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Ahsan MN, Thakur S. The great Indian demonetization and gender gap in health outcomes: Evidence from two Indian states. ECONOMICS AND HUMAN BIOLOGY 2024; 53:101369. [PMID: 38447319 DOI: 10.1016/j.ehb.2024.101369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 12/11/2023] [Accepted: 02/07/2024] [Indexed: 03/08/2024]
Abstract
We utilize the timing of India's 2016 demonetization policy to examine whether a negative macroeconomic shock disproportionately affects women's health outcomes relative to men's. Our empirical framework considers women as the treated group and men as the comparison group. Using data from the National Family Health Survey-4 and a household fixed effects model, we find that the induced income shock leads to a 4% decline in hemoglobin for women as compared to the pre-demonetization level. This corresponds to a 21% increase in the gender gap in hemoglobin. The result is further validated with an event study and a variety of robustness checks. An examination of food consumption suggests that this pattern is possibly driven by a widening male-female gap in the consumption of iron-rich foods.
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Ghatak D, Sahoo S, Sarkar S, Sharma V. Who eats last? Intra-household gender inequality in food allocation among children in educationally backward areas of India. POPULATION STUDIES 2024; 78:63-77. [PMID: 38032523 DOI: 10.1080/00324728.2023.2272991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 05/24/2023] [Indexed: 12/01/2023]
Abstract
The practice of women eating after men is a common gender-inequitable food allocation mechanism among adults in Indian households and has been associated with poor health and nutritional outcomes for women. However, empirical evidence on whether a similar practice of girls eating after boys is prevalent among children is scarce. Using primary data from a household survey conducted in educationally backward areas of four Indian states, we provide new evidence of this practice among children. Almost 28 per cent of the sample households follow the mealtime custom of girls eating after boys. Scheduled Tribes and households with higher incomes are less likely to follow this practice. Other relevant factors include children's relative ages by sex and an interplay between family size and children's sex composition. While our findings may not be generalizable, they suggest an intersectionality between gender and other dimensions of inequality, namely social identity and economic class.
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Affiliation(s)
| | - Soham Sahoo
- Indian Institute of Management Bangalore
- London School of Economics and Political Science
| | - Sudipa Sarkar
- National Law School of India University
- University of Warwick
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Alemu R, Masters WA, Finaret AB. Sibling rivalry between twins in utero and childhood: Evidence from birthweight and survival of 95 919 twin pairs in 72 low- and middle-income countries. Am J Hum Biol 2023. [PMID: 36864771 DOI: 10.1002/ajhb.23887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND This study explores the magnitude and timing of sex and gender disparities in child development by describing differences in health outcomes for male and female siblings, comparing twins to control for all aspects of life circumstances other than sex and gender. METHODS We construct a repeat cross-sectional dataset of 191 838 twins among 1.7 million births recorded in 214 nationally representative household surveys for 72 countries between 1990 and 2016. To test for biological or social mechanisms that might favor the health of male or female infants, we describe differences in birthweights, attained heights, weights, and survival to distinguish gestational health from care practices after each child is born. RESULTS We find that male fetuses grow at the expense of their co-twin, significantly reducing their sibling's birthweight and survival probabilities, but only if the other fetus is male. Female fetuses are born significantly heavier when they share the uterus with a male co-twin and have no significant difference in survival probability whether they happen to draw a male or a female co-twin. These findings demonstrate that sex-specific sibling rivalry and male frailty begin in utero, prior to gender bias after birth that typically favors male children. CONCLUSIONS Sex differences in child health may have competing effects with gender bias that occurs during childhood. Worse health outcomes for males with a male co-twin could be linked to hormone levels or male frailty, and could lead to underestimates of the effect sizes of later gender bias against girls. Gender bias favoring surviving male children may explain the lack of differences in height and weight observed for twins with either male or female co-twins.
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Affiliation(s)
- Robel Alemu
- Anderson School of Management, University of California Los Angeles, Los Angeles, California, USA.,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - William A Masters
- Friedman School of Nutrition Science and Policy, Tufts University, Medford, Massachusetts, USA
| | - Amelia B Finaret
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Edinburgh, UK.,Department of Global Health, Allegheny College, Meadville, Pennsylvania, USA
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Spatial heterogeneity in son preference across India’s 640 districts: An application of small-area estimation. DEMOGRAPHIC RESEARCH 2022. [DOI: 10.4054/demres.2022.47.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Gupta A. Seasonal variation in infant mortality in India. POPULATION STUDIES 2022; 76:535-552. [PMID: 36106801 DOI: 10.1080/00324728.2022.2112746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Investigating seasonal variation in health helps us understand interactions between population, environment, and disease. Using information on birth month and year, survival status within the first year of life, and age at death (if applicable) of more than 330,000 children observed in four rounds of India's Demographic and Health Surveys, I estimate period mortality rates between birth and age one (1m0) by calendar month. Relative to spring months, infant mortality is higher in the summer, monsoon, and winter months. If spring mortality conditions had been prevalent throughout the year, mortality below age one would have been lower by 11.4 deaths per 1,000 in the early 1990s and 3.7 deaths per 1,000 in the mid-2010s. Seasonal variation in infant mortality has declined overall but remains higher among disadvantaged children. The results highlight the multiple environmental health threats that Indian infants face and the short time of year when these threats are less salient.
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Koroma MM, Kabba JA, Wanda J, Yu J, Zhou F, Liang Z, Tarawally AB, Chigoneka K, Dai YC. Under-Five Mortality in Sierra Leone and Possible Associated Factors: Evidence from the 2019 Demographic and Health Survey. Health Policy Plan 2022; 37:1210-1220. [PMID: 36052949 DOI: 10.1093/heapol/czac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 07/20/2022] [Accepted: 09/02/2022] [Indexed: 11/13/2022] Open
Abstract
High under-five mortality rate remains one of the public health challenges, especially in sub-Saharans Africa, accounting for more than half of all global cases. Sierra Leone was and still one of the countries with the highest under-five mortality rate. Using the latest 2019 SLDHS data, we investigated factors associated with under-five mortality in Sierra Leone. A total of 9771 mothers aged 15-49 years in the country were interviewed and included in the analysis. The dependent variable is child status (dead=1; alive=0). A total of 871 (9%) children died before their fifth birthday. Maternal age of 20-24 years (AOR=0.46; CI=0.33-0.64; P<0.001) up to 40-44 years (AOR=0.43; CI=0.27-0.7; P=0.001), currently breastfeeding (AOR=0.20; CI=0.17-0.24; P<0.001), maternal media exposure and usage of reading newspapers/magazines less than once a week (AOR=0.48; CI=0.28-0.85; P=0.011) were more likely to enhance child survivability through their fifth birthday. Also, the child sex being female (AOR=0.68; CI=0.59-0.79) was more likely to survive under-five mortality compared to their male counterpart. On the other hand, mothers who listened to radio at least once a week (AOR=1.31; CI=1.08-1.59; P=0.007) watched television less than once a week (AOR=1.48; CI=1.16-1.90), had two (AOR=3.4, CI=2.78-4.16; P<0.001) or three and above birth (AOR=8.11; CI=6.07-10.83; P<0.001) in five years, had multiple birth children (AOR=1.41; CI=1.08-1.86) and very small-sized child at birth (AOR= 1.95; CI=1.41-2.70) were more likely to lose their children below the age of five years. The factors contributing to under-five mortality in Sierra Leone are critical to ensuring child survival and improving maternal health. Breastfeeding, maternal age, media exposure, child's sex, multiple birth type, very small-sized child and the total number of births in five years were significant drivers of under-five mortality. The result affirms the need for attention to be focused on enhancing the survival rate of under-five children in Sierra Leone.
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Affiliation(s)
- Mark Momoh Koroma
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China
| | - Jessicah Wanda
- Department of Nursing, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Jingrong Yu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Feiyuan Zhou
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Zhiyan Liang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | | | - Kuleza Chigoneka
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Ying-Chun Dai
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
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Do precarious female employment and political autonomy affect the under-5 mortality rate? Evidence from 166 countries. PLoS One 2022; 17:e0269575. [PMID: 35759457 PMCID: PMC9236242 DOI: 10.1371/journal.pone.0269575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/22/2022] [Indexed: 11/19/2022] Open
Abstract
The United Nations’ Sustainable Development Goals (SDGs) were designed to benefit the globalized world by safeguarding economic and environmental resources necessary for quality health and well-being and moderate growth and development. The study focused specifically on SDG-3 (good health and well-being), SDG-5 (gender equality), and SDG-8 (decent work and economic growth) to identify the most significant influencing factors that can affect the under-5 mortality rate in a large cross-section of 166 countries. The research used three different regression apparatuses to produce consistent and unbiased estimates: cross-sectional, robust least squares, and quantile regression approaches. Additionally, the innovation accounting matrix technique examines the intertemporal relationships between the variables over the time horizon. The data reveal that precarious female employment increases the under-5 mortality rate. On the other hand, women’s political autonomy continued economic growth, and higher immunization coverage is supporting factors for achieving healthcare sustainability agenda. The ex-ante analysis indicates that per capita income will significantly impact the under-5 mortality rate, followed by women’s political autonomy, insecure female employment, and immunization coverage during the next ten years. The results are consistent with other health indicators such as the health damage function, labour market function, and wealth function. The study suggests that the more unlocking women’s potential in political life, the more likely it is to achieve equitable healthcare choices and reduce the mortality rate among children under five. As a result, there is an urgent need for women to have an equitable share of the labour market to appropriately meet their family healthcare demands.
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Abstract
Stigma changes over time: it waxes and wanes through history, is manifested within humans who develop over time and is tied to statuses (such as attributes, illnesses and identities) that have varying courses. Despite the inherent fluidity of stigma, theories, research and interventions typically treat associations between stigma and health as stagnant. Consequently, the literature provides little insight into when experiences of stigma are most harmful to health and when stigma interventions should be implemented. In this Perspective, we argue that integrating time into stigma research can accelerate progress towards understanding and intervening in associations between stigma and health inequities. We situate time in relation to key concepts in stigma research, identify three timescales that are relevant for understanding stigma (historical context, human development and status course), and outline a time-based research agenda to improve scientists’ ability to understand and address stigma to improve health. Associations between stigma and health are typically treated as stagnant. In this Perspective, Earnshaw et al. argue that considering stigma in relation to historical, human development and status course timescales can advance progress in understanding and addressing stigma to improve health.
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Hodsoll J, Pickles A, Bozicevic L, Supraja TA, Hill J, Chandra PS, Sharp H. A Comparison of Non-verbal Maternal Care of Male and Female Infants in India and the United Kingdom: The Parent-Infant Caregiving Touch Scale in Two Cultures. Front Psychol 2022; 13:852618. [PMID: 35401353 PMCID: PMC8984138 DOI: 10.3389/fpsyg.2022.852618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/21/2022] [Indexed: 12/04/2022] Open
Abstract
Differences in infant caregiving behavior between cultures have long been noted, although the quantified comparison of touch-based caregiving using uniform standardized methodology has been much more limited. The Parent-Infant Caregiving Touch scale (PICTS) was developed for this purpose and programming effects of early parental tactile stimulation (stroking) on infant hypothalamic-pituitary adrenal (HPA)-axis functioning (stress-response system), cardiovascular regulation and behavioral outcomes, similar to that reported in animals, have now been demonstrated. In order to inform future studies examining such programming effects in India, we first aimed to describe and examine, using parametric and non-parametric item-response methods, the item-response frequencies and characteristics of responses on the PICTS, and evidence for cross-cultural differential item functioning (DIF) in the United Kingdom (UK) and India. Second, in the context of a cultural favoring of male children in India, we also aimed to test the association between the sex of the infant and infant "stroking" in both cultural settings. The PICTS was administered at 8-12 weeks postpartum to mothers in two-cohort studies: The Wirral Child Health and Development Study, United Kingdom (n = 874) and the Bangalore Child Health and Development Study, India (n = 395). Mokken scale analysis, parametric item-response analysis, and structural equation modeling for categorical items were used. Items for two dimensions, one for stroking behavior and one for holding behavior, could be identified as meeting many of the criteria required for Mokken scales in the United Kingdom, only the stroking scale met these criteria in the sample from India. Thus, while a comparison between the two cultures was possible for the stroking construct, comparisons for the other non-verbal parenting constructs within PICTS were not. Analyses revealed higher rates of early stroking being reported for the United Kingdom than India, but no sex differences in rates in either country and no differential sex difference by culture. We conclude that PICTS items can be used reliably in both countries to conduct further research on the role of early tactile stimulation in shaping important child development outcomes.
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Affiliation(s)
- John Hodsoll
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Andrew Pickles
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Laura Bozicevic
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | | | - Jonathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Prabha S. Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Helen Sharp
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
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Pandian RK, Allendorf K. The Rise of Sonless Families in Asia and North Africa. Demography 2022; 59:761-786. [PMID: 35275160 DOI: 10.1215/00703370-9815547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A neglected consequence of declining fertility is the likely rise of families with children of one sex-only sons or only daughters. Increases in such families present important demographic shifts that may weaken patrilineal family systems. We assess whether sons-only and daughters-only families rose in Asia and North Africa from the early 1990s to around 2015. Using 88 surveys and two censuses, we examine how the number and sex composition of children of mothers aged 40-49 changed across 20 countries, representing 87% of the region's population and 54% of the global population. We also compare observed trends to sex-indifferent counterfactuals, quantify contributions of fertility declines with decompositions, and investigate subnational trends in China and India. Increases in sons-only families were universal where numbers of children fell. Growth of daughters-only families was suppressed in patrilineal contexts, but these sonless families still rose significantly in 13 of 18 countries where numbers declined. By 2015, over a quarter of families in the region had only sons and nearly a fifth only daughters. There was considerable variation across countries: recent levels ranged from 28.3% to 3.4% daughters-only and from 40.1% to 6.0% sons-only. China and the rest of East Asia had the highest shares.
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Affiliation(s)
| | - Keera Allendorf
- Department of Sociology, Indiana University, Bloomington, IN, USA
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