for tuberculosis, a leading cause of death in India.

There were also significant differences across social groups: life expectancy fell by 1.3 years for upper-caste Hindus, 5.4 years for Muslims and 2.7 years for those belonging to lower castes.

Public health experts have long known about health inequities in India, but these findings highlight the scale of those inequities, Vyas says. “Seeing how different populations are affected differently is important for developing policy responses,” she says.

But the study had limitations. Because of the chaos during the lockdown, the 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 did not look at causes of death. “We can only speculate as to why this pattern is the case,” Kashyap says. “But we can’t say for sure what the cause is.”