The Consequences of Social Inequality for the Health and Development of India’s Children: The Case of Caste, Sanitation, and Child Height

The links among social inequality, economic inequality, and health have long been of interest to social scientists, but causal links are difficult to investigate empirically. In particular, studies examining the impact of social status on one’s own health may overlook important effects of inequality on the health of populations as a whole occurring due to negative externalities of social forces. A recent literature on caste, sanitation, and child net nutrition provides an example of one social context where social inequality makes an entire population less healthy. This paper presents new observational analysis of the India Human Development Survey that provides descriptive evidence of this mechanism. We show that, on average, children in rural India are shorter if they live in villages where more people report practicing untouchability—meaning that they enforce caste hierarchies in their interactions with people from the lowest castes. This association is explained by the association between casteism and the prevalence of rural open defecation.