The Consequences of Social Inequality for the Health and Development of India’s Children: The Case of Caste, Sanitation, and Child Height
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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. This paper presents new observational analysis of the India Human Development Survey that provides descriptive evidence of this mechanism. We show that, on average, children in rural India are shorter if they live in villages where more people report practicing untouchability—meaning that they enforce caste hierarchies in their interactions with people from the lowest castes. This association is explained by the association between casteism and the prevalence of rural open defecation.
KeywordsSocial inequality Health Height India Caste Sanitation Open defecation
Separately from this project, Coffey and Spears have received research funding from the NIH, the IGC, and the Bill and Melinda Gates Foundation. Funding was provided by National Institute of Child Health and Human Development (Grant No. P2CHD042849).
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Conflict of interest
All authors declare that they have no conflict of interest.
Human and Animal Rights
This article does not contain any studies with human participants performed by any of the authors, because the IHDS data that we received online are anonymous.
- Case, A., & Coates, T. (2017). Fear and despair: Consequences of inequity. In A. L. Plough (Ed.), Knowledge to action: Accelerating progress in health, well-being, and equity. Oxford: Oxford University Press.Google Scholar
- Coffey, D., Gupta, A., Hathi, P., Khurana, N., Spears, D., Srivastav, N., & Vyas, S. (2014). Revealed preference for open defecation: Evidence from a new survey in rural north India. Economic & Political Weekly, Special article, XLIX(38).Google Scholar
- Coffey, D., & Spears, D. (2017). Where India goes: Abandoned toilets, stunted development and the costs of caste. New York: Harper Collins.Google Scholar
- Coffey, D., & Spears, D. (2018). Open defecation in rural India, 2015–2016: Levels and trends in NHFS-4. Economic and Political Weekly, 53(9), 10–13.Google Scholar
- Cutler, D. M., Lleras-Muney, A., & Vogl, T. (2011). Socioeconomic status and health: Dimensions and mechanisms. In S. Glied & P. C. Smith (Eds.), Oxford handbook of health economics. Oxford: Oxford University Press.Google Scholar
- Deaton, A. (2013). The great escape: Health, wealth, and the origins of inequality. Princeton: Princeton University Press.Google Scholar
- Geruso, M., & Spears, D. (2018). Neighborhood sanitation and infant mortality. American Economic Journal: Applied Economics, 10(2), 125–162.Google Scholar
- Ghosh, A., Gupta, A., & Spears, D. (2014). Are children in West Bengal shorter than children in Bangladesh? Economic & Political Weekly, 49(8), 21.Google Scholar
- IHDS (2011). India Human Development Survey-II: A public use database for informed public policy. https://ihds.umd.edu/sites/ihds.umd.edu/files/BriefII.pdf. Accessed 18 June 2018.
- Spears, D. & Thorat, A. (2017). The puzzle of open defecation in rural India: Evidence from a novel measure of caste attitudes in a nationally-representative survey. Forthcoming in Economic Development and Cultural Change.Google Scholar
- Thorat, A., & Joshi, O. (2015). The continuing practice of untouchability in India: Patterns and mitigating influences. India Human Development Study Working Paper, 3.Google Scholar
- UN (2010). State of the world’s indigenous peoples. Press release. http://www.un.org/esa/socdev/unpfii/documents/SOWIP/press%20package/sowip-press-package-en.pdf. Accessed 14 June 2018.