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