Population Council, One Dag Hammarskjold Plaza, New York, NY 10017, USA.
Soc Sci Med. 2012 Dec;75(12):2160-9. doi: 10.1016/j.socscimed.2012.08.012. Epub 2012 Aug 24.
India experienced tremendous economic growth since the mid-1980s but this growth was paralleled by sharp rises in economic inequality. Urban areas experienced greater economic growth as well as greater increases in economic inequality than rural areas. During the same period, child health improved on average but socioeconomic differentials in child health persisted. This paper attempts to explain wealth-based inequalities in child mortality and malnutrition using a regression-based decomposition approach. Data for the analysis come from the 1992/93, 1998/99, and 2005/06 Indian National Family Health Surveys. Inequalities in child health are measured using the concentration index. The concentration index for each outcome is then decomposed into the contributions of wealth-based inequality in the observed determinants of child health. Results indicate that mortality inequality declined in urban areas but remained unchanged or increased in rural areas. Malnutrition inequality increased dramatically both in urban and rural areas. The two largest individual/household-level sources of disparities in child health are (i) inequality in the distribution of wealth itself, and (ii) inequality in maternal education. The contributions of observed determinants (i) to neonatal mortality inequality remained unchanged, (ii) to child mortality inequality increased, and (ii) to malnutrition inequality increased. It is possible that the increases in child health inequality reflect urban biases in economic growth, and the mixed performance of public programs that could have otherwise offset the impacts of unequal growth.
自 20 世纪 80 年代中期以来，印度经历了巨大的经济增长，但这种增长伴随着经济不平等的急剧上升。城市地区的经济增长速度快于农村地区，经济不平等程度也高于农村地区。在此期间，儿童健康状况普遍得到改善，但儿童健康方面的社会经济差异仍然存在。本文试图采用基于回归的分解方法来解释儿童死亡率和营养不良方面的财富不平等现象。分析数据来自于 1992/93、1998/99 和 2005/06 年印度国家家庭健康调查。使用集中指数来衡量儿童健康方面的不平等。然后，将每个结果的集中指数分解为观察到的儿童健康决定因素的财富不平等的贡献。结果表明，城市地区的死亡率不平等状况有所下降，但农村地区的死亡率不平等状况保持不变或有所上升。城乡地区的营养不良不平等状况急剧增加。造成儿童健康差异的两个最大的个体/家庭层面的原因是：（i）财富分配不平等本身，（ii）母亲教育不平等。观察到的决定因素（i）对新生儿死亡率不平等的贡献保持不变，（ii）对儿童死亡率不平等的贡献增加，（ii）对营养不良不平等的贡献增加。儿童健康不平等的增加可能反映了经济增长中的城市偏见，以及公共计划的表现参差不齐，否则这些计划可能会抵消不平等增长的影响。
