Kerala is unique among Indian states for having achieved demographic transition much earlier than the national average, characterized by the following:
Declining Fertility: Kerala's Total Fertility Rate (TFR) has been below the replacement level (2.1) for decades, contributing to very low population growth.
Low Infant Mortality: Contrary to option (B), Kerala has one of the lowest Infant Mortality Rates (IMR) in India, comparable to developed nations, indicating high-quality public health.
Ageing Population: Due to low birth rates and high life expectancy, the proportion of the elderly population in Kerala is significantly higher than the Indian average, leading to an ageing population. The state is projected to have one of the highest shares of senior citizens in the country.
Migration Effect: The sustained, large-scale emigration (primarily to the Gulf countries) has resulted in a "missing middle" or a shortage of young working-age men, which further compounds the demographic shift toward an older population structure.
Therefore, the key features are the low birth rates and the resultant increase in the elderly population.
