Maternal and Child Health Journal

, Volume 17, Issue 8, pp 1499–1507 | Cite as

Adjusted Effects of Domestic Violence, Tobacco use, and Indoor Air Pollution from Use of Solid Fuel on Child Mortality

  • Shanta PandeyEmail author
  • Yuan Lin


Studies that have separately examined the consequences of gender based violence upon women, use of solid fuel for cooking, and mother and father’s use of tobacco on child health have concluded that they serve as risk factors for maternal and child health. Some authors have implied that these studies may have run the risk of overestimating the burden of disease of one factor over another. In this paper, we included all four factors in the same model to estimate their adjusted effects on child mortality, controlling for the demographic factors. The data come from 2005 to 2006 National Family Health Survey of India that interviewed a nationally representative sample of 39,257 couples. Of the four factors, mothers’ use of tobacco presented the highest risk for child mortality (OR = 1.42; CI = 1.27–1.60) followed by fathers’ use of tobacco (OR = 1.23; CI = 1.12–1.36), households’ use of solid fuel for cooking (OR = 1.23; CI = 1.06–1.43), and physical abuse upon mothers (OR = 1.20; CI = 1.10–1.32). Among the households that used solid fuel for cooking, improved cookstoves users experienced 28 % lower odds of child mortality (OR = 0.72; CI = 0.61–0.86) compared to nonusers of improved cookstoves. Additionally, increase in age of mothers at birth of first child, parents’ education, and household wealth served as protective factors for child mortality. To prevent child death, programs should focus on reducing couple’s use of tobacco, protecting women from physical abuse, and helping households switch from solid to liquid fuel. Moreover, a significant reduction in child death could be attained by improving girls’ education, and delaying their age at marriage and first birth.


Child mortality Tobacco use Gender based violence Indoor air pollution Improved cookstoves 


  1. 1.
    Black, R. E., Morris, S. S., & Bryce, J. (2003). Where and why are 10 million children dying every year? Lancet, 361(9376), 2226–2234.CrossRefPubMedGoogle Scholar
  2. 2.
    World Health Organization. (2010). World health statistics 2010. Geneva: WHO Press.Google Scholar
  3. 3.
    United Nations. (2010). The millennium development goals report. New York: Author.Google Scholar
  4. 4.
    Nandi, A. (2010). If you build it, will they come?: Demand-side incentives for public healthcare delivery in India. The Center for Disease Dynamics, Economics and Policy.Google Scholar
  5. 5.
    Rajaratnam, J. K., Marcus, J. R., Flaxman, A. D., et al. (2010). Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries, 1970–2010: A systematic analysis of progress towards Millennium Development Goal 4. Lancet, 375(9730), 1988–2008.CrossRefPubMedGoogle Scholar
  6. 6.
    Jewkes, R. (2002). Intimate partner violence: Causes and prevention. Lancet, 359(9315), 1423–1429.CrossRefPubMedGoogle Scholar
  7. 7.
    Silverman, J. G., Decker, M. R., Cheng, D. M., et al. (2011). Gender-based disparities in infant and child mortality based on maternal exposure to spousal violence: The heavy burden borne by Indian girls. Archives of Pediatrics and Adolescent Medicine, 165(1), 22–27.CrossRefPubMedGoogle Scholar
  8. 8.
    Ackerson, L. K., & Subramanian, S. V. (2009). Intimate partner violence and death among infants and children in India. Pediatrics, 124(5), e878–e889.CrossRefPubMedGoogle Scholar
  9. 9.
    Simister, J., & Mehta, P. S. (2010). Gender-based violence in India: Long-term trends. Journal of Interpersonal Violence, 25(9), 1594–1611.CrossRefPubMedGoogle Scholar
  10. 10.
    Koenig, M. A., Stephenson, R., Acharya, R., Barrick, L., Ahmed, S., & Hindin, M. (2010). Domestic violence and early childhood mortality in rural India: Evidence from prospective data. International Journal of Epidemiology, 39(3), 825–833.CrossRefPubMedGoogle Scholar
  11. 11.
    Dietz, P. M., England, L. J., Shapiro-Mendoza, C. K., Tong, V. T., Farr, S. L., & Callaghan, W. M. (2010). Infant morbidity and mortality attributable to prenatal smoking in the U.S. American Journal of Preventive Medicine, 39(1), 45–52.CrossRefPubMedGoogle Scholar
  12. 12.
    Maritz, G. S., & Harding, R. (2011). Life-long programming implications of exposure to tobacco smoking and nicotine before and soon after birth: Evidence for altered lung development. International Journal of Environmental Research and Public Health, 8(3), 875–898.CrossRefPubMedGoogle Scholar
  13. 13.
    DiFranza, J. R., Aligne, C. A., & Weitzman, M. (2004). Prenatal and postnatal environmental tobacco smoke exposure and children’s health. Pediatrics, 113(4 Suppl), 1007–1015.PubMedGoogle Scholar
  14. 14.
    Pattenden, S., Antova, T., Neuberger, M., et al. (2006). Parental smoking and children’s respiratory health: Independent effects of prenatal and postnatal exposure. Tobacco Control, 15(4), 294–301.CrossRefPubMedGoogle Scholar
  15. 15.
    Jurado, D., Munoz, C., Luna Jde, D., & Munoz-Hoyos, A. (2005). Is maternal smoking more determinant than paternal smoking on the respiratory symptoms of young children? Respiratory Medicine, 99(9), 1138–1144.CrossRefPubMedGoogle Scholar
  16. 16.
    Fantuzzi, G., Vaccaro, V., Aggazzotti, G., et al. (2008). Exposure to active and passive smoking during pregnancy and severe small for gestational age at term. Journal of Maternal-Fetal & Neonatal Medicine, 21(9), 643–647.CrossRefGoogle Scholar
  17. 17.
    Goel, P., Radotra, A., Singh, I., Aggarwal, A., & Dua, D. (2004). Effects of passive smoking on outcome in pregnancy. Journal of Postgraduate Medicine, 50(1), 12–16.PubMedGoogle Scholar
  18. 18.
    Salihu, H. M., Aliyu, M. H., Pierre-Louis, B. J., & Alexander, G. R. (2003). Levels of excess infant deaths attributable to maternal smoking during pregnancy in the United States. Maternal and Child Health Journal, 7(4), 219–227.CrossRefPubMedGoogle Scholar
  19. 19.
    Dherani, M., Pope, D., Mascarenhas, M., Smith, K. R., Weber, M., & Bruce, N. (2008). Indoor air pollution from unprocessed solid fuel use and pneumonia risk in children aged under five years: A systematic review and meta-analysis. Bulletin of the World Health Organization, 86(5), 390–398.CrossRefPubMedGoogle Scholar
  20. 20.
    Wilkinson, P., Smith, K. R., Davies, M., et al. (2009). Public health benefits of strategies to reduce greenhouse-gas emissions: Household energy. Lancet, 374(9705), 1917–1929.CrossRefPubMedGoogle Scholar
  21. 21.
    Rehfuess, E., Mehta, S., & Pruss-Ustun, A. (2006). Assessing household solid fuel use: Multiple implications for the Millennium Development Goals. Environmental Health Perspectives, 114(3), 373–378.CrossRefPubMedGoogle Scholar
  22. 22.
    Martin, W. J., 2nd, Glass, R. I., Balbus, J. M., & Collins, F. S. (2011). Public health. A major environmental cause of death. Science, 334(6053), 180–181.CrossRefPubMedGoogle Scholar
  23. 23.
    Kabeer, N., & Subrahmanian, R. (Eds.). (1999). Institutions, relations and outcomes: A framework and case studies for gender aware-planning. New Delhi: Raj Press.Google Scholar
  24. 24.
    Kabeer, N. (1994). Reversed Realities: Gender hierarchies in development thought. London: Verso Publications.Google Scholar
  25. 25.
    Borooah, V. K. (2004). Gender bias among children in India in their diet and immunisation against disease. Social Science and Medicine, 58(9), 1719–1731.CrossRefPubMedGoogle Scholar
  26. 26.
    Pandey, A., Sengupta, P. G., Mondal, S. K., et al. (2002). Gender differences in healthcare-seeking during common illnesses in a rural community of West Bengal, India. Journal of Health, Population, and Nutrition, 20(4), 306–311.PubMedGoogle Scholar
  27. 27.
    Gupta, M. D. (1995). Life course perspectives on women’s autonomy and health outcomes. American Anthropologist, 97(3), 481–491.CrossRefGoogle Scholar
  28. 28.
    Morrison, A., Ellsberg, M., & Bott, S. (2007). Addressing gender-based violence: A critical review of interventions. The World Bank Research Observer, 22(1), 25–51.CrossRefGoogle Scholar
  29. 29.
    Heise, L. L. (1998). Violence against women: An integrated, ecological framework. Violence Against Women, 4(3), 262–290.CrossRefPubMedGoogle Scholar
  30. 30.
    Bandura, A. (1986). Social foundations of thought and action : A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  31. 31.
    Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  32. 32.
    Hochbaum, G. M. (1958). Public participation in medical screening programs; a socio-psychological study. Washington: US Department of Health, Education, and Welfare, Public Health Service, Bureau of State Services, Division of Special Health Services, Tuberculosis Program.Google Scholar
  33. 33.
    Becker, M. H. (1974). The Health belief model and personal health behavior. San Francisco: Society for Public Health Education.Google Scholar
  34. 34.
    Janz, N. K. (1988). The Health Belief Model in understanding cardiovascular risk factor reduction behaviors. Cardiovascular Nursing, 24(6), 39–41.Google Scholar
  35. 35.
    Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11(1), 1–47.CrossRefPubMedGoogle Scholar
  36. 36.
    Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Health behavior and health education: Theory, research, and practice (4th ed.). San Francisco, CA: Jossey-Bass.Google Scholar
  37. 37.
    Weinstein, N. D., Marcus, S. E., & Moser, R. P. (2005). Smokers’ unrealistic optimism about their risk. Tobacco Control, 14(1), 55–59.CrossRefPubMedGoogle Scholar
  38. 38.
    Wilson, N., Thomson, G., Weerasekera, D., et al. (2009). Smoker misperceptions around tobacco: National survey data of particular relevance to protecting Maori health. New Zealand Medical Journal, 122(1306), 123–127.PubMedGoogle Scholar
  39. 39.
    International Institute for Population Sciences (IIPS) and Macro International. (2007). National Family Health Survey (NFHS-3), 2005–06: India: Volume I. Mumbai: IPS.Google Scholar
  40. 40.
    Kishor, S., & Johnson, K. (2004). Profiling domestic violence: A multi-country study. Calverton, MD: ORC Macro.Google Scholar
  41. 41.
    Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences. NJ: Lawrence Erlbaum Associates, Inc.Google Scholar
  42. 42.
    Hosmer, D. W., & Lemeshow, S. (2000). Applied logistic regression. New York: John Wiley & Sons.CrossRefGoogle Scholar
  43. 43.
    Goswami, H. (2003–2005). The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003; Rules, 2004; Rules, 2005; and Supreme Court Judgement in Murli S. Deora Vs. Union of India & others case. Chandigarh: Burning Brain Society.Google Scholar
  44. 44.
    Wakefield, M. A., Loken, B., & Hornik, R. C. (2010). Use of mass media campaigns to change health behaviour. Lancet, 376(9748), 1261–1271.CrossRefPubMedGoogle Scholar
  45. 45.
    Bala, M., Strzeszynski, L., & Cahill, K. (2008). Mass media interventions for smoking cessation in adults. Cochrane Database of Systematic Reviews, (1), CD004704.Google Scholar
  46. 46.
    Wakefield, M. A., Durkin, S., Spittal, M. J., et al. (2008). Impact of tobacco control policies and mass media campaigns on monthly adult smoking prevalence. American Journal of Public Health, 98(8), 1443–1450.CrossRefPubMedGoogle Scholar
  47. 47.
    Niederdeppe, J., Kuang, X., Crock, B., & Skelton, A. (2008). Media campaigns to promote smoking cessation among socioeconomically disadvantaged populations: What do we know, what do we need to learn, and what should we do now? Social Science and Medicine, 67(9), 1343–1355.CrossRefPubMedGoogle Scholar
  48. 48.
    Niederdeppe, J., Fiore, M. C., Baker, T. B., & Smith, S. S. (2008). Smoking-cessation media campaigns and their effectiveness among socioeconomically advantaged and disadvantaged populations. American Journal of Public Health, 98(5), 916–924.CrossRefPubMedGoogle Scholar
  49. 49.
    Piwoz, E. G., Huffman, S. L., & Quinn, V. J. (2003). Promotion and advocacy for improved complementary feeding: Can we apply the lessons learned from breastfeeding? Food and Nutrition Bulletin, 24(1), 29–44.PubMedGoogle Scholar
  50. 50.
    Gupta, A., Dadhich, J., & Faridi, M. (2010). Breastfeeding and complementary feeding as a public health intervention for child survival in India. Indian Journal of Pediatrics, 77(4), 413–418.CrossRefPubMedGoogle Scholar
  51. 51.
    Babu, B. V., & Kar, S. K. (2009). Domestic violence against women in eastern India: A population-based study on prevalence and related issues. BMC Public Health, 9, 129.CrossRefPubMedGoogle Scholar
  52. 52.
    Koenig, M. A., Stephenson, R., Ahmed, S., Jejeebhoy, S. J., & Campball, J. (2006). Individual and contextual determinants of domestic violence in North India. American Journal of Public Health, 96(1), 132–137.CrossRefPubMedGoogle Scholar
  53. 53.
    Babu, B. V., & Kar, S. K. (2010). Domestic violence in Eastern India: Factors associated with victimization and perpetration. Public Health, 124(3), 136–148.CrossRefPubMedGoogle Scholar
  54. 54.
    Speizer, I. S., & Pearson, E. (2011). Association between early marriage and intimate partner violence in India: A focus on youth from Bihar and Rajasthan. Journal of Interpersonal Violence, 26(10), 1963–1981.CrossRefPubMedGoogle Scholar
  55. 55.
    Kishore, V. V. N., & Ramana, P. V. (2002). Improved cookstoves in rural India: How improved are they?: A critique of the perceived benefits from the National Programme on Improved Chulhas (NPIC). Energy, 27(1), 47–63.CrossRefGoogle Scholar
  56. 56.
    Wilkinson, P., Smith, K. R., Davies, M., et al. (2009). Public health benefits of strategies to reduce greenhouse-gas emissions: household energy. The Lancet, 374(9705), 1917–1929.CrossRefGoogle Scholar
  57. 57.
    Roden, C. A., Bond, T. C., Conway, S., Osorto Pinel, A. B., MacCarty, N., & Still, D. (2009). Laboratory and field investigations of particulate and carbon monoxide emissions from traditional and improved cookstoves. Atmospheric Environment, 43(6), 1170–1181.CrossRefGoogle Scholar
  58. 58.
    Chengappa, C., Edwards, R., Bajpai, R., Shields, K. N., & Smith, K. R. (2007). Impact of improved cookstoves on indoor air quality in the Bundelkhand region in India. Energy for Sustainable Development, XI(2), 33–44.CrossRefGoogle Scholar
  59. 59.
    Jetter, J. J., & Kariher, P. (2009). Solid-fuel household cook stoves: Characterization of performance and emissions. Biomass and Bioenergy, 33(2), 294–305.CrossRefGoogle Scholar
  60. 60.
    Polsky, D., & Ly, C. (2012). The health consequences of indoor air pollution: A review of the solutions and challenges. White paper. Philadelphia: University of Pennsylvania. Retrieved October 8, 2012 from
  61. 61.
    Ministry of Law and Justice of India. (2007). The Prohibition of Child Marriage Act, 2006. New Delhi: Government of India.Google Scholar
  62. 62.
    Grown, C., Gupta, G. R., & Pande, R. (2005). Taking action to improve women’s health through gender equality and women’s empowerment. Lancet, 365, 541–543.PubMedGoogle Scholar
  63. 63.
    Pandey, S., & Lin, Y. (2012). Tobacco use among married women in Nepal: The role of women’s empowerment. Maternal & Child Health Journal (on-line first).Google Scholar
  64. 64.
    Kojima, M., Bacon, R., & Zhou, X. (2011). Who uses bottled gas? Evidence from households in developing countries. Washington, DC: The World Bank.Google Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.George Warren Brown School of Social WorkWashington UniversitySt. LouisUSA
  2. 2.School of Social Service AdministrationUniversity of ChicagoChicagoUSA

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