Hostname: page-component-6587cd75c8-6qszs Total loading time: 0 Render date: 2025-04-23T20:56:27.013Z Has data issue: false hasContentIssue false
  • English
  • Français

Gender disparities in the prevalence of undernutrition in India: the unexplored effects of drinking contaminated water

Published online by Cambridge University Press:  27 December 2024

Khushboo Aggarwal  and
Rashmi Barua Open the ORCID record for Rashmi Barua [Opens in a new window]
Khushboo Aggarwal
Affiliation:
Delhi School of Public Policy and Governance, Institution of Eminence, University of Delhi, New Delhi, India
Rashmi Barua*
Affiliation:
Centre for International Trade and Development (CITD), Jawaharlal Nehru University, New Delhi, India
*
*Corresponding author: Rashmi Barua; Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Stunting, a manifestation of chronic malnutrition, is widespread in India. This, coupled with biased preferences of parents towards their eldest sons, has led to stunting and underweight among girls that grows sharply with increasing birth order. We study the impact of an environmental water pollutant on child growth outcomes in arsenic contaminated regions of India. Using a large, nationally representative household survey and exploiting variation in soil textures across districts as an instrument for arsenic, we find that arsenic exposure beyond the safe threshold level is negatively associated with height-for-age and weight-for-age. Negative effects are larger for girls who are born at higher birth orders relative to the eldest. This, we argue, suggests that the lack of adequate nutrition and health care during early childhood can make girls more vulnerable to external environmental hazards due to their lower immunity and underdeveloped bodies.

Keywords

arsenicwaterchild healthbirth ordergender

JEL classification

Q54: Climate • Natural Disasters and Their Management • Global Warming I3: Welfare, Well-Being, and Poverty I15: Health and Economic Development Q53: Air Pollution • Water Pollution • Noise • Hazardous Waste • Solid Waste • Recycling
Type
Research Article
Information
Environment and Development Economics , Volume 30 , Issue 2 , April 2025 , pp. 114 - 134
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Acemoglu, D and Angrist, J (2000) How large are human-capital externalities? Evidence from compulsory schooling laws. NBER Macroeconomics Annual 15, 9–59.CrossRefGoogle Scholar
Aggarwal, K, Barua, R and Vidal-Fernandez, M (2024) Still waters run deep: groundwater contamination and education outcomes in India. Economics of Education Review 100, 102525.CrossRefGoogle Scholar
Aksan, AM (2021) Son preference and the fertility squeeze in India. Journal of Demographic Economics 87, 67–106.CrossRefGoogle Scholar
Angrist, JD and Pischke, JS (2009) Mostly Harmless Econometrics: An Empiricist's Companion. Princeton, NJ: Princeton University Press.CrossRefGoogle Scholar
Arceo, E, Hanna, R and Oliva, P (2016) Does the effect of pollution on infant mortality differ between developing and developed countries? Evidence from Mexico City. The Economic Journal 126, 257–280.CrossRefGoogle Scholar
Asadullah, MN and Chaudhury, N (2011), Poisoning the mind: arsenic contamination of drinking water wells and children's educational achievement in rural Bangladesh, Economics of Education Review 30, 873–888.CrossRefGoogle Scholar
Bae, S, Kamynina, E, Guetterman, HM, Farinola, AF, Caudill, MA, Berry, RJ, Cassano, PA and Stover, PJ (2021) Provision of folic acid for reducing arsenic toxicity in arsenic-exposed children and adults. Cochrane Database of Systematic Reviews 10, CD012649.Google ScholarPubMed
Bahrami-Rad, D (2021) Keeping it in the family: female inheritance, inmarriage, and the status of women. Journal of Development Economics 153, 102714.CrossRefGoogle Scholar
Bardhan, PK (1974) On life and death questions. Economic and Political Weekly 9, 1293–1304.Google Scholar
Becker, GS and Tomes, N (1976) Child endowments and the quantity and quality of children. Journal of Political Economy 84, 143–162.CrossRefGoogle Scholar
Behrman, JR and Taubman, P (1986) Birth order, schooling, and earnings. Journal of Labor Economics 4, S121–S145.CrossRefGoogle ScholarPubMed
Behrman, JR, Pollak, RA and Taubman, P (1986) Do parents favor boys? International Economic Review 27, 33–54.CrossRefGoogle Scholar
Billings, SB and Schnepel, KT (2018) Life after lead: effects of early interventions for children exposed to lead. American Economic Journal: Applied Economics 10, 315–344.Google Scholar
Booth, AL and Kee, HJ (2009) Birth order matters: the effect of family size and birth order on educational attainment. Journal of Population Economics 22, 367–397.CrossRefGoogle Scholar
Brainerd, E and Menon, N (2014) Seasonal effects of water quality: the hidden costs of the green revolution to infant and child health in India. Journal of Development Economics 107, 49–64.CrossRefGoogle Scholar
Carranza, E (2014) Soil endowments, female labour force participation and the demographic deficit of women in India. American Economic Journal: Applied Economics 6, 197–225.Google Scholar
Case, A and Paxson, C (2008) Stature and status: height, ability, and labor market outcomes. Journal of Political Economy 116, 499–532.CrossRefGoogle ScholarPubMed
Central Ground Water Board (2022) Dynamic Ground Water Resources of India, River Development & Ganga Rejuvenation. New Delhi: Ministry of Jal Shakti, Government of India.Google Scholar
Chaudhry, TT, Khan, M and Mir, AS (2021) Son-biased fertility stopping, birth spacing, and child nutritional status in Pakistan. Review of Development Economics 25, 712–736.CrossRefGoogle Scholar
Chung, W and Das Gupta, M (2007) The decline of son preference in South Korea: the roles of development and public policy. Population and Development Review 33, 757–783.CrossRefGoogle Scholar
Clougherty, JE (2010) A growing role for gender analysis in air pollution epidemiology. Environmental Health Perspective 118, 167–176.CrossRefGoogle ScholarPubMed
Coffey, D and Spears, D (2021) Neonatal death in India: birth order in a context of maternal undernutrition. The Economic Journal 131, 2478–2507.CrossRefGoogle Scholar
Deaton, A and Drèze, J (2009) Food and nutrition in India: facts and interpretations. Economic and Political Weekly 44, 42–65.Google Scholar
Deguen, S, Amuzu, M, Simoncic, V and Kihal-Talantikite, W (2022) Exposome and social vulnerability: an overview of the literature review. International Journal of Environmental Research and Public Health 19, 3534.CrossRefGoogle ScholarPubMed
DeRose, LF, Das, M and Millman, SR (2000) Does female disadvantage mean lower access to food? Population and Development Review 26, 517–547.CrossRefGoogle Scholar
Do, QT, Joshi, S and Stolper, S (2018) Can environmental policy reduce infant mortality? Evidence from the Ganga pollution cases. Journal of Development Economics 133, 306–325.CrossRefGoogle Scholar
Dyson, T and Moore, M (1983) On kinship structure, female autonomy, and demographic behavior in India. Population and Development Review 9, 35–60.CrossRefGoogle Scholar
Fängström, B, Moore, S, Nermell, B, Kuenstl, L, Goessler, W, Grandér, M, Kabir, I, Palm, B, Arifeen, SE and Vahter, M (2008) Breast-feeding protects against arsenic exposure in Bangladeshi infants. Environmental Health Perspectives 116, 963–969.CrossRefGoogle ScholarPubMed
Fecht, D, Fischer, P, Fortunato, L, Hoek, G, De Hoogh, K, Marra, M, Kruize, H, Vienneau, D, Beelen, R and Hansell, A (2015) Associations between air pollution and socioeconomic characteristics, ethnicity and age profile of neighbourhoods in England and the Netherlands. Environmental Pollution 198, 201–210.CrossRefGoogle ScholarPubMed
Fledderjohann, J and Channon, M (2022) Gender, nutritional disparities, and child survival in Nepal. BMC Nutrition 8, 50.CrossRefGoogle ScholarPubMed
Fledderjohann, J, Agrawal, S, Vellakkal, S, Basu, S, Campbell, O, Doyle, P, Ebrahim, S and Stuckler, D (2014) Do girls have a nutritional disadvantage compared with boys? Statistical models of breastfeeding and food consumption inequalities among Indian siblings. PLoS ONE 9, e107172.CrossRefGoogle ScholarPubMed
Foster, A, Gutierrez, E and Kumar, N (2009) Voluntary compliance, pollution levels, and infant mortality in Mexico. American Economic Review 99, 191–197.CrossRefGoogle ScholarPubMed
Gardner, RM, Kippler, M, Tofail, F, Bottai, M, Hamadani, J, Grandér, M, Nermell, B, Palm, B, Rasmussen, KM and Vahter, M (2013) Environmental exposure to metals and children's growth to age 5 years: a prospective cohort study. American Journal of Epidemiology 177, 1356–1367.CrossRefGoogle ScholarPubMed
Garg, A and Morduch, J (1998) Sibling rivalry and the gender gap: evidence from child health outcomes in Ghana. Journal of Population Economics 11, 471–493.CrossRefGoogle ScholarPubMed
Glewwe, P and Miguel, EA (2007) The impact of child health and nutrition on education in less developed countries. Handbook of Development Economics 4, 3561–3606.CrossRefGoogle Scholar
Gómez-Roig, MD, Pascal, R, Cahuana, MJ, García-Algar, O, Sebastiani, G, Andreu-Fernández, V, Martínez, L, Rodríguez, G, Iglesia, I, Ortiz-Arrabal, O, Mesa, MD, Cabero, MJ, Guerra, L, Llurba, E, Domínguez, C, Zanini, MJ, Foraster, M, Larqué, E, Cabañas, F, Lopez-Azorín, M, Pérez, A, Loureiro, B, Pallás-Alonso, CR, Escuder-Vieco, D and Vento, M (2021) Environmental exposure during pregnancy: influence on prenatal development and early life: a comprehensive review. Fetal Diagnosis and Therapy 48, 245–257.CrossRefGoogle ScholarPubMed
Goyal, N and Canning, D (2018) Exposure to ambient fine particulate air pollution in utero as a risk factor for child stunting in Bangladesh. International Journal of Environmental Research and Public Health 15, 22.CrossRefGoogle Scholar
Greenstone, M and Hanna, R (2014) Environmental regulations, air and water pollution, and infant mortality in India. American Economic Review 104, 3038–3072.CrossRefGoogle Scholar
Guilmoto, CZ, Saikia, N, Tamrakar, V and Bora, JK (2018) Excess under-5 female mortality across India: a spatial analysis using 2011 census data. The Lancet Global Health 6, e650–e658.CrossRefGoogle ScholarPubMed
Herath, I, Vithanage, M, Bundschuh, J, Maity, JP and Bhattacharya, P (2016) Natural arsenic in global groundwaters: distribution and geochemical triggers for mobilization, Current Pollution Reports 2, 68–89.CrossRefGoogle Scholar
Huang, B, Yuan, Z, Li, D, Zheng, M, Nie, X and Liao, Y (2020) Effects of soil particle size on the adsorption, distribution, and migration behaviors of heavy metal(loid)s in soil: a review. Environmental Science: Processes & Impacts 22, 1596–1615.Google Scholar
Jayachandran, S and Kuziemko, I (2011) Why do mothers breastfeed girls less than boys? Evidence and implications for child health in India. The Quarterly Journal of Economics 126, 1485–1538.CrossRefGoogle ScholarPubMed
Jayachandran, S and Pande, R (2017) Why are Indian children so short? The role of birth order and son preference. American Economic Review 107, 2600–2629.CrossRefGoogle Scholar
Keskin, P, Shastry, GK and Willis, H (2017) Water quality awareness and breastfeeding: evidence of health behavior change in Bangladesh. Review of Economics and Statistics 99, 265–280.CrossRefGoogle Scholar
Kile, ML, Cardenas, A, Rodrigues, E, Mazumdar, M, Dobson, C, Golam, M, Quamruzzaman, Q, Rahman, M and Christiani, DC (2016) Estimating effects of arsenic exposure during pregnancy on perinatal outcomes in a Bangladeshi cohort, Epidemiology (Cambridge, Mass.) 27, 173–181.Google Scholar
Kugler, AD and Kumar, S (2017) Preference for boys, family size, and educational attainment in India. Demography 54, 835–859.CrossRefGoogle ScholarPubMed
Lundberg, S (2005) Sons, daughters, and parental behaviour. Oxford Review of Economic Policy 21, 340–356.CrossRefGoogle Scholar
Lynch, J, Smith, GD, Harper, S and Bainbridge, K (2006) Explaining the social gradient in coronary heart disease: comparing relative and absolute risk approaches. Journal of Epidemiology & Community Health 60, 436–441.CrossRefGoogle ScholarPubMed
Madajewicz, M, Pfaff, A, van Geen, A, Graziano, J, Hussein, I, Momotaj, H, Sylvi, R and Ahsan, H (2007) Can information alone change behavior? Response to arsenic contamination of groundwater in Bangladesh, Journal of Development Economics 84, 731–754.CrossRefGoogle Scholar
McArthur, JM, Ravenscroft, P, Safiulla, S and Thirlwall, MF (2001) Arsenic in groundwater: testing pollution mechanisms for sedimentary aquifers in Bangladesh. Water Resources Research 37, 109–117.CrossRefGoogle Scholar
Neidell, MJ (2004) Air pollution, health, and socio-economic status: the effect of outdoor air quality on childhood asthma. Journal of Health Economics 23, 1209–1236.CrossRefGoogle ScholarPubMed
Pörtner, CC (2022) Birth spacing and fertility in the presence of son preference and sex-selective abortions: India's experience over four decades. Demography 59, 61–88.CrossRefGoogle ScholarPubMed
Rahman, A, Granberg, C and Persson, LÅ (2017) Early life arsenic exposure, infant and child growth, and morbidity: a systematic review. Archives of Toxicology 91, 3459–3467.CrossRefGoogle ScholarPubMed
Samiee, F, Leili, M, Faradmal, J, Torkshavand, Z and Asadi, G (2019) Exposure to arsenic through breast milk from mothers exposed to high levels of arsenic in drinking water: infant risk assessment. Food Control 106, 106669.CrossRefGoogle Scholar
Spears, D, Coffey, D and Behrman, JR (2022) Endogenous inclusion in the demographic and health survey anthropometric sample: implications for studying height within households. Journal of Development Economics 155, 102783.CrossRefGoogle ScholarPubMed
Tanaka, S (2015) Environmental regulations on air pollution in China and their impact on infant mortality. Journal of Health Economics 42, 90–103.CrossRefGoogle Scholar
Thurstans, S, Sessions, N, Dolan, C, Sadler, K, Cichon, B, Isanaka, S, Roberfroid, D, Stobaugh, H, Webb, P and Khara, T (2022) The relationship between wasting and stunting in young children: a systematic review. Maternal & Child Nutrition 18, e13246.CrossRefGoogle Scholar
Trejo, S, Yeomans-Maldonado, G and Jacob, B (2021) The psychosocial effects of the Flint water crisis on school-age children. Working Paper 29341, National Bureau of Economic Research, Cambridge, MA.CrossRefGoogle Scholar
UNICEF (2013) Improving Child Nutrition: The Achievable Imperative for Global Progress. New York: United Nations Children's Fund (UNICEF).Google Scholar
Vogl, TS (2016) Differential fertility, human capital, and development. The Review of Economic Studies 83, 365–401.CrossRefGoogle Scholar
Watanabe, C, Matsui, T, Inaoka, T, Kadono, T, Miyazaki, K, Bae, MJ, Ono, T, Ohtsuka, R and Bokul, AT (2007) Dermatological and nutritional/growth effects among children living in arsenic-contaminated communities in rural Bangladesh. Journal of Environmental Science and Health, Part A 42, 1835–1841.CrossRefGoogle ScholarPubMed
Supplementary material: File

Aggarwal and Barua supplementary material

Aggarwal and Barua supplementary material
Download Aggarwal and Barua supplementary material(File)
File 674.6 KB