There is new evidence that the unequal social status of women could play a significant — and as yet ignored — role in explaining India’s “inexplicably” high under-nutrition levels.
For its per capita income, India has stubbornly higher than expected levels of stunting and under-weight among children and adults — the so-called “Asian enigma” which, with countries like Bangladesh making strong progress on development indicators, has increasingly become the “Indian enigma.” While much of the earlier discussions, including influential work by Nobel laureate Amartya Sen, focussed on food availability and consumption, there has been a growing acknowledgement, including by Dr. Sen himself, that food consumption alone does not explain the scale of India’s under-nutrition.
Some including Columbia University economist Arvind Panagariya have argued that inadequacy of the consumption explanation means the numbers themselves are wrong, but others have come forward with explanations for the gap. Dean Spears, a visiting economist at the Centre for Development Economics at the Delhi School of Economics, for instance, has shown that poor sanitation — and open defecation in particular — can account for a large part of the international variation in height, including that between India and sub-Saharan Africa.
A growing body of evidence is also now showing that the low social status of women — something difficult to capture statistically — could be a big part of the explanation. A new working paper by economists Diane Coffey, a PhD candidate at the Office of Population Research at Princeton University; Reetika Khera of the Indian Institute of Technology-Delhi; and Mr. Spears has shown that the younger daughters-in-law in a rural joint family have shorter children on average.
While this is no longer the typical Indian family, it provides a rare econometric measure of “social status.” Sure enough, the younger daughters-in-law “report having less say in a range of household decisions; they spend less time outside the home on a normal day than [the older] daughters-in-law; and, they have lower body mass index [BMI] scores than their [older] counterparts,” the researchers find, using official National Family Health Survey data.
As a result, their children on average are shorter than the children of the household’s older couple, even after controlling for to women in other settings as well,” Ms. Khera said. “The difference in status between two daughters-in-law is small compared to other social hierarchies in Indian society, such as between men and ‘men, and between high and low caste people. It is likely that these larger status differences also have important implications for Indian children’s health and well-being,” Ms. Coffey said.
Recent research by Angus Deaton, Professor of Economics at Princeton University and the Woodrow Wilson School of Public and International affairs and leading global expert on poverty and nutrition in the developing world, has shown that Indian women’s nutrition is undeniably not improving at the same pace as men’s. Mr. Deaton has found that Indian men’s heights are growing at nearly three times the rates of women and the gap is widening. “I do not know how to explain this change other than through differential access to whatever improvements there have been in health or food or both,” he said.
While most of the discussion in India equates under-nutrition with under-weight, height is an important correlate of early life health; Indians are among the shortest people in the world. Although height is usually believed to be entirely genetically determined, experts have concluded this is not the case, and populations considered short have over time grown far taller with rising incomes and quality of life. Mr. Deaton reiterated to The Hindu that genetic variations across and between countries are not important for height.
Rather than too few explanations for India’s nutrition “puzzle,” there are too many, Mr. Spears said. “For years, people have found it puzzling that children in India are shorter, on average, even than poorer children in sub-Saharan Africa. But children’s poor growth is no surprise, given the enormous range of threats to early life health and net nutrition: sanitation and the disease environment, problematic feeding practices, and low social status of young women — that is, the mothers who are children’s source of nutrition during pregnancy and breastfeeding,” he said.
