The Lost Years: A Land Where Being Born Woman Means Dying Sooner

India is shining in many ways. Becoming Atma Nirbhar, India is seen at the forefront of technology and increasing its footprint in diplomatic corridors. But, beneath the progress, a silent crisis is unfolding in its heartland – Jharkhand, a mineral-rich state yet scarred by poverty.

Across the world, from the wealthiest nations to the poorest corners of Sub-Saharan Africa, women live longer than men. This biological and social advantage has emerged stronger over the decades, signalling  the resilience and slow gains from investments in women health, education and empowerment. In India too has historically mirrored this trend - women have for decades outlived men. Except in Jharkhand – according to the recently published Sample Registration System (SRS) data Jharkhand stand out as the  only state where women have shorter life expectancy. This is an alarming anomaly that  highlights India’s unfinished journey towards gender justice, social dignity and systematic care.

A decade ago, women in Jharkhand lived a few months longer than men – consistent to with biological advantages that typically affords females lower mortality.  Ironically, this reversal comes at a time when Jharkhand has made commendable gains in infant and maternal health. The SRS 2025 reveals that infant mortality has declined to 25 per 1000 live births, down from 54 in the NFHS-2 (1998-99). Neonatal care and immunization has improved, and institutional births have increased to over 76% (NFHS-5). Maternal mortality has dropped sharply from 261 per 1,00,000 births in 2007-09 to 51 in 2019-21.  This early life interventions save lives at critical stages of life-risks; but those gains are not translating into extended life spans. What erases the advantage between adolescents and old-age?

The answer lies in the every-day grind of life and living-conditions at home, neighbourhood and the cumulative neglect across systems shaping women’s opportunities.  Girls born these regions survive infancy, but soon encounter constrains - limited education, hazardous and invisible work, early marriage, healthcare focused on maternal and childcare, relentless labour, and social norms shape their days.   

The image of tribal and rural women is often of them bend over field, trekking to collect firewood or water, cooking over smoky challah. This invisible un-paid work of women brings no-income, little recognition and immense physical stress; often ignored their own aliments. While school attendance at ages  6-10 exceeds  93% for both the genders , by 15-17 it drops to  62% for girls and 65% for boys (NFHS-5).  Early exit from education, limits formal employment. Those who works pushed into dangerous and unregulated sectors including mica scavenging, open-pit mining jobs that erode health and go unrecorded.  

 The gendered longevity  gap reflects multiple deprivation – early marriage, malnutrition, social silencing and limited access to healthcare. Nearly one in three women in Jharkhand were marry  before turning eighteen, among the highest in India.  NFHS-5 reveals that  10 percent of women aged 15-19 years were  mothers or pregnant at the time of survey. Teenage pregnancies  carry  long term health risks for both mother and child. Despite falling fertility rates, early and frequent pregnancies persist.

 Underneath this is deep-rooted gender inequality. In   homes where women often eat last and least; girl grow up in malnutrition, enter motherhood unhealthy, and remain nutritionally deprived.   Anamia affects three-fifth of women at childbearing age. An anaemic woman at twenties , is at higher risk from even minor illness. The NFHS-5 also noted that underweight women with low BMI are far more prevalent- evidence of persistent deprivation.

The quality of life at  home and habitat  shares life-outcomes. A recent Development Inelegance Unit report  shows the districts of Jharkhand lags in quality of life indices. Only one-third household  use clean cooking fuel, most relying on wood or dung   causing indoor air pollution that harms women. Jharkhand’s mining wealth brings national prosperity but burdens locals with taxic runoffs in water and dust on crops. Women struggle to find clean water, suffers respiratory illness and face rising  skin ailments.  From these regions men often migrate in search of livelihoods, women left behind to cope with.

It is a mirror to the full arc of a woman’s life, shaped by the place she inhabits, the opportunities she is denied, and the quiet burdens she carries. In last few years, governments has launched serval initiatives to support women’s welfare – covering health, housing, education, nutrition and credit. Yet these efforts, however well-intended, often operate in silos. Their top down-down, delivery-focused logic rarely link the interlinked  realities women live. The challenge, therefore, is not about better implementation of projects, it requires a redesigned  eco-system, grounded in people’s aspirations and aligned with complexity of lived experiences that is intersectoral and inclusive of women at every stage of life.  Because the quality of life—and ultimately, longevity—is deeply spatial. Where one is born, lives, and grows old determines their lifespan.

Here, the Neighbourhoods of Care’ approach of Transform Rural India (TRI) offers a grounded multi-dimensional alternative and way forward. In an integrated, community-driven it weaves together health, nutrition, education, gender, climate change, governance and prosperity into a living eco-system- built around care of people, communities and planet. Anchored in local realities, it empowers women not as beneficiaries but as designers of solutions. By engaging  Self-Help Groups (SHGs), Panchayats and frontline workers, the model fosters collective action on health  and wellbeing.  It invites systems to listen to the silences, bank on  the aspirations, shifting from reactive crisis response to generational care, and built institutions that allow women to flourish across life lifetime, in their own localities. If Jharkhand’s paradox tells us how place can shorten a woman’s life, the Neighbourhoods of Care approach is the ways that show how the right place can extend it - turning every women into builder of a better future.   

The article is authored by  Shyamal Santra, Associate Director - Health & Nutrition & Co-Designer of Neighborhoods of Care (NoC), Transform Rural India, solution designers for regenerative development