Is Income More Relevant than Education? Dynamic of Determinants of Inequality Child Undernutrition Indicator in India, 2006-21

Prateek Singh, Indian Institute of Technology, Mandi
William Joe, Institute of Economic Growth

Stunting remains a global health challenge, affecting 149.2 million children under five and causing long-term health issues such as metabolic disorders and chronic diseases. Nutrition-sensitive programs are widely seen as essential to combating malnutrition. This research explores whether community and individual factors that influenced stunting 15 years ago still persist, and examines how evolving income, education, and socioeconomic dynamics shape current priorities and interventions. We analyzed data from NFHS-3, NFHS-4, and NFHS-5 across different age groups using logistic regression to assess associations between factors and anthropometric failure, and calculated the Population Attributable Risk (PAR) for stunting. Stunting declined from 48.0% in 2006 to 35.5% in 2021, but the mean Z-score remained stable (-3.2 in 2006, -3.0 in 2016, and -3.1 in 2021). While short maternal stature (OR>2.0) and maternal education (OR>1.3) were key factors in 2006, household wealth (OR>1.4) became an additional significant factor in 2016 and 2021. Over the past 15 years, stunting in children has persisted, especially among poor families and under-educated mothers. While wasting affects all socioeconomic groups, stunting factors are evolving. Maternal height, BMI, education, household wealth, and air quality are now key factors to address in ensuring children's healthy development.

Keywords: Health and Morbidity, Children, Adolescents, and Youth, Inequality, Disadvantage and Discrimination, Big data

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