Marginalized Groups in India: Women, Tribes, Disabled, Migrants, and Elderly

Across India, millions of people remain on the edges of opportunity, dignity, and basic services. They are pushed there not by personal failure but by structures built over generations: caste hierarchies, gender norms, physical inaccessibility, and economic systems that reward only certain kinds of work. Women, Scheduled Castes and Scheduled Tribes, persons with disabilities, migrants, and the elderly are commonly identified as the groups most exposed to this kind of exclusion. Understanding how each group is marginalized, and how these disadvantages overlap, is the first step toward building a society where access to health and rights is not a privilege but a guarantee.

What marginalization actually means 🔗

Marginalization is the process by which certain individuals or communities are pushed to the social, economic, and political fringes. It is not a single event but a slow accumulation of barriers. A marginalized group typically faces humiliation, exclusion, economic deprivation, and ill-treatment that limits its ability to access resources others take for granted.

A key feature of marginalization is that disadvantages stack. A person is rarely marginalized along just one axis. A tribal woman with a disability, for instance, faces overlapping layers of exclusion that compound one another. This overlap is sometimes described as double jeopardy: in a patriarchal society, a woman with a disability faces discrimination both for her gender and for her impairment, leaving her with far less access to care than either factor alone would suggest.

Women: health and rights at the margins 🔗

Women form half the population yet continue to occupy a lower social position than men in many parts of the country. This shows up most sharply in health outcomes, where early marriage, restricted access to care, and economic dependence combine to put women at risk.

The cost of early marriage 🔗

Despite laws against it dating back to 1929, child marriage remains widespread. A study published in The Lancet Global Health found that about one in five girls in India are still married below the legal age, which the authors call a worrying sign of weak policy design. The health consequences are severe. Girls married young tend to begin childbearing early, and maternal mortality is higher among women who marry and conceive early because their bodies are not ready for pregnancy and childbirth.

The effects do not end with the first pregnancy. Research using national survey data shows that women married as children continue to face greater problems accessing healthcare well into adulthood compared with those married as adults. Early marriage often cuts short a girl’s education, which in turn lowers her use of contraception and antenatal care, deepening the cycle of poor health.

Limited access and economic dependence 🔗

Even women who marry as adults frequently struggle to reach quality care. Lower social status translates into less decision-making power within the household, and studies have repeatedly shown that women with less autonomy have poorer access to health services. A large proportion of women do not receive adequate prenatal care, and gender-based and domestic violence remain high. The progress is real but uneven: India’s maternal mortality ratio has fallen substantially over the decades, yet the burden still falls heaviest on the poorest and least empowered women.

Scheduled Castes and Scheduled Tribes: discrimination written into health outcomes 🔗

Caste remains one of the strongest predictors of wellbeing in India. Scheduled Castes (SCs) have historically faced social exclusion and make up about 16.6 percent of the population, while Scheduled Tribes (STs), or Adivasis, account for roughly 8.6 percent and have endured deprivation rooted in ethnicity for centuries. Both groups are largely landless, concentrated in rural areas, and dependent on agricultural or casual labour.

Mortality and the antenatal care gap 🔗

The clearest evidence of structural disadvantage appears in child survival. According to NFHS-5 data, the under-five mortality rate among the ST population was 50 deaths per 1,000 live births compared with a national average of around 42, a gap that points directly to unequal access to care. National surveys also show that the probability of not receiving full antenatal care or full childhood immunization is highest among SC and ST families, ahead of economic class, mother’s education, and place of residence as a predictor.

These differences are not accidental. Researchers attribute the premature deaths of children from deprived castes and tribes to poverty, low education, and poor access to healthcare. Life expectancy itself splits along caste lines, with SCs recording among the lowest figures of any social group.

Why the gap persists 🔗

Even where public health facilities exist, limited accessibility and the unavailability of complete services keep utilization low among disadvantaged groups. Geographic isolation of many tribal habitations, the cost of reaching distant facilities, and the discomfort of facing discrimination from providers all push these communities toward delayed or absent care.

Persons with disabilities: rights on paper, barriers in practice 🔗

India has built a progressive legal framework for disability. The Rights of Persons with Disabilities (RPwD) Act, 2016 replaced the older 1995 law, expanded the recognised categories to 21 disabilities, and reframed disability as a condition shaped by social and environmental barriers rather than a fixed medical label. The law also mandates free healthcare in the vicinity and barrier-free access in government and private hospitals.

The implementation gap 🔗

The distance between law and lived reality remains wide. Years after the RPwD Act was passed, many states had not begun implementing it fully, many had not appointed Disability Commissioners, and enforcement mechanisms stayed weak. Most public buildings, transport systems, and digital platforms are still inaccessible, and healthcare in particular continues to be a problem area.

Invisible disabilities and the certification trap 🔗

A specific structural barrier is the certification system. To claim most entitlements, a person must obtain certification of at least 40 percent disability, known as a benchmark disability. But this assessment relies heavily on visible, measurable impairments such as limb or vision loss, which means conditions like chronic pain, fatigue, depression, and learning disabilities are poorly captured. Mental health illustrates the scale of the problem: the treatment gap for mental health disorders ranges from 76 to 85 percent, meaning roughly four out of five people with conditions like depression or anxiety receive no treatment at all.

Migrants: mobile bodies, immobile entitlements 🔗

Internal migration moves tens of millions of people in search of work, yet welfare entitlements rarely travel with them. Most government schemes, ration access, and health enrolments are tied to a person’s home state or district, so migrants frequently fall through the cracks at both ends.

The health consequences are well documented. A study comparing migrants and non-migrants found that people with internal migrant status were more vulnerable to poor health outcomes in later life, leading the authors to call for separate health policies for this group. Migrants also risk losing health coverage altogether, since absence during enrolment periods can break their access to insurance schemes. Add to this the high rate of work-related injuries in labour-intensive jobs, and the result is a population that works hardest yet receives some of the weakest protection.

The elderly: a fast-growing group facing thinning support 🔗

India is ageing rapidly. The number of people aged 60 and above is projected to rise from around 7.5 percent of the population in 2010 to over 11 percent by 2025, and to eventually surpass the number of children. Yet the systems meant to support older people remain thin, particularly in rural areas where most elderly live.

Health needs without health systems 🔗

Older people carry a heavy burden of chronic illness. Across India, non-communicable diseases such as diabetes, cancer, and cardiovascular conditions are responsible for about 52 percent of deaths, and around 40 percent of older people across Asia and the Pacific lack access to pensions, forcing many to keep working in informal jobs without protection. Rural health systems are often not prepared or equipped for the needs of the elderly, a gap worsened by the out-migration of younger family members who once provided care.

The double burden on elderly women 🔗

Ageing is not gender-neutral. Because women tend to live longer, over half of elderly women become widows, and widowhood in India still carries social stigma. Widows often lose property rights, face ostracism, and are nearly twice as likely as elderly men to have no income of their own, even though they report poorer health. Here again the layers of marginalization stack: being old, being a woman, and being widowed combine into a single, compounded disadvantage.

Why these groups must be understood together 🔗

It is tempting to treat each group as a separate policy box, but their disadvantages are connected by common threads: poverty, low education, geographic isolation, social stigma, and weak enforcement of otherwise strong laws. A migrant may also be from a Scheduled Caste; an elderly person may also have a disability; a tribal woman may face every barrier at once. Recognising these intersections is what separates genuine inclusion from token gestures. Welfare schemes such as employment guarantees, health insurance, housing support, and social security pensions exist precisely because no single intervention can address marginalization on its own.

What do you think? Which barrier do you believe is hardest to dismantle: the physical and economic ones like inaccessible buildings and lost entitlements, or the social ones like caste discrimination and the stigma around widowhood and disability? And when several disadvantages overlap in one person, should support be designed around the individual rather than around separate group categories?

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