Both women’s status and children’s health in South Asia are abysmal. Can a well-defined link be established from women’s status to child health? This column presents results of a study that uses variation in the status of women in joint rural households to show that children born to lower status daughters-in-law are shorter than those born to higher status daughters-in-law, despite there being no apparent difference in pre-marriage characteristics of parents.
In the mid-1990s, Ramalingaswami, Jonsson, and Rohde1 suggested that women’s very low status in South Asian societies likely plays an important role in determining children’s health. Indeed, fifteen years later, both women’s status and children’s health continue to be very poor in South Asia. The under six sex ratio in the 2011 Indian census was 914 girls to 1000 boys, and the most recent nationally representative estimates from India suggest that almost half of children under five years old are stunted, or more than 2 standard deviations shorter than the World Health Organization´s (WHO) international reference norms for healthy children.
Although it is clear that both the situation of women and girls and the state of children’s health in South Asia are abysmal, it has been difficult to establish well-identified links from women´s low status to child health. In this column, I discuss my recent research with Reetika Khera and Dean Spears, which uses variation in the status of women in joint rural households to identify an effect of women´s status on child health. In brief, we find that the children born to lower status daughters-in-law in joint rural households are shorter than those born to higher status daughters-in-law, despite there being no apparent differences in the pre-marriage characteristics of their mothers and fathers.
Women’s status in joint households
The Indian joint household typically consists of older parents, their sons, and the sons´ wives and children. Although the majority of households in rural India today consist of nuclear families, and this has been the case for several decades, joint households are nonetheless common, particularly among households with young children. Indeed, about 11% of children under five in the National Family Health Survey (NFHS) 3 lived in joint households.
Joint households are characterised by patriarchy and by age-hierarchy: women are subordinate to men and younger members are subordinate to older members. Older brothers generally have higher status than younger brothers, and a woman´s status is derived by her husband´s status in the household. Women are expected to display subordinate behaviour when they are in their husbands´ homes.
Women married to a younger brother are expected to be particularly modest and self-effacing, especially in front of senior males. In many families, these women are expected to veil their faces, sit on the floor, and remain quiet in the presence of their husband’s father and older brothers. While life for the women married to older brothers is certainly not carefree and without displays of subordination, they can be more at ease in the presence of their husband’s younger brothers, and often have authority over the women married to younger brothers.
Lower status of choti bahu despite pre-marriage similarities
In Hindi, the woman married to the younger brother is called the choti bahu, or “small daughter-in-law,” and the woman married to the older brother is called the bari bahu, or “big daughter-in-law.” Although status differences between bari and choti bahus are fairly well accepted in the anthropological and demographic literatures, we found confirmatory evidence for this pattern in large datasets from India.
First, we used the NFHS to show that women married to younger brothers report having less say in household decisions than women married to older brothers. Additionally, we used the India Time Use Survey to show that they also spend less time outside on a normal day than women married to older brothers, suggesting that their mobility is more limited. Finally, the NFHS shows that choti bahus have lower body mass index scores than their higher ranking counterparts.
One might think that perhaps these differences in indicators of women’s status are due to differences in the women before they get married, but we find no evidence of this. Bari and choti bahus have the same amount of education (if anything choti bahus are a bit more educated, likely because they are, on average younger), were married at the same ages and have similar heights. Adult heights, like child heights, are an important indicator of health in childhood, and of genetic height potential. The fact that there are no height differences between bari and choti bahus is an important part of the argument that women’s status is the key difference between bari and choti bahus that leads to a difference in the heights of their children. We likewise check for differences between the children’s fathers2 and find that they also have similar education levels, employment statuses, and heights.
Women’s status and children’s heights
We identify an effect of women´s status on children´s height by comparing children living in the same joint household whose mothers are assigned different social status as a result of their marriage to older or younger brothers. Thus, we are comparing cousins who share much of the same social environments, economic resources, and disease environments, all of which importantly influence child health and child height3. The analysis also takes into account factors specific to the child and their nuclear family (including, of course, the child’s age). We find that children of bari bahus are about a fifth to a third of a standard deviation taller than the children of choti bahus.
Height differences are apparent across the distribution of mothers’ heights, and when comparing children of the same birth order in their nuclear families. For a subsample of the children we can control for characteristics of their fathers; this does not change the result that children of choti bahus are shoter, on average, than children of bari bahus.
Why these findings matter
These findings are important for several reasons. First, they provide causal identification of an effect of women´s status on child height and human capital accumulation. This has been difficult to show both because women’s status is hard to measure, and because poor women’s status often goes along with other things that damage children’s health, like low education. Second, they advance a growing literature documenting that human capital is malleable in early life, which is important since early life health insults have lasting consequences. Third, these findings remind us that households in rural India are not unitary decision makers, which makes policy intervention to reach vulnerable women and children particularly challenging.
- Ramalingaswami, V., U. Jonsson, and J. Rohde (1996). Commentary: The Asian Enigma. The progress of nations, United Nations Children’s Fund.
- Only a subsample of the children’s fathers were interviewed by the NFHS.
- We use fixed effects regressions to control for any aspect about the child´s experience that is shared across cousins.