why are Indian children short? introduction to a conference on sanitation, stunting, and growing human capital Dean Spears – 2 August 2013
why are Indian children short?
introduction to a conference on sanitation, stunting,
and growing human capital
Dean Spears – 2 August 2013
thank you.• Centre for Development Economics at DSE
– Abhijit Banerji– Ashwini Deshpande– J.V. Meenakshi– Surjeet Singh
• World Bank Water & Sanitation Programme– Shalini Agrawal– Sonali David– Manish Kumar
economists’ conference rules, not seminar rules
one: why height?the importance of development in the first two years of life
height versus weight
• exercising and going on a diet– sometimes makes me thinner– never makes me shorter– weight is about “net nutrition” recently– “net” of losses to disease and energy spent
• in contrast, height is about early life health and net nutrition– and early life is a very important time
UNICEF: “The first two years are forever”
Indian children, 2005 DHS
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aren’t some people genetically taller or shorter than others?
of course!
each of us has a genetic
potential height
Early life disease, health, and nutrition shape whether we reach it
small kids? big deal!
• height is not the only thing developing in the first few years life
• the same early life health that helps bodies grow tall also helps brains grow smart
• height predicts (on average):– cognitive achievement– adult occupation class, employment, wages– adult health, mortality, and happiness– promotion of people in large organizations (!)
height and cognitive achievement
earnings, men in Mexico (Vogl, 2012)
if we know about the average height of a
population, we know many important things
two: why are children in India so short?
an “Asian Enigma?”
source: Jayachandran and Pande, 2013
Indian children: below the trend
how tall are Indian-origin children in South Africa?
data: NiDS, National Income Dynamics Survey
“White”“Indian”“Coloured”“African”
when environments change, population heights change
source: Angus Deaton
what threats to child health are particularly bad in India?
too many
there are germs in feces, which get onto children’s fingers and feet,
into water and foods, and wherever flies go
• diarrhea direct loss of food• enteropathy no absorption• energy consumption fighting disease
three: open defecation and child height
R² = 54%
merely wealth? controlling for GDP changes little
differences from country averages
would any “good” property similarly predict height?
Explaining stunting internationally is challenging: Many indicators are potentially correlated with child height.
association with average child height, across DHS country-years
variable: female literacy
calorie deficit electrifi. democracy breastfeed. fed liquids open
defecation
association: 0.0143* -0.00251* 0.00675* -0.0274* -0.109+ 0.0102* -1.239*
(0.00267) (0.00120) (0.00254) (0.0117) (0.0605) (0.00292) (0.226)
The other variables cannot explain international differences in child height, after
accounting for open defecation and GDP.
association with child height, across DHS country-years
variable: female literacy
calorie deficit electrifi. democracy breastfeed. fed liquids open
defecation
association: 0.00348 0.0000230 -0.00271 -0.0119 -0.103* 0.00320
(0.00327) (0.000964) (0.00226) (0.00787) (0.0370) (0.00208)
open defecation -0.880* -1.002* -0.918* -0.843* -1.003* -0.939* -1.002*(0.205) (0.157) (0.141) (0.212) (0.153) (0.164) (0.156)
GDP per capita ü ü ü ü ü ü üyears ü ü ü ü ü ü ü
Goes away with country FEs
region trends
a double threat: open defecation amid high population density
population densty: Indian states as countries
the South Asia – Sub-Saharan Africa gap
• restrict the sample to South Asia and Sub-Saharan Africa
• measure the difference between South Asia and Africa
• how much does statistically controlling for open defecation reduce the difference between South Asia and Africa?
the South Asia – Sub-Saharan Africa gap
paper: www.riceinstitute.org
• Indian districts where open defecation decreased by more between the NFHS-1 and NFHS-2 saw greater increases in child height, on average
• re-weighting child-level Indian NFHS-3 data to match the distribution of sanitation facing African children in comparable DHS data can more than eliminate the India-Africa gap
open defecation: a threat to human capital
• child height is an important economic variable because so much is developing in the first two years
• Indian children are exceptionally short; shorter children within India achieve less, on average
• open defecation can statistically account for international variation in child height
• if so, then sanitation would be a health, economic, and human development priority