Mortality rate still above pre-pandemic levels and total fertility rate below replacement level for the fifth consecutive year were highlights of the Sample Registration System (SRS) report for 2024, released on Thursday by the Office of the Registrar General of India (ORGI) working under the Ministry of Home Affairs. SRS reports are based on sample surveys and are considered the most reliable annual estimates of vital statistics.
The 2024 SRS report shows that India’s crude birth rate – the number of births per thousand population – was 18.3 in 2024, down from 18.4 in 2023. The number fell from 14.9 to 14.7 in urban areas and from 20.3 to 20.2 in rural areas. There was also a marginal improvement in the sex ratio at birth, or the number of girls born per 1,000 male children. The sex ratio at birth – averaged over three years – rose by one point from 2021-2023 to 918 in 2022-2024.
While the birth rate fell, the number of children expected to be born by women over reproductive age, or total fertility rate, remained steady at 2023 levels of 1.9. This was also the case in rural and urban areas, where the number remained constant at 2.1 and 1.5. To be sure, levels of the total fertility rate, unlike the birth rate, change slowly. What is interesting about the TFR figure is that it has remained below replacement level (2.1) – that is, a sustainable TFR of 2.1 means a stable population – for the fifth year in a row, and at replacement level for the second year in a row in rural areas. In urban areas, the number has remained below the replacement rate every year after 2005.
While the index moved in the birth rate, the number of deaths per thousand population – the crude death rate – remained steady at 6.4. This is certainly largely due to rural areas, where the number has remained steady at 6.8. In urban areas, the mortality rate fell from 5.7 in 2023 to 5.6 in 2024. Likewise, the infant mortality rate – that is, deaths of children under one year of age per 1,000 live births – continued to decline, albeit slowly. The number decreased from 25 in 2023 to 24 in 2024.
A somewhat worrying trend in the crude death rate is that it remains above the 6 level seen in 2019 and 2020. This is concerning because the death rate rose to 7.5 in 2021, the deadliest year of the Covid-19 pandemic. While the number in 2024 is well below that peak, it still does not reach the levels seen before the pandemic-related spike.
Cause of death statistics from the SRS similarly show that the proportion of deaths from respiratory infections remains higher than pre-pandemic levels. The figure was 5.7% in 2022-24 (this figure is available as a three-year average), which is well below the 9.3% figure in 2021-2023 and the recent peak of 10% in 2020-2022, but still higher than the figure of 3.6% in 2017-19 and 4.9% in 2018-20.
However, the marginal reduction in the share of deaths due to respiratory infections meant that the share of deaths due to motor vehicle accidents rose from 2.9% to 3.2%, and deaths due to suicide from 2.5% to 2.8%. While the SRS does not give an absolute number of deaths by cause, the Deaths from Accidents and Suicides in India (ADSI) for 2024, released by the Home Ministry’s National Crime Records Bureau (NCRB), also shows a rise in deaths due to suicide and motor vehicle accidents.
Likewise, deaths from non-communicable diseases increased from 56.7% to 60.1%, with deaths from respiratory infections decreasing. The share of cardiovascular disease, or diseases related to the heart and blood vessels, which is the largest cause of death among the 27 causes included in the report, rose from 31% to 32.1%. The share of cardiovascular diseases in total deaths certainly did not decrease even at the height of the epidemic. This is to be expected, as COVID-19 is thought to have increased rates of cardiovascular disease.
