Caste matters: perceived discrimination among women in rural India

Subjective social status and socio-demographic correlates of perceived discrimination among older adults in India

BACKGROUND

Considering India's diversity, marked by differences in caste, class, ethnicity, religion, region, and language, discrimination can take on varying forms across social-structural locations. We examined the association between subjective social status (SSS) and perceived discrimination, and assessed the sociodemographic correlates of perceived discrimination among older persons in India.

METHODS

Data come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 30,253 adults 60 years or older. SSS was examined using the Macarthur scale with a ladder technique. Perceived discrimination was evaluated with the Everyday Discrimination Scale. Multivariable logistic regression models examined the odds of reporting discrimination by its types and attributions.

RESULTS

39% of older adults reported low SSS, whereas 7.3% reported high SSS. Older adults with low SSS had significantly higher odds of experiencing some discrimination than those with high SSS. Compared to high-SSS peers, low-SSS individuals attributed age, gender, caste, financial, and health status as reasons for discrimination. Older women attributed gender as a reason for discrimination. Caste was reported as a reason for discrimination by rural but not urban dwellers. Relative to northerners, those from southern India reported age, financial, and health statuses as reasons for discrimination.

CONCLUSIONS

That low-SSS older adults reported age, gender, caste, financial status, and health status as reasons for discrimination and that this association persisted after considering objective indicators of socioeconomic status (SES) is suggestive of SSS as independently consequential for perceived discrimination. These findings are useful for care providers and practitioners as they encourage older patients -- especially those with low SSS who may feel stigmatized -- to seek care, comply with care regimen, and engage in behaviors that protect and promote health.

Disparity by caste and tribe: Understanding women's empowerment and health outcomes in India

AIM

Women's empowerment status varies greatly in India according to caste, class, ethnicity and region. This paper aims to investigate the caste/tribe disparity in women's empowerment by region, the main correlates of each domain of empowerment, and the association of women's empowerment with nutritional and health care access outcomes, specifically anaemia, menstrual hygiene, and institutional delivery.

METHODOLOGY

Using National Family Health Survey-5 (2019-2021) data, we have created a modified survey-based women's empowerment index (SWPER) using principal component analysis with Oblique varimax rotation. The first four components are interpreted as an attitude to violence, freedom of movement, decision-making power and social independence. Several multivariate regression models were used to understand the factor associated with empowerment and the association of women's empowerment with different health outcomes.

RESULTS

The results indicate that women from the forward castes are the most empowered in most domains except decision-making. However, after controlling other background variables, the forward castes women are found to be the most empowered in attitude to violence, whereas Scheduled Castes and Scheduled Tribes women were found to be the most empowered women in decision-making. With regards to social independence, deprived castes women are more empowered than the forward castes women. The likelihood of empowerment in social independence domain increases with increasing wealth. There are wide regional variations in empowerment level between different social groups. Caste/tribe identity plays a significant role in determining health outcomes in India. Among all empowerment domains, social independence emerges as the most significant associated factor with improved health across all caste/tribe groups.

CONCLUSION

The path to women's empowerment in India must recognize the intersectionality of caste/tribe identities, and address regional disparities. Social independence emerges as a critical determinant across all caste/tribe groups for improving health. Measures should be taken to empower women through the underlying factors of social independence.

Drivers of perceived discrimination among older adults in India: an intersectional analysis

Discrimination is harmful action taken against individuals or groups to protect customary relations of power and privilege. Older adults are particularly vulnerable to experiences of discrimination that adversely affect their quality of life. We use data from the Longitudinal Ageing Study of India (LASI; Wave 1; 2017-2018) to examine different contextual forces that shape the experiences of discrimination in older adults in India, specifically gender, caste, and economic condition. We used the theory of intersectionality to hypothesize that economic condition, caste, and gender combine uniquely to engender perceived discrimination in older adults. We first used a concentration index to determine the sample's pre-existing inequality levels. The concentration curve evidenced a disproportionate concentration of discrimination among people with low income. Next, we used a three-way ANCOVA to examine the effects of caste, gender, and economic condition on individuals' experiences of discrimination. A significant interaction effect of caste, gender, and economic condition [F(1, 30,394) = 8.91 p = 0.003] evidenced the compounding effects of inequalities on experiences of discrimination. Finally, we ran a moderation model to test the ameliorating effects of education on experiences of discrimination experienced by marginalized castes. The model was significant (β= -0.192; p < 0.001), thereby supporting the proposition that increased education level can lead to an increased sense of belonging and perceptions of equal treatment, which relate negatively to perceived discrimination. Results are discussed considering intersectionality in peoples' struggles and resilience in India.

Quality of life and caste discrimination among the tribal population, Chengalpattu, Tamil Nadu, India: A community-based cross-sectional study

Background

According to the 2011 census in Tamil Nadu, out of a total population of 721.47 lakhs, 7.95 lakhs were scheduled tribes (STs), which constitutes about 1.1% of ST in Tamil Nadu and 0.8% of ST compared to the total ST population in India. A brief understanding of India's caste system and its evolution over time was required to determine caste-based discrimination. Hence, they are vulnerable and isolated due to this untouchability in the caste system. This study focuses on the quality of life (QOL) and caste discrimination among the tribal population of Chengalpattu district. Further, it provides suggestions to improve the QOL and to put an end to discrimination.

Methodology

It is a community-based cross-sectional study, conducted among 300 participants among the tribal population in Chengalpattu district by a systematic random sampling technique.

Results

The QOL scores were further converted into categorical variables by obtaining the mean score and dividing the group into those who got a score above the mean and those below the mean. They were labeled as good and poor QOL. More than half of them (52.7%) had poor QOL. Almost two-third of the workers had poor QOL in the social relationship (60.7%) and psychological (64%) domains, and nearly half in the physical (52.7%) and environmental (52.7%) domains. Out of 300 participants included in the analyses, 141 (47%) participants reported experiencing discrimination a few times a year/a few times a month.

Conclusion

This study found that the tribal population in Chengalpattu district has poor social and psychological QOL compared to QOL in the environmental and physical domains. In spite of many government initiatives, a wide range of issues and problems are being faced by the tribals in India. Hence, we recommend strategies to improve the physical, social, and psychological well-being of this vulnerable population through strict legislation. The other component regarding discrimination concluded that caste but not socio-economic class is closely linked with perceived discrimination among the tribal population in Chengalpattu district and their responses to unfair treatment.

A global study into Indian women's experiences of domestic violence and control: the role of patriarchal beliefs

Domestic violence (DV) is a serious and preventable human rights issue that disproportionately affects certain groups of people, including Indian women. Feminist theory suggests that patriarchal ideologies produce an entitlement in male perpetrators of DV; however, this has not been examined in the context of women from the Indian subcontinent. This study examined Indian women's experiences of abuse (physical, sexual, and psychological) and controlling behavior across 31 countries by examining the relationship between the patriarchal beliefs held by the women's partners and the women's experience of DV. This study uses an intersectional feminist framework to examine the variables. Data from an online questionnaire was collected from 825 Indian women aged between 18 and 77 years (M = 35.64, SD = 8.71) living in 31 countries across Asia (37.1%), Europe (18.3%), Oceania (23.8%), the Americas (16.1%) and Africa (3.2%) and analyzed using a hierarchical linear regression. A majority of participants (72.5%) had experienced at least one form of abuse during their relationship, and over a third (35.1%) had experienced controlling behavior. In support of the central hypotheses, after controlling for potential confounders, women whose partners showed greater endorsement of patriarchal beliefs were less likely to have access to freedom during their relationship (ß = -0.38, p < 0.001) and were more likely to have been abused by their partner or a member of his family (ß = 0.34, p < 0.001). The findings of this study highlight the need to engage with men in Indian communities through culturally-tailored intervention strategies designed to challenge the patriarchal ideologies that propagate, justify, and excuse DV.

Prevalence and correlates of major depressive disorder among a national sample of middle-aged and older adults in India

Objectives: This study aimed to assess the prevalence and correlates of major depressive disorder (MDD) among middle-age and older adults in India.Methods: The cross-sectional sample consisted of 72,262 persons (45 years and older) from the 2017 to 2018 Longitudinal Ageing Study in India (LASI) Wave 1. MDD is defined using DSM-5 criteria and measured with the CIDI-SF. Logistic regression was used to evaluate the associations with MDD.Results: The prevalence of past 12-month MDD was 7.6%, 8.1% among women and 7.0% among men, and 8.2% in persons 60 years and older. In the final adjusted model, food insecurity, having 3-6 discrimination experiences, ill-treatment, victim of violent crime, disaster exposure, unsafe home/neighbourhood, poor childhood health, hypertension, stroke, tobacco use, and physical pain were positively associated with MDD. Being male, married, high socioeconomic status, living in urban areas, high spirituality/religiosity, health insurance and medium social network were negatively associated with MDD.Conclusion: Almost one in ten middle-aged and older adults in India had MDD and several associated factors were identified.

Association of objective and subjective socioeconomic markers with cognitive impairment among older adults: cross-sectional evidence from a developing country

OBJECTIVE

This study explored how various markers of objective and subjective socioeconomic status (SES) are associated with cognitive impairment among older Indian adults.

DESIGN

A cross-sectional study was conducted using large nationally representative survey data.

SETTING AND PARTICIPANT

This study used data from the Longitudinal Ageing Study in India (2017-2018). The sample included 31 464 older adults aged 60 years and above.

PRIMARY AND SECONDARY OUTCOME MEASURES

Outcome variable was cognitive impairment, measured through broad domains of memory, orientation, arithmetic function, and visuo-spatial and constructive skills. We estimated descriptive statistics and presented cross-tabulations of the outcome. Χ2 test was used to evaluate the significance level of differences in cognitive impairment by subjective (ladder) and objective SES measures (monthly per-capita consumption expenditure (MPCE) quintile, education and caste status). Multivariable linear and logistic regression analyses were conducted to fulfil the objectives.

RESULTS

A proportion of 41.7% and 43.4% of older adults belonged to low subjective (ladder) and objective (MPCE) SES, respectively. Older adults with low subjective (adjusted OR (aOR): 2.04; p<0.05) and objective SES (aOR: 1.32; p<0.05) had higher odds of having cognitive impairment in comparison with their counterparts, with a stronger subjective SES-cognitive impairment association. Older adults with lower education or belonged to lower caste had higher odds of cognitive impairment than their counterparts. Interaction analyses revealed that older adults who belonged to lower subjective and objective (poorest MPCE quintile, Scheduled Castes and lowest education) SES had 2.45 (CI: 1.77 to 3.39), 4.56 (CI: 2.97 to 6.98) and 54.41 (CI: 7.61 to 388.93) higher odds of cognitive impairment than those from higher subjective and objective SES, respectively.

CONCLUSION

Subjective measures of SES were linked to cognitive outcomes, even more strongly than objective measures of SES; considering the relative ease of obtaining such measures, subjective SES measures are a promising target for future study on socioeconomic indicators of cognitive impairment.

Decomposing the gap in intimate partner violence between Scheduled Caste and general category women in India: An analysis of NFHS-5 data

Scheduled Caste (SC) women, one of India's most oppressed and neglected population groups, are the most vulnerable to intimate partner violence (IPV). IPV, on the other hand, is less common among women in the General category. No study has been conducted to measure the gap in IPV between these two groups. This study is an attempt to fill this gap. This study aims to comprehensively explore the factors that underlie and explain the gap in IPV between SC and General women. Information on 10,168 ever-married SC and 9695 ever-married General women aged 15–49 from the fifth round of the National Family Health Survey was analyzed. The Fairlie decomposition (Blinder–Oaxaca decomposition modified for binary outcomes) was used in this study to explain the gap in ever experience of IPV prevalence between SC and General women. About 37.3% and 24.4% of ever-married SC and General women in India suffered either physical or mental or sexual violence from their husbands. The large part of the gap in IPV between SC and General women was due to differences in husbands' alcohol consumption (26.33% gap), wealth index (24.48% gap), controlling behavior by husband (24%) and parental IPV (15.87% gap). With the introduction of appropriate interventions and programs, these gaps can be reduced. Interventions aimed at reducing alcoholism should be emphasized.

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Intimate Partner Violence (IPV) was more prevalent in Scheduled Caste (SC) women than in General category women.

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Wealth, parental IPV, husband’s alcohol consumption and controlling behavior explained 90% of the SC-General gap in IPV.

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Group differences in husband’s alcohol consumption explained about one-fourth of the SC-General gap in IPV.

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Wealth index and husband’s controlling behavior explained about 24.5% and 24.0% of the gap in IPV, respectively.

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In short run, interventions aimed at reducing alcoholism should be emphasized.

Impact of hair type, hair sample weight, external hair exposures, and race on cumulative hair cortisol

The biomarker cortisol assesses the impact of biopsychosocial stressors that activate the stress response system. Hair has emerged as a valid and non-invasive means of gauging cumulative cortisol deposited over month-long periods of time. Established protocols for the extraction of hair cortisol are being validated and refined in humans, yet methodological information about hair characteristics on cortisol remains limited. In addition to external hair exposures (e.g. dye, time spent outside), we examined hair categorization or type (e.g. kinky, straight) by extending a hair typing methodology for scientific use that is currently popular among hair care professionals. We then examined the interaction between hair type and race on cortisol levels with a hair questionnaire. Three studies were pooled to investigate how sample weight, hair type, race, heat exposures, and hair treatments impacted cumulative hair cortisol concentrations. Study 1 consisted of Adult Kenyan Medical Workers (N = 44); Study 2 Mexican and Mexican Americans (N = 106); and Study 3 American Youth (N = 107). We found significantly higher cortisol in 5 mg of hair when compared to larger sample weights, and higher cortisol in those who spent more time outdoors. Cortisol concentrations differed between racial groups and varied by hair type; moreover, there were directional differences in cumulative cortisol from straighter to curlier hair types which depended on racial group. In addition to demonstrating the impact of relatively novel control factors like hair sample weight, outdoor exposure, and hair type, the present study illustrates the importance of disentangling hair type and race to understand variability in cumulative hair cortisol. These influences should be included in future studies that measure hair cortisol.

Caste and COVID-19: Psychosocial disparities amongst rural Indian women during the coronavirus pandemic

The COVID-19 pandemic has exacerbated preexisting mental health disparities. In India, marginalization based on caste membership, gender, and rural residence are critical determinants of inequity across the lifespan. Guided by the theoretical frameworks of minority stress and intersectionality, this study examined caste-based disparities in fear of coronavirus (FOC), mental health symptoms, and perceived loneliness amongst rural women in north India during the COVID-19 pandemic. Participants (N = 316) completed self-report measures and were classified into three groups based on their responses: General caste (GC, n = 124), other backward castes (OBC, n = 122), and scheduled caste or tribe (SC/ST, n = 71). Using a three-way ANOVA and Tukey t-tests, women in SC/ST and OBC groups reported greater FOC (OBC d = .37; SC/ST d = .40) and greater mental health symptoms (OBC d = .58; SC/ST d = .43) relative to the GC group. OBC, but not SC/ST, group also reported higher perceived loneliness (d = .32). The results were consistent after adjusting for demographic variables such as wealth and highlight caste as an important social determinant for well-being during the COVID-19 pandemic amongst rural Indian women.

From criminalised histories to rightful present – nomadic women demand equal rights to sexual and reproductive health: a study in Maharashtra, India

This paper presents the findings of a research study in Thane District, Maharashtra, India, on access to sexual and reproductive health and rights (SRHR) for women and girls of Nomadic and Denotified Tribes (NT-DNT). NT-DNT communities face stigma and violence due to their historically criminalised status and nomadic lifestyle. Their precarious legal, social, and economic status has a negative impact on women’s SRHR. Existing literature on this subject is sparse, and studies by researchers from within the community, which could bring about organic and community-led change, are almost non-existent. This study, carried out by a woman from a Nomadic Tribe, presents an insider’s perspective on the experiences of and factors underlying the violation of the SRHR of girls and women of NT-DNT communities. The study used a human rights-based participatory methodology with qualitative methods including three focus group discussions with 21 women and 10 in-depth interviews with women and key informants from NT-DNT communities. The findings describe the gender, community, and health system barriers which hinder women’s and girls’ access to SRHR. Issues such as language barriers between the women and medical fraternity, criminalisation by the police, and extreme deprivation – more intense than faced by the general poor – are unique to women of these communities. The NT-DNT communities face extreme deprivation of basic resources such as identity documents, shelter, sanitation, education support, workplace safety, and transportation, which further deny women their sexual and reproductive rights. The paper aims to amplify these women's voices to advocate for better SRHR services for women and girls of NT-DNT communities.

Perceived discrimination and health outcomes among middle-aged and older adults in India: results of a national survey in 2017-2018

BACKGROUND

The study aimed to estimate the associations between perceived discrimination and poor physical health, poor mental health, and health risk behaviours in middle-aged and older adults in a national population survey in India.

METHODS

The sample included 72,262 middle-aged and older adults from a cross-sectional national community dwelling survey in India in 2017-2018.

RESULTS

The prevalence of moderate (1-2 types) perceived discrimination was 10.7%, and high (3-6 types) perceived discrimination was 6.6%. In the final adjusted logistic, linear or Poisson regression analyses, moderate and/or high perceived discrimination was significantly positively associated with poor mental health (low life satisfaction, poor cognitive functioning, insomnia symptoms, and depressive symptoms), poor physical health (pain conditions count, and functional limitations), and health risk behaviours (heavy episodic drinking and physical inactivity).

CONCLUSION

Perceived discrimination is associated with poor mental health, poor physical health, and health risk behaviour, emphasising the need to consider perceived discrimination in various physical and mental health contexts.

Impact of socio-economic inequity in access to maternal health benefits in India: Evidence from Janani Suraksha Yojana using NFHS data

BACKGROUND

Caste plays a significant role in Indian society and it influences women to health care access in the community. The implementation of the maternal health benefits scheme in India is biased due to caste identity. In this context, the paper investigates access to Janani Suraksha Yojana (JSY) among social groups to establish that caste still plays a pivotal role in Indian society. Also, this paper aims to quantify the discrimination against Scheduled Castes/Scheduled Tribes (SCs/STs) in accessing JSY.

METHODS

This paper uses a national-level data set of both NFHS-3 (2005-06) and NFHS-4 (2015-16). Both descriptive statistics and the Fairlie decomposition econometric model have been used to measure the explained and unexplained differences in access to JSY between SCs/STs and non-SCs/STs groups.

RESULTS

Overall, the total coverage of JSY in India is still, 36.4%. Further, it is found that 72% of access to JSY is explained by endowment variables. The remaining unexplained percentage (28%) indicates that there is caste discrimination (inequity associated social-discrimination) against SCs/STs in access to JSY. The highest difference (54%) between SCs/STs and non-SCs/STs in access to JSY comes from the wealth quintile, with the positive sign indicating that the gap between the two social groups is widening.

DISCUSSION AND CONCLUSION

It is necessary for the government to implement a better way to counter the caste-based discrimination in access to maternal health benefits scheme. In this regard, ASHA and Anganwadi workers must be trained to reduce the influence of dominant caste groups as well as they must be recruited from the same community to identify the right beneficiaries of JSY and in order to reduce inequity associated with social-discrimination.

How the Coronavirus Lockdown Impacts the Impoverished in India

In response to the coronavirus pandemic, several countries have imposed curfews, quarantines, and lockdowns to restrict the spread of the infection among people. India had initiated a nationwide lockdown to combat the pandemic starting from the last week of March until the end of May 2020. But, the lockdown had continued subsequently in several red zones across parts of the country for few months. However, scientists have criticized the government's abrupt lockdown since it prevented people from preparing for the worst aftermath. Besides, the curfews have blocked millions of impoverished migrant workers from leaving cities to return to their homes in distant rural villages. As a result, the destitute workers have endured enormous hardship and outright discrimination desolately leading to their added physical and mental distress, pain, suffering, and death. Most of the victims of the lockdown have belonged to the economically distressed lower social classes of the Indian caste hierarchy. This article outlines their sufferings triggered by the long drawn-out lockdown episode.

Caste, religion and regional differentials in life expectancy at birth in India: cross-sectional estimates from recent National Family Health Survey

OBJECTIVE

Though estimates of longevity are available by states, age, sex and place of residence in India, disaggregated estimates by social and economic groups are limited. This study estimates the life expectancy at birth and premature mortality by caste, religion and regions of India.

DESIGN

This study primarily used cross-sectional data from the National Family Health Survey (NFHS-4), 2015-2016 and the Sample Registration System (SRS), 2011-2015. The NFHS-4 is the largest ever demographic and health survey covering 601 509 households and 811 808 individuals across all states and union territories in India.

MEASURES

The abridged life table is constructed to estimate the life expectancy at birth, adult mortality (45q15) and premature mortality (70q0) by caste, religion and region.

RESULTS

Life expectancy at birth was estimated at 63.1 years (95% CI 62.60 -63.64) for scheduled castes (SC), 64.0 years (95% CI 63.25 - 64.88) for scheduled tribes (ST), 65.1 years (95% CI 64.69 - 65.42) for other backward classes (OBC) and 68.0 years (95% CI 67.44 - 68.45) for others. The life expectancy at birth was higher among o Christians 68.1 years (95% CI 66.44 - 69.60) than Muslims 66.0 years (95% CI 65.29 - 66.54) and Hindus 65.0 years (95% CI 64.74 -65.22). Life expectancy at birth was higher among females than among males across social groups in India. Premature mortality was higher among SC (0.382), followed by ST (0.381), OBC (0.344) and others (0.301). The regional variation in life expectancy by age and sex is large.

CONCLUSION

In India, social and religious differentials in life expectancy by sex are modest and need to be investigated among poor and rich within these groups. Premature mortality and adult mortality are also high across social and religious groups.

Measures of Racism, Sexism, Heterosexism, and Gender Binarism for Health Equity Research: From Structural Injustice to Embodied Harm-An Ecosocial Analysis

Racism. Sexism. Heterosexism. Gender binarism. Together, they comprise intimately harmful, distinct, and entangled societal systems of self-serving domination and privilege that structure the embodiment of health inequities. Guided by the ecosocial theory of disease distribution, I synthesize key features of the specified "isms" and provide a measurement schema, informed by research from both the Global North and the Global South. Metrics discussed include (a) structural, including explicit rules and laws, nonexplicit rules and laws, and area-based or institutional nonrule measures; and (b) individual-level (exposures and internalized) measures, including explicit self-report, implicit, and experimental. Recommendations include (a) expanding the use of structural measures to extend beyond the current primary emphasis on psychosocial individual-level measures; (b) analyzing exposure in relation to both life course and historical generation; (c) developing measures of anti-isms; and (d) developing terrestrially grounded measures that can reveal links between the structural drivers of unjust isms and their toll on environmental degradation, climate change, and health inequities.