Is Economic Growth Associated with Reduction in Child Undernutrition
in India?
Background:
Economic growth is widely perceived as a major policy instrument in reducing
childhood undernutrition in India. We assessed the association between
changes in state per capita income and the risk of undernutrition among
children in India.
Methods and Findings:
Data for this analysis came from three cross-sectional waves of the National
Family Health Survey (NFHS) conducted in 1992–93,
1998–99, and 2005–06 in India. The sample sizes in the
three waves were 33,816, 30,383, and 28,876 children, respectively. After
excluding observations missing on the child anthropometric measures and the
independent variables included in the study, the analytic sample size was
28,066, 26,121, and 23,139, respectively, with a pooled sample size of
77,326 children. The proportion of missing data was
12%–20%. The outcomes were underweight,
stunting, and wasting, defined as more than two standard deviations below
the World Health Organization–determined median scores by age and
gender. We also examined severe underweight, severe stunting, and severe
wasting. The main exposure of interest was per capita income at the state
level at each survey period measured as per capita net state domestic
product measured in 2008 prices. We estimated fixed and random effects
logistic models that accounted for the clustering of the data. In models
that did not account for survey-period effects, there appeared to be an
inverse association between state economic growth and risk of undernutrition
among children. However, in models accounting for data structure related to
repeated cross-sectional design through survey period effects, state
economic growth was not associated with the risk of underweight (OR 1.01,
95% CI 0.98, 1.04), stunting (OR 1.02, 95% CI 0.99,
1.05), and wasting (OR 0.99, 95% CI 0.96, 1.02). Adjustment for
demographic and socioeconomic covariates did not alter these estimates.
Similar patterns were observed for severe undernutrition outcomes.
Conclusions:
We failed to find consistent evidence that economic growth leads to reduction
in childhood undernutrition in India. Direct investments in appropriate
health interventions may be necessary to reduce childhood undernutrition in
India.
:
Please see later in the article for the Editors' Summary
Vyšlo v časopise:
Is Economic Growth Associated with Reduction in Child Undernutrition
in India?. PLoS Med 8(3): e32767. doi:10.1371/journal.pmed.1000424
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pmed.1000424
Souhrn
Background:
Economic growth is widely perceived as a major policy instrument in reducing
childhood undernutrition in India. We assessed the association between
changes in state per capita income and the risk of undernutrition among
children in India.
Methods and Findings:
Data for this analysis came from three cross-sectional waves of the National
Family Health Survey (NFHS) conducted in 1992–93,
1998–99, and 2005–06 in India. The sample sizes in the
three waves were 33,816, 30,383, and 28,876 children, respectively. After
excluding observations missing on the child anthropometric measures and the
independent variables included in the study, the analytic sample size was
28,066, 26,121, and 23,139, respectively, with a pooled sample size of
77,326 children. The proportion of missing data was
12%–20%. The outcomes were underweight,
stunting, and wasting, defined as more than two standard deviations below
the World Health Organization–determined median scores by age and
gender. We also examined severe underweight, severe stunting, and severe
wasting. The main exposure of interest was per capita income at the state
level at each survey period measured as per capita net state domestic
product measured in 2008 prices. We estimated fixed and random effects
logistic models that accounted for the clustering of the data. In models
that did not account for survey-period effects, there appeared to be an
inverse association between state economic growth and risk of undernutrition
among children. However, in models accounting for data structure related to
repeated cross-sectional design through survey period effects, state
economic growth was not associated with the risk of underweight (OR 1.01,
95% CI 0.98, 1.04), stunting (OR 1.02, 95% CI 0.99,
1.05), and wasting (OR 0.99, 95% CI 0.96, 1.02). Adjustment for
demographic and socioeconomic covariates did not alter these estimates.
Similar patterns were observed for severe undernutrition outcomes.
Conclusions:
We failed to find consistent evidence that economic growth leads to reduction
in childhood undernutrition in India. Direct investments in appropriate
health interventions may be necessary to reduce childhood undernutrition in
India.
:
Please see later in the article for the Editors' Summary
Zdroje
1. Preston
SH
1975
The changing relation between mortality and level of economic
development.
Population Studies
29
231
248
2. Pritchett
L
Summers
LH
1997
Wealthier is healthier.
J Hum Resour
31
841
868
3. Smith
LC
Haddad
L
2002
How potent is economic growth in reducing undernutrition? What
are the pathways of impact? New cross-country evidence.
Econ Dev Cult Change
51
55
76
4. Ravallion
M
1990
Income effects on undernutrition.
Econ Dev Cult Change
38
489
515
5. Anand
S
Ravallion
M
1993
Human development in poor countries: on the role of private
incomes and public services.
J Econ Perspect
7
133
150
6. Dreze
J
Sen
AK
1995
India: economic development and social opportunity.
New Delhi
Oxford University Press
7. Dreze
J
Sen
AK
1998
Indian development: selected regional perspectives.
New Delhi
Oxford University Press
8. Dreze
J
Sen
A
1989
Hunger and public action.
Oxford
Clarenden Press
9. Sen
AK
1999
Health in development.
Bull World Health Organ
77
619
623
10. Subramanian
SV
Belli
P
Kawachi
I
2002
The macroeconomic determinants of health.
Annu Rev Public Health
23
287
302
11. Wolfe
B
Behrman
JR
1983
Is income overrated in determining adequate nutrition?
Econ Dev Cult Change
31
525
549
12. Behrman
JR
Wolfe
BL
1984
More evidence on nutrition demand: income seems overrated and
women's schooling underemphasized.
J Dev Econ
14
105
128
13. World
Bank
1993
World development report: investing in health.
Washington DC
World Bank
14. Bloom
DE
Canning
D
2009
Population health and economic growth.
Spence
M
Lewis
M
Health and growth: commission on growth and development
Washington DC
The World Bank
15. Basu
K
Maertens
A
2007
The pattern and causes of economic growth in India.
Oxford Review of Economic Policy
23
143
167
16. Subramanyam
MA
Kawachi
I
Berkman
LF
Subramanian
SV
2010
Socioeconomic inequalities in childhood undernutrition in India:
analyzing trends between 1992 and 2005.
PLoS One
5
e11392
doi:10.1371/journal.pone.0011392
17. Shiva Kumar
AK
2007
Why are levels of child malnutrition not improving?
Econ Polit Wkly
1337
1345
18. Subramanian
SV
Ackerson
LK
Davey Smith
G
John
NA
2009
Association of maternal height with child mortality,
anthropometric failure, and anemia in India.
JAMA
301
1691
1701
19. IIPS, Macro-International
2007
National Family Health Survey (NFHS-3), 2005-2006: India: Volume
I.
Mumbai
International Institute for Population Sciences
20. IIPS, Macro-International
2007
National Family Health Survey (NFHS-3), 2005-2006: India: Volume
II.
Mumbai
International Institute for Population Sciences
21. Black
RE
Allen
LH
Bhutta
ZA
Caulfield
LE
de Onis
M
2008
Maternal and child undernutrition: global and regional exposures
and health consequences.
Lancet
371
243
260
22. Waterlow
JC
1972
Classification and definition of protein-calorie malnutrition.
Br Med J
3
566
569
23. IIPS
2006
Anthropometry, anaemia and HIV testing field manual: 2005-2006
National Family Health Survey (NFHS-3) India.
Mumbai
International Institute for Population Sciences
24. WHO
2006
WHO child growth standards: length/height-for-age,
weight-for-age, weight-for-length, weight-for-height and body mass
index-for-age: methods and development.
Geneva
World Health Organization
25. Reserve Bank of India
2008
Handbook of statistics on Indian economy.
New Delhi
Government of India
26. Deaton
A
2005
Measuring poverty in a growing world (or measuring growth in a
poor world).
Rev Econ Stat
87
1
19
27. EPW Research Foundation
1995
Special statistics-17: national accounts statistics of India - 6:
net state domestic product.
Econ Polit Wkly, 2007
30
3321
3328
28. Chitnis
S
1997
Definition of the terms scheduled castes and scheduled tribes: a
crisis of ambivalence.
Pai Panandiker
VA
The politics of backwardness: reservation policy in India/edited by VA
Pai Panandiker
New Delhi
Konark
88
107
29. Subramanian
SV
Davey Smith
G
Subramanyam
M
2006
Indigenous health and socioeconomic status in India.
PLoS Med
3
e421
doi:10.1371/journal.pmed.0030421
30. Filmer
D
Pritchett
LH
2001
Estimating wealth effects without expenditure data–or
tears: an application to educational enrollments in states of India.
Demography
38
115
132
31. Subramanian
SV
Glymour
MM
Kawachi
I
2007
Identifying causal ecologic effects on health: a methodologic
assessment.
Galea
S
Macrosocial determinants of population health
New York
Springer Media
301
331
32. Allison
PD
2005
Fixed effects regression methods for longitudinal data using SAS.
Cary, NC
SAS Institute Inc
33. Rasbash
J
Steele
F
Browne
WJ
Goldstein
H
2009
A user's guide to MLwiN, v2.10.
Bristol, UK
Centre for Multilevel Modelling, University of
Bristol
34. SAS
2002
SAS. 9.1 ed.
Cary, NC
SAS Institute Inc
35. Subramanian
SV
Smith
GD
2006
Patterns, distribution, and determinants of under- and
overnutrition: a population-based study of women in India.
Am J Clin Nutr
84
633
640
36. Thacker
N
Shendurnikar
N
2004
Current status of polio eradication and future prospects.
Indian J Pediatr
71
241
245
37. Bonu
S
Rani
M
Baker
TD
2003
The impact of the national polio immunization campaign on levels
and equity in immunization coverage: evidence from rural North India.
Soc Sci Med
57
1807
1819
38. Tandon
R
2002
The making of a polio-free India.
Indian J Pediatr
69
683
685
39. Sokey
J
1996
Polio eradication in India: pulse polio immunization.
Indian Pediatrics
33
254
256
40. Dev
SM, Ravi C (2007)
Poverty and inequality:
All-India and states, 1983-2005. Econ Polit Wkly 10: 509-521
41. Subramanian
SV
Ackerson
LK
Davey Smith
G
2010
Parental BMI and childhood undernutrition in India: an assessment
of intrauterine influence. Pediatrics 126: e663-e671
42. Ozaltin
E
Hill
K
Subramanian
SV
2010
Association of maternal stature with offspring mortality,
underweight, and stunting in low- to middle-income countries. JAMA 303:
1507-1516
43. Özaltin
E
Hill
K
Subramanian
SV
2009
Association between maternal stature and offspring mortality, and
anthropometric failure in 54 low-to-middle income countries.
Boston
Harvard School of Public Health
44. Schady
N
Paxson
CH
2007
Does money matter?
The effects of cash transfers on child health and development in rural
Ecuador
Washington DC
The World Bank
45. WHO
1986
Use and interpretation of anthropometric indicators of
nutritional status.
Bull World Health Org
64
929
941
46. Deaton
A
2003
Prices and poverty in India, 1987-2000.
Econ Polit Wkly
38
362
368
47. MDG
Monitor
2010
Tracking the millennium development goals.
India, progress by goal. Available: http://www.mdgmonitor.org/country_progress.cfm?c=IND&cd=356
48. Black
RE
Caulfield
L
Bhutta
ZA
Victora
CG
2008
Malnutrition kills directly, not
indirectly—authors' reply.
Lancet
371
1750
Štítky
Interné lekárstvoČlánok vyšiel v časopise
PLOS Medicine
2011 Číslo 3
- Parazitičtí červi v terapii Crohnovy choroby a dalších zánětlivých autoimunitních onemocnění
- Pleiotropní účinky statinů na kardiovaskulární systém
- Statiny indukovaná myopatie: Jak na diferenciální diagnostiku?
- Význam hydratace při hojení ran
- DESATORO PRE PRAX: Aktuálne odporúčanie ESPEN pre nutričný manažment u pacientov s COVID-19
Najčítanejšie v tomto čísle
- The BCG World Atlas: A Database of Global BCG Vaccination Policies and Practices
- How Can Institutional Review Boards Best Interpret Preclinical Data?
- The Challenge of Discharging Research Ethics Duties in Resource-Constrained Settings
- HIV-1 Drug Resistance Emergence among Breastfeeding Infants Born to HIV-Infected Mothers during a Single-Arm Trial of Triple-Antiretroviral Prophylaxis for Prevention of Mother-To-Child Transmission: A Secondary Analysis