Cesarean births are becoming more common in India, with health implications for both mothers and infants. Between 2005 and 2015, the proportion of cesarean births to total births in India roughly doubled, from 9% to 17%. We analyze Annual Health Survey data from the state of Odisha in eastern India.
View Article and Find Full Text PDFThe premise that a woman's social status has intergenerational effects on her children's health has featured prominently in population science research and in development policy. This study focuses on an important case in which social hierarchy has such an effect. In joint patrilocal households in rural India, women married to the younger brother are assigned lower social rank than women married to the older brother in the same household.
View Article and Find Full Text PDFDevelopment economists study both anthropometry and intra-household allocation. In these literatures, the Demographic and Household Surveys (DHS) are essential. The DHS censors its anthropometric sample by age: only children under five are measured.
View Article and Find Full Text PDFEcon J (London)
August 2021
We document a novel fact about neonatal death, or death in the first month of life. Globally, neonatal mortality is disproportionately concentrated in India. We identify a large effect of birth order on neonatal mortality that is unique to India: later-born siblings have a steep survival advantage relative to the birth-order gradient in other developing countries.
View Article and Find Full Text PDFIn high-income countries, population health surveys often measure mental health. This is less common in low- and middle-income countries (LMICs), including in India, where mental health is under-researched relative to its disease burden. The objective of this study is to assess the performance of two questionnaires for measuring population mental health in a mobile phone survey.
View Article and Find Full Text PDFThe 2011 India Human Development Survey found that in about a quarter of Indian households, women are expected to have their meals after men have finished eating. This study investigates whether this form of gender discrimination is associated with worse mental health outcomes for women. Our primary data source is a new, state-representative mobile phone survey of women ages 18-65 in Bihar, Jharkhand, and Maharashtra in 2018.
View Article and Find Full Text PDFThe relationship between mental health and social disadvantage in low- and middle-income countries is poorly understood. Our study contributes the first population-level analysis of mental health disparities in India, where the two marginalized groups that we study constitute a population larger than that of the USA. Applying two complementary empirical strategies to data on 10,125 adults interviewed by the World Health Organisation's Survey of Global Ageing and Adult Health (WHO-SAGE), we document and standardize gaps in self-reported mental health between the dominant social group (higher caste Hindus) and two marginalized social groups (Scheduled Castes and Muslims).
View Article and Find Full Text PDFThe UN Sustainable Development Goals call for the elimination of open defecation by 2030. Assessing global progress will require learning from India's sanitation efforts because of its ambitious program of high-profile behavior change messaging to tackle open defecation, and because open defecation is widespread in India. In 2014, the Prime Minister announced a policy called the Swachh Bharat Mission (SBM), which aimed to eliminate open defecation by 2019.
View Article and Find Full Text PDFNearly seventy years after India adopted one of the most progressive constitutions in the world ensuring equality for all its citizens irrespective of caste, class, race, and gender, the mind-set of its vast majority Indian remains steeped in gender and caste bias. Results from a new telephonic survey confirm persistence of conservative gender and caste attitudes in Indian society. High proportions of men and women across all social groups disapprove of women working outside their homes, consider it 'acceptable for husbands to beat their wives', and would object to relatives marrying a Dalit person.
View Article and Find Full Text PDFSince October 2014, the Government of India has worked towards the goal of eliminating open defecation by 2019 through the Swachh Bharat Mission. Since October 2014, the Government of India (GOI) has worked towards the goal of eliminating open defecation by 2019 through the Swachh Bharat Mission (SBM). In 2014, several of the co-authors reported on a survey of rural sanitation behaviour in North India (Coffey et al 2014) conducted by the Research Institute for Compassionate Economics (r.
View Article and Find Full Text PDFSurvey evidence from rural North India showing persistent solid fuel use despite increases in liquefied petroleum gas ownership is presented. Although three-quarters of survey households in these states had LPG, almost all also had a stove that uses solid fuels. Among those owning both, almost three-quarters used solid fuels the day before the survey.
View Article and Find Full Text PDFObjectives: To investigate differences in reported open defecation between a question about latrine use or open defecation for every household member and a household-level question.
Setting: Rural India is home to most of the world's open defecation. India's Demographic and Health Survey (DHS) 2015-2016 estimates that 54% of households in rural India defecate in the open.
The links among social inequality, economic inequality, and health have long been of interest to social scientists, but causal links are difficult to investigate empirically. In particular, studies examining the impact of social status on one's own health may overlook important effects of inequality on the health of populations as a whole occurring due to negative externalities of social forces. A recent literature on caste, sanitation, and child net nutrition provides an example of one social context where social inequality makes an entire population less healthy.
View Article and Find Full Text PDFObjective: We assess the feasibility of measuring awareness and use of medical abortion via a mobile phone survey on social attitudes in India.
Study Design: In 2018, we conducted a mobile phone survey with 3455 married men and women in Bihar and Maharashtra, two of India's most populous states. As part of a broader survey on social inequality, welfare programs, and health, we asked respondents about their awareness of medical abortion and whether they (or their wife) had ever had a medical abortion.
This study investigates disparities in child height-an important marker of population-level health-among population groups in rural India. India is an informative context in which to study processes of health disparities because of wide heterogeneity in the degree of local segregation or integration among caste groups. Building on a literature that identifies discrimination by quantifying whether differences in socioeconomic status (SES) can account for differences in health, we decompose height differences between rural children from higher castes and rural children from three disadvantaged groups.
View Article and Find Full Text PDFDemogr Res
February 2019
Background: Reducing neonatal mortality in India is critical to achieving the 2030 Sustainable Development Goal of a global neonatal mortality rate (NNM) of no more than 12 per 1,000. Policy efforts to reduce India's NNM, including a large-scale conditional cash transfer program, have focused on promoting birth in health facilities, rather than at home. Between 2005 and 2015, the percentage of facility births doubled, from 40% to 80%.
View Article and Find Full Text PDFEcon Polit Wkly
August 2018
An analysis of child height-for-age using the newly released data from the National Family Health Survey-4 indicates that the average child height increased by about four-tenths of a height-for-age standard deviation between 2005 and 2015. Although important, this increase is small relative to India's overall height deficit, and relative to economic progress; children in India remain among the shortest in the world. It is unsurprising that the increase in height-for-age has been modest because none of the principal factors responsible for India's poor child height outcomes have substantially improved over the last decade.
View Article and Find Full Text PDFAnaemia impairs physical and cognitive development in children and reduces human capital accumulation. The prior economics literature has focused on the role of inadequate nutrition in causing anaemia. This article is the first to show that sanitation, a public good, significantly contributes to preventing anaemia.
View Article and Find Full Text PDFA representative phone survey to study explicit prejudice against women and Dalits in Delhi, Mumbai, Uttar Pradesh, and Rajasthan reveals widespread prejudice in several domains and discusses the consequences for women and Dalits, and society as a whole. The results suggest the need for a more robust public discourse and active approach to measuring and challenging prejudice and discrimination.
View Article and Find Full Text PDFOpen defecation, which is still practiced by about a billion people worldwide, is one of the most compelling examples of how place influences health in developing countries. Efforts by governments and development organizations to address the world's remaining open defecation would be greatly supported by a better understanding of why some people adopt latrines and others do not. We analyze the 2005 and 2012 rounds of the India Human Development Survey (IHDS), a nationally representative panel of households in India, the country which is home to 60% of the people worldwide who defecate in the open.
View Article and Find Full Text PDFA long literature in demography has debated the importance of place for health, especially children's health. In this study, we assess whether the importance of dense settlement for infant mortality and child height is moderated by exposure to local sanitation behavior. Is open defecation (i.
View Article and Find Full Text PDFIndia has far higher open defecation rates than other developing regions where people are poorer, literacy rates are lower, and water is relatively more scarce. In practice, government programmes in rural India have paid little attention in understanding why so many rural Indians defecate in the open rather than use affordable pit latrines. Drawing on new data, a study points out that widespread open defecation in rural India is on account of beliefs, values, and norms about purity, pollution, caste, and untouchability that cause people to reject affordable latrines.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
March 2015
Despite being wealthier, Indian children are significantly shorter and smaller than African children. These differences begin very early in life, suggesting that they may in part reflect differences in maternal health. By applying reweighting estimation strategies to the Demographic and Health Surveys, this paper reports, to my knowledge, the first representative estimates of prepregnancy body mass index and weight gain during pregnancy for India and sub-Saharan Africa.
View Article and Find Full Text PDFHeight is a marker for health, cognitive ability and economic productivity. Recent research on the determinants of height suggests that postneonatal mortality predicts height because it is a measure of the early life disease environment to which a cohort is exposed. This article advances the literature on the determinants of height by examining the role of early life mortality, including neonatal mortality, in India, a large developing country with a very short population.
View Article and Find Full Text PDF