Understanding wealth-based inequalities in child health in India: A decomposition approach
Understanding wealth-based inequalities in child health in India: A decomposition approach
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DOI：
10.1016/j.socscimed.2012.08.012
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发表时间：
2012-12-01
影响因子：
5.4
通讯作者：
Chalasani, Satvika
中科院分区：
文献类型：
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作者：
Chalasani, Satvika
自 20 世纪 80 年代中期以来，印度经历了巨大的经济增长，但与此同时，经济不平等也急剧加剧。与农村地区相比，城市地区的经济增长更快，但经济不平等的加剧也更大。同一时期，儿童健康状况平均有所改善，但儿童健康状况的社会经济差异依然存在。本文试图使用基于回归的分解方法来解释儿童死亡率和营养不良方面基于财富的不平等。分析数据来自 1992/93、1998/99 和 2005/06 印度全国家庭健康调查。儿童健康方面的不平等是用集中指数来衡量的。然后将每个结果的集中指数分解为基于财富的不平等对观察到的儿童健康决定因素的贡献。结果表明，城市地区的死亡率不平等程度有所下降，但农村地区的死亡率不平等程度保持不变或有所增加。城市和农村地区的营养不良不平等现象急剧加剧。个人/家庭层面儿童健康差异的两个最大来源是（i）财富分配本身的不平等，以及（ii）孕产妇教育的不平等。观察到的决定因素（i）对新生儿死亡率不平等的贡献保持不变，（ii）对儿童死亡率不平等的贡献有所增加，（ii）对营养不良不平等的贡献有所增加。儿童健康不平等的加剧可能反映了城市经济增长的偏差，以及公共项目的好坏参半的表现，而这些项目本可以抵消不平等增长的影响。 (C) 2012 Elsevier Ltd. 保留所有权利。
India experienced tremendous economic growth since the mid-1980s but this growth was paralleled by sharp rises in economic inequality. Urban areas experienced greater economic growth as well as greater increases in economic inequality than rural areas. During the same period, child health improved on average but socioeconomic differentials in child health persisted. This paper attempts to explain wealth-based inequalities in child mortality and malnutrition using a regression-based decomposition approach. Data for the analysis come from the 1992/93, 1998/99, and 2005/06 Indian National Family Health Surveys. Inequalities in child health are measured using the concentration index. The concentration index for each outcome is then decomposed into the contributions of wealth-based inequality in the observed determinants of child health. Results indicate that mortality inequality declined in urban areas but remained unchanged or increased in rural areas. Malnutrition inequality increased dramatically both in urban and rural areas. The two largest individual/household-level sources of disparities in child health are (i) inequality in the distribution of wealth itself, and (ii) inequality in maternal education. The contributions of observed determinants (i) to neonatal mortality inequality remained unchanged, (ii) to child mortality inequality increased, and (ii) to malnutrition inequality increased. It is possible that the increases in child health inequality reflect urban biases in economic growth, and the mixed performance of public programs that could have otherwise offset the impacts of unequal growth. (C) 2012 Elsevier Ltd. All rights reserved.