Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-26T17:58:13.828Z Has data issue: false hasContentIssue false

Testing the regional Convergence Hypothesis for the progress in health status in India during 1980–2015

Published online by Cambridge University Press:  10 June 2020

Mohammad Zahid Siddiqui*
Affiliation:
Centre for the Study of Regional Development (CSRD), Jawaharlal Nehru University, Delhi, India
Srinivas Goli
Affiliation:
Centre for the Study of Regional Development (CSRD), Jawaharlal Nehru University, Delhi, India UWA Public Policy Institute, University of Western Australia, Perth, Australia
Anu Rammohan
Affiliation:
Department of Economics, University of Western Australia (M251), Crawley, Australia
*
*Corresponding author. Email: [email protected]

Abstract

The key challenges of global health policy are not limited to improving average health status, with a need for greater focus on reducing regional inequalities in health outcomes. This study aimed to assess health inequalities across the major Indian states used data from the Sample Registration System (SRS, 1981–2015), National Family Health Survey (NFHS, 1992–2015) and other Indian government official statistics. Catching-up plots, absolute and conditional β-convergence models, sigma (σ) plots and Kernel Density plots were used to test the Convergence Hypothesis, Dispersion Measure of Mortality (DMM) and the Gini index to measure progress in absolute and relative health inequalities across the major Indian states. The findings from the absolute β-convergence measure showed convergence in life expectancy at birth among the states. The results from the β- and σ-convergences showed convergence replacing divergence post-2000 for child and maternal mortality indicators. Furthermore, the estimates suggested a continued divergence for child underweight, but slow improvements in child full immunization. The trends in inter-state inequality suggest a decline in absolute inequality, but a significant increase or stationary trend in relative health inequality during 1981–2015. The application of different convergence metrics worked as robustness checks in the assessment of the convergence process in the selected health indicators for India over the study period.

Type
Research Article
Copyright
© The Author(s), 2020. 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.)

References

Atkinson, T (2015) Inequality: What Can Be done? Harvard University Press.CrossRefGoogle Scholar
Barro, RJ (1991) Economic growth in a cross-section of countries. Quarterly Journal of Economics 106, 407444.Google Scholar
Barro, RJ and Sala-I-Martin, X (1991) Convergence across states and regions. Brooking Papers of Economy Activity 1, 107182.CrossRefGoogle Scholar
Barro, RJ and Sala-I-Martin, X (1992) Convergence. Journal of Political Economy 100, 223251.CrossRefGoogle Scholar
Barro, RJ and Sala-I-Martin, X (1995) Economic Growth. McGraw-Hill, New York.Google Scholar
Blas, E and Kurup, SA (2010) Synergy for equity. In Blas, E and Kurup, SA (eds) Equity, Social Determinants, and Public Health Programmes. World Health Organization, Geneva, pp. 261284.Google Scholar
Bloom, DE and Canning, D (2007) Mortality traps and the dynamics of health transitions. Proceedings of the National Academy of Sciences 104(41), 1604416049.CrossRefGoogle ScholarPubMed
Clark, R (2011) World health inequality: convergence, divergence, and development. Social Science & Medicine 72, 617624.CrossRefGoogle ScholarPubMed
Deaton, A (2013) The Great Escape: Health Wealth, and Origins of Inequality. Princeton University Press.Google Scholar
Dorius, SF (2008) Global demographic convergence? A reconsideration of changing inter country inequality in fertility. Population and Development Review 34(3), 519539.Google Scholar
Dorius, SF and Firebaugh, G (2010) Trends in global gender inequality. Social Forces 88(5), 19411968.CrossRefGoogle ScholarPubMed
Drèze, J and Sen, AK (2012) Indian Development: Selected Regional Perspectives. Oxford University Press.Google Scholar
Drèze, J and Sen, AK (2013) An Uncertain Glory: India and its Contradictions. Princeton University Press.Google Scholar
Franklin, RS (2002) Fertility convergence across Italy’s regions, 1952–1995. Paper presented at the 41st Annual Meeting, Western Regional Science Association, Monterey, CA, USA.Google Scholar
Franklin, RS (2003) Italian fertility, 1864 to 1961: an analysis of regional trends. Paper prepared at the 43rd European Congress of the Regional Science Association, 27–30th August 2003, Jyväskylä, Finland.Google Scholar
Gachter and Theurl (2011) Health status convergence at the local level: empirical evidence from Austria. International Journal for Equity in Health 10, 34. doi: 10.1186/1475-9276-10-34.Google Scholar
Goesling, B and Firebaugh, G (2004) The trend in international health inequality. Population and Development Review 30(1), 131146.CrossRefGoogle Scholar
Goli, S (2014) Demographic convergence and its linkage with health inequalities in India. Doctoral thesis, International Institute for Population Sciences, Mumbai, India.CrossRefGoogle Scholar
Goli, S and Arokiasamy, P (2013) Trends in health and health inequalities among major states of India: assessing progress through convergence models. Health Economics Policy and Law 9(2), 143168.CrossRefGoogle ScholarPubMed
Goli, S and Arokiasamy, P (2014) Maternal and child mortality indicators across 187 countries of the world: converging or diverging. Global Public Health 9(3), 342360.CrossRefGoogle ScholarPubMed
Moradhvaj, Goli S, Chakravorty, S and Rammohan, A (2019) World health status 1950–2015: converging or diverging? PLoS One 14(3), e0213139.Google Scholar
Goli, S and Siddiqui, MZ (2015) Rise and fall of between-state inequalities in demographic progress in India: application of “inequality life cycle hypothesis”. Social Science Spectrum 1(3), 167180.Google Scholar
Government of India (2017) Economic Survey Report 2016–17. Volume 2. Ministry of Finance Department of Economic Affairs Economic Division, Delhi. URL: http://www.thehinducentre.com/multimedia/archive/03193/Economic_Survey_vo_3193544a.pdf (accessed 18th October 2018).Google Scholar
IIPS and Macro International (1995) National Family Health Survey Report. Ministry of Health and Family Welfare, Government of India.Google Scholar
IIPS and Macro International (2000) National Family Health Survey Report. Ministry of Health and Family Welfare, Government of India.Google Scholar
IIPS and Macro International (2007) National Family Health Survey Report. Ministry of Health and Family Welfare, Government of India.Google Scholar
IIPS and Macro International (2017) National Family Health Survey (1–4) Report. Ministry of Health and Family Welfare, Government of India.Google Scholar
James, KS (2011) India’s demographic change: opportunities and challenges. Science 29(333[6042]), 576580.CrossRefGoogle Scholar
James, KS and Goli, S (2016) Demographic changes in India: is the country prepared for the challenge? Brown Journal of World Affairs 23(1), 169188.Google Scholar
Jamison, DT, Summers, LH, Alleyne, G et al. (2013) CIH Report Global Health 2035. The Lancet Commission on Investing in Health.Google Scholar
Janssen, F, Hende, A, Beer, J and Wissen, L (2016) Sigma and beta convergence in regional mortality: a case study of the Netherlands. Demographic Research 35, 81116.CrossRefGoogle Scholar
Lim, SS, Allen, K, Bhutta, ZA, Dandona, L, Forouzanfar, MH, Pullman, N et al. (2016) Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. The Lancet 388, 18131850.CrossRefGoogle Scholar
McMichael, AJ, Mckee, M, Shkolnikov, V and Valkonen, T (2004) Mortality trends and setbacks: global convergence or divergence? The Lancet 363, 11551159.CrossRefGoogle ScholarPubMed
Marmot, M (2015a) The Health Gap: The Challenge of an Unequal World. Bloomsbury Publishing.Google ScholarPubMed
Marmot, M (2015b) Status Syndrome: How to Place on the Social Gradient Directly Affects Your Health. Bloomsbury Publishing.Google Scholar
Milanovic, B (2016) Global inequality: a new approach for the age of globalization. Panoeconomicus 63(4), 493501.Google Scholar
Moser, K, Shkolnikov, V and Leon, D (2005) World mortality 1950–2000: divergence replaces convergence from the late 1980s. Bulletin of the World Health Organization 83(3), 202209.Google ScholarPubMed
Nayyar, D (2013) Catch Up: Developing Countries in the World Economy. Oxford University Press.CrossRefGoogle Scholar
Neumayer, E (2003) Beyond income: convergence in living standards, big time. Structural Change and Economic Dynamics 14, 275296.CrossRefGoogle Scholar
Nixon, J (2001) Convergence of health care spending and health outcomes in the European Union, 1960‒95. Centre for Health Economics Discussion Paper Series, doi: 10.7748/nm.8.2.39.s18 Google Scholar
O’Connell, M (1981) Regional fertility patterns in the United States: convergence or divergence? International Regional Science Review 6, 114.CrossRefGoogle ScholarPubMed
Office of Registrar General of India (2007) Sample Registration System Year Book. Government of India, New Delhi.Google Scholar
Office of Registrar General of India (2009) Sample Registration System Year Book. Government of India, New Delhi.Google Scholar
Office of Registrar General of India (2014) Sample Registration System Year Book. Government of India, New Delhi.Google Scholar
Office of Registrar General of India (2015) Sample Registration System Year Book. Government of India, New Delhi.Google Scholar
Office of Registrar General of India (2017) Compendium of Sample Registration System Year Books (1981–2016). Government of India New Delhi.Google Scholar
Oxfam (2017) Oxfam Briefing Paper. Starting with People: A Human Economy Approach to Inclusive Growth in Africa. URL: https://www-cdn.oxfam.org/s3fs-public/file_attachments/bp-inclusive-growth-africa-020517-summ-en.pdf Google Scholar
Piketty, T (2014) Capital in the Twenty-First Century. Belknap Press of Harvard University Press, Cambridge, MA, and London, UK.CrossRefGoogle ScholarPubMed
Quah, DT (1993) Empirical cross-section dynamics in economic growth. European Economic Review 37, 426434.CrossRefGoogle Scholar
Rahman, MM, Karan, A, Rahman, MS, Parsons, A, Abe, SK, Bilano, V et al. (2017) Progress toward universal health coverage: a comparative analysis in 5 South Asian countries. JAMA Internal Medicine 177, 1297–305.CrossRefGoogle ScholarPubMed
Ram, U Jha, P and Ram, F et al. (2013) Neonatal, 1–59 month, and under-5 mortality in 597 Indian districts, 2001 to 2012: estimates from national demographic and mortality surveys. Lancet Global Health 1, e219e226.CrossRefGoogle ScholarPubMed
Reddy, KS, Patel, V, Jha, P, Paul, VK, Kumar, AK, Dandona, L et al. (2011) Towards achievement of universal health care in India by 2020: a call to action. The Lancet 8(377), 760.CrossRefGoogle Scholar
Rey, S and Montouri, DB (1999) US regional income convergence: a spatial econometric perspective. Regional Studies 33, 143156.CrossRefGoogle Scholar
Rivas, MDG and Villarroya, IS (2016) Testing the Convergence Hypothesis for OECD countries: a reappraisal. Economics Discussion Paper No. 2016-45. Kiel Institute for the World Economy.Google Scholar
Roberto, MG, Juan, DDJ and Jose, M (2007) Decentralisation and convergence in health among the provinces of Spain (1980–2001). Social Science & Medicine 64(6), 12531264. Google Scholar
Saikia, N, Jasilionis, D, Ram, F and Shkolnikov, V (2011) Trends in geographic mortality differentials in India. Population Studies 65(1), 7389.CrossRefGoogle ScholarPubMed
Saikia, N, Singh, A, Jasilionis, D and Ram, F (2013) Explaining the rural–urban gap in infant mortality in India. Demographic Research 29(18), 473506.CrossRefGoogle Scholar
Shkolnikov, VM, Andreev, EM and Begun, AZ (2003) Gini coefficient as a life table function: computation from discrete data, decomposition of differentials and empirical examples. Demographic Research 8(11), 305358.CrossRefGoogle Scholar
Shkolnikov, VM, Andreev, EM, Jdanov, DA, Jasilionis, D, Kravdal, Ø, Vågerö, D and Valkonen, T (2012) Increasing absolute mortality disparities by education in Finland, Norway, and Sweden, 1971–2000. Journal of Epidemiology and Community Health 66, 372378.CrossRefGoogle ScholarPubMed
Singh, A, Pathak, PK, Chauhan, RK and Pan, W (2011) Infant and child mortality in India in the last two decades: a geospatial analysis. PLoS One 6(11), e26856.CrossRefGoogle ScholarPubMed
Stiglitz, J (2015) The Great Divide. Penguin, UK. ISBN: 9780141981222.Google Scholar
Strulik, H and Vollmer, S (2015) The fertility transition around the world. Journal of Population Economics 28(1), 31.CrossRefGoogle Scholar
Taylor, S (2009) Wealth, health and equity: convergence to divergence in late 20th-century globalization. British Medical Bulletin 91, 2948.Google ScholarPubMed
Tryggvi, T, Herbertsson, TT, Orszag, JM et al. (2000) Population Dynamics and Convergence in Fertility Rates . SSRN Electronic Journal, doi: 10.2139/ssrn.273382 Google Scholar
UNICEF (2011) Global Inequality: Beyond the Bottom Billion – A Review of Income Distribution in 141 Countries. UNICEF. URL: http://www.unicef.org/socialpolicy/index_58230.html (accessed 12th October 2018).Google Scholar
United Nations (2019a) World Mortality 2019: Data Booklet (ST/ESA/SER.A/436). Population Division, Department of Economic and Social Affairs, United Nations.Google Scholar
United Nations (2019b) The Sustainable Development Goals Report. URL: https://unstats.un.org/sdgs/report/2019/The-Sustainable-Development-Goals-Report-2019.pdf (accessed 7th May 2019).Google Scholar
Vallin, J, Andreev, E, Mesle, F and Shkolnikov, V (2005) Geographical diversity of cause-of-death patterns and trends in Russia. Demographic Research 12(13), 323380.CrossRefGoogle Scholar
Vallin, J and Mesle, F (2001) Trends in mortality in Europe since 1950: age-, sex and cause-specific mortality. In Vallin, J et al. (eds) Trends in Mortality and Differential Mortality. Council of Europe Publishing, Strasbourg, pp. 31184.Google Scholar
Vallin, J and Mesle, F (2004) Convergences and divergences in mortality: a new approach to health transition. Demographic Research S2(2), 1144.CrossRefGoogle Scholar
Visaria, L (2004a) Mortality trends and the health transition. In Dyson, T et al. (eds) Twenty-first Century India – Population, Economy, Human Development, and the Environment. Oxford University Press, New Delhi, pp. 3256.Google Scholar
Visaria, L (2004b) The continuing fertility transition. In Dyson, T et al. (eds) Twenty-first Century India – Population, Economy, Human Development, and the Environment. Oxford University Press, New Delhi, pp. 5773.Google Scholar
Wang, Y (2004) A nonparametric analysis of the personal income distribution across the provinces and states in the US and Canada. Regional and Sectoral Economic Studies 4(1), 524.Google Scholar
Whitehead, M, Dahgren, G and Evans, T (2001) Equity and health sector reforms: can low-income countries escape the medical poverty trap? The Lancet 358, 833836.CrossRefGoogle ScholarPubMed
WHO (2008) World Health Report on Primary Health Care: Now More Than Ever. World Health Organization, Geneva.Google Scholar
WHO (2015) Monitoring Health Inequality: An Essential Step for Achieving Health Equity. World Health Organization, Geneva.Google Scholar
Wilson, C (2001) On the scale of global demographic convergence 1950–2000. Population Development Review 27, 155171.CrossRefGoogle ScholarPubMed
Wilson, C (2011) Understanding global demographic convergence since 1950. Population and Development Review 37, 375388.CrossRefGoogle Scholar
Young, AT, Higgins, MJ and Levy, D (2008) Σ-convergence versus β-convergence: evidence form U.S. county-level data. Journal of Money, Credit, and Banking 40, 10831093.CrossRefGoogle Scholar