Datta Biplab Kumar, Thakkar Shriya
Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA.
Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA.
Dialogues Health. 2024 Jul 26;5:100186. doi: 10.1016/j.dialog.2024.100186. eCollection 2024 Dec.
The provisions and recognition of Schedule Castes (SCs), the constitutional term for the Dalits in India, have been exclusively extended to Hindus, Buddhists, and Sikhs (HBS). Omission of Dalit Muslims and Christians (MC) from the SC category stripped them of the affirmative action benefits tied with the SC status. This study aimed to explore how such differential treatment might play a role in differential health outcomes in Dalit women in India.
Drawing data on 177,346 Dalit women, aged 20 to 49 years, from two successive nationally representative surveys, we assessed the differential likelihood of hypertension and diabetes, between MC- and HBS- Dalit women. Accounting for birth cohort-, survey wave-, and state of residence- fixed effects, along with socioeconomic conditions and cardiometabolic risk factors, we obtained adjusted odds of having hypertension and diabetes in MC women. To check the validity of our results, we conducted similar analyses using data on 170,889 Scheduled Tribe (ST) women, another marginalized group, whose ST-status recognition were not tied to religion.
We found that Dalit MC women were 1.13 (95% CI: 1.03-1.25) and 1.19 (95% CI: 1.05-1.36) times more likely to have hypertension and diabetes, respectively, compared to Dalit HBS women. Conversely, no statistically significant differential likelihood of these conditions was observed between MC and HBS women in the ST sample.
Our investigation thus, indicated a potential link at the crossroads of religion and caste that may contribute to the health disparities among marginalized women in India.
印度宪法中为达利特人设立的在册种姓（SCs）条款及认定仅适用于印度教徒、佛教徒和锡克教徒（HBS）。达利特穆斯林和基督教徒（MC）被排除在册种姓类别之外，这使他们失去了与在册种姓身份相关的平权行动福利。本研究旨在探讨这种差别待遇如何可能在印度达利特女性的不同健康结果中发挥作用。
利用连续两次全国代表性调查中177346名年龄在20至49岁之间的达利特女性的数据，我们评估了MC达利特女性和HBS达利特女性患高血压和糖尿病的不同可能性。在考虑出生队列、调查轮次和居住州固定效应以及社会经济状况和心血管代谢风险因素的情况下，我们得出了MC女性患高血压和糖尿病的调整后优势比。为检验我们结果的有效性，我们使用了170889名在册部落（ST）女性的数据进行了类似分析，ST女性是另一个边缘化群体，其ST身份认定与宗教无关。
我们发现，与HBS达利特女性相比，MC达利特女性患高血压和糖尿病的可能性分别高出1.13倍（95%置信区间：1.03 - 1.25）和1.19倍（95%置信区间：1.05 - 1.36）。相反，在ST样本中，MC女性和HBS女性之间未观察到这些疾病的统计学显著差异可能性。
因此，我们的调查表明，宗教和种姓的交叉点可能存在潜在联系，这可能导致印度边缘化女性的健康差距。
