As of 2014, Kerala has a Human Development Index (HDI) of 0.790 which comes under the “high” category and it is the highest in the country and a consumption-based HDI of 0.920, which is better than that of many developed countries. Comparatively higher spending of the government in primary level education, health care and elimination of poverty from the 19th century onward has helped the state maintain an exceptionally high HDI; report was prepared by the central government’s Institute of Applied Manpower Research. However, the Human Development Report, 2005 prepared by Centre for Development Studies envisages a virtuous phase of inclusive development for the state since the advancement in human development had already started aiding the economic development of the state. Kerala, which is referred to being healthier than even many states of the United States, is a pioneer in implementing the Universal health care programme. Kerala is the cleanest and healthiest state in India.
According to a 2005–2006 national survey and the 2011 census, Kerala has the highest literacy rate (93.91) among Indian states. The life expectancy in Kerala is 74 years, among the highest in India as of 2011. Kerala’s rural poverty rate fell from 59% (1973–1974) to 12% (1999–2010); the overall (urban and rural) rate fell 47% between the 1970s and 2000s against the 29% fall in overall poverty rate in India.By 1999–2000, the rural and urban poverty rates dropped to 10.0% and 9.6% respectively. These changes stem largely from efforts begun in the late 19th century by the kingdoms of Cochin and Travancore to boost social welfare. This focus was maintained by Kerala’s post-independence government.:48 The United Nations Children’s Fund (UNICEF) and the World Health Organisation designated Kerala the world’s first “baby-friendly state” because of its effective promotion of breast-feeding over formulas. Over 95% of Keralite births are hospital delivered and the state also has the lowest Infant mortality rates in the country. Third National Family Health Survey ranks Kerala first in the list of “Institutional Delivery” with 100% births in medical facility. Ayurveda (both elite and popular forms),:13 siddha, and many endangered and endemic modes of traditional medicine, including kalari, marmachikitsa and vishavaidyam, are practised. Some occupational communities such as Kaniyar were known as native medicine men in relation with practice of such streams of medical systems, apart from their traditional vocation. These propagate via gurukula discipleship,:5–6 and comprise a fusion of both medicinal and alternative treatments.:15
Kerala has undergone the “demographic transition” characteristic of such developed nations as Canada, Japan, and Norway.:1 as 11.2% of people are over the age of 60, and due to the low birthrate of 18 per 1,000. In 1991, Kerala’s total fertility rate (TFR) was the lowest in India. Hindus had a TFR of 1.66, Christians; 1.78, and Muslims; 2.97. The sub-replacement fertility level and infant mortality rate are lower compared to those of other states; estimated from 12:49 to 14:5 deaths per 1,000 live births. The state also is regarded as the “least corrupt Indian state” according to the surveys conducted by Transparency International (2005) and India Today (1997). However, Kerala’s morbidity rate is higher than that of any other Indian state—118 (rural) and 88 (urban) per 1,000 people. The corresponding figures for all India were 55 and 54 per 1,000 respectively as of 2004.:5 Kerala’s 13.3% prevalence of low birth weight is higher than that of many first world nations. Outbreaks of water-borne diseases such as diarrhoea, dysentery, hepatitis, and typhoid among the more than 50% of people who rely on 3 million water wells is an issue worsened by the lack of sewers.:5–7 Kerala has the lowest homicide rate among Indian states, with 1.1 per 100,000 in 2011. In respect of women empowerment, some negative factors such as higher suicide rate, lower share of earned income, child marriage, complaints of sexual harassment and limited freedom are reported.
In 2014, Kerala had the highest conviction rate of any state, over 77%. Kerala has the lowest proportion of homeless people in rural India – 0.04%, and the state is attempting to reach the goal of becoming the first “Zero Homeless State”, in addition to its acclaimed “Zero landless project”, with private organisations and the expatriate Malayali community funding many projects for building homes for the homeless.The state was also in the lowest bottom in the India State Hunger Index next only to Punjab. In 2015 Kerala became the first “complete digital state” by implementing various e-governance initiatives.