India's Sample Registration System (SRS) estimated the Total Fertility Rate (TFR) for 2020 at approximately 2.0. The replacement-level fertility is 2.1. If a population has a TFR below 2.1 for a prolonged period, which of the following demographic consequences is MOST likely in the long term?

• A Immediate population decline
• B Rapid increase in child mortality due to fewer children being born
• C Population aging followed by eventual population decline due to demographic momentum ✓
• D Increased dependency ratio due to high proportion of children

Explanation

When TFR falls below replacement level (2.1), populations do not immediately shrink because of demographic momentum — a large existing cohort of women of reproductive age continues producing children even at sub-replacement fertility. Over decades, as this cohort ages, births decline, elderly proportion rises (population aging), and eventually absolute population decline occurs. The dependency ratio increases but due to elderly (not children), creating economic pressures.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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