S V Subramanian’s Co-Authored Publication in the Journal of Global Health Sciences

Dr. S V Subramanian, Professor of Population Health and Geography, and others have recently authored “Equal risk, unequal burden? Gender differentials in COVID-19 mortality in India” in the Journal of Global Health Sciences. The study has been featured in BBC, The New Indian Express and The Telegraph.



Early reports on coronavirus disease 2019 (COVID-19) case fatalities in India suggests that males are at a greater disadvantage than females, but it is unclear whether males experience a higher risk of mortality throughout the age-spectrum or there are sex-differentials in survival risk. We adopt a gender lens and present a disaggregated view of age-sex specific COVID-19 infection and mortality risk in India.


We use crowdsourced data (https://www.covid19india.org/) to provide preliminary estimates for age-sex specific COVID-19 case fatality rate (CFR) for India. We analyse the burden of the cases and deaths for age-sex categories. CFR is estimated as the ratio of confirmed deaths in total confirmed cases. We report binomial confidence interval for the CFR estimates. Also, an adjusted-CFR is developed to capture the potential mortality among the currently active infections.


As of May 20, 2020, males share a higher burden (66%) of COVID-19 infections than females (34%) but the infection is more or less evenly distributed in under-five as well as elderly age groups. The CFR among males and females is 2.9% and 3.3%, respectively. The age-specific COVID-19 CFR assumes ‘Nike-swoosh’ pattern with elevated risks among the elderly. The World Health Organization world standard population structure standardized CFR for India is 3.34%. The adjusted-CFR is estimated to be 4.8%.


Early evidence indicates that males have higher overall burden, but females have a higher relative-risk of COVID-19 mortality in India. Elderly males and females both display high mortality risk and require special care when infected. Greater focus on data collection and sharing of age-sex specific COVID-19 cases and mortality data is necessary to develop robust estimates of COVID-19 case fatality to support policy decisions.


Joe W, Kumar A, Rajpal S, Mishra U, Subramanian SV. Equal risk, unequal burden? Gender differentials in COVID-19 mortality in India. J Glob Health Sci. 2020 Jun;2(1):e17. https://doi.org/10.35500/jghs.2020.2.e17

Read the full publication.