Caste and Religion Versus Wealth: What Matters Most in Adult Mortality in India?

Moradhvaj Dhakad, Center for Development Studies, JNU
Nandita Saikia, International Institute for Population Sciences (IIPS)

The low- and middle-income countries (LMICs) have limited evidence of adult mortality due to the lack of reliable data. We estimated social (caste-religion) and economic (wealth quintile) inequality in adult mortality using the three rounds of the National Family Health Survey (NFHS1998-99, NFHS 2015-16 and NFHS 2019-21). We estimated the probability of death in the 15-59 age group social and economic characteristics. We employed the Cox proportional hazards model to assess the risk of death associated with these characteristics, adjusting for other relevant predictors. Disparities in adult mortality by social and economic groups have persisted for more than two decades, with marginal declines in social inequality. During study period, economic inequality in adult mortality has consistently been more pronounced than social inequality. The Cox-proportional hazard regression shows that, for males, Muslims have a lower hazard ratio (HR) of death compared to OBCs and upper-caste Hindus across all surveys. For adult females, upper caste and OBCs, as well as Muslims, have significantly lower HRs compared to SCs. Notably, males living in urban areas exhibit higher adult mortality than their rural counterparts. This study estimates adult mortality by socio-economic groups in LMICs using Cox-proportional hazard models, accounting for regional heterogeneity.

Keywords: Mortality and Longevity, Health and Morbidity, Inequality, Disadvantage and Discrimination

See paper.