Spatial Disparities in Health and Life Expectancy Among Older People in Nepal

Population ageing is a problem in Nepal; there is still a lack of nationally representative evidence on the geographical variations of healthy ageing. This study compared survival to age 60 years, LLE at age 60 years and prevalence of disability among older people (aged ≥60 years) in 7 provinces and 3 ecological belts of Nepal. A secondary analysis of cross-sectional data from the National Population and Housing Census (NPC) 2021 of 2,977,318 older adults was conducted. Survival, life expectancy, and disability were described and compared by province, ecological belt, sex, and type of disability. The proportion of the population reaching age 60 years in the country was 80.0% and life expectancy at birth was 19.4 years. Survival was higher and life span longer for females than for males. Survival rates in the provinces ranged from 76.8% in Lumbini to 82.6% in Bagmati. Across all age groups, 6.92% of older adults had at least one type of disability, which was 4.57% in Madhesh and 9.54% in Karnali. The highest prevalence was for physical disability (2.0%), low vision (1.8%) and hearing impairment (0.8%). There are notable geographical and sex differences in healthy ageing in Nepal, which underlines the need for ageing, disability, rehabilitation, and health-resource-specific strategies.