From 1971 to 2020, death rates declined across both Kerala and India, reflecting improved healthcare. Kerala consistently had lower rates than the national average due to better health systems. While India's rural death rate dropped from 16.4 to 6.4, Kerala’s stayed around 7.0. Urban death rates also declined, with India falling to 5.1 and Kerala slightly higher at 7.1 in 2020. A recent rise in Kerala’s rates may be linked to an ageing population.