PMID- 21408084
OWN - NLM
STAT- MEDLINE
DCOM- 20110622
LR  - 20240324
IS  - 1549-1676 (Electronic)
IS  - 1549-1277 (Print)
IS  - 1549-1277 (Linking)
VI  - 8
IP  - 3
DP  - 2011 Mar
TI  - Is economic growth associated with reduction in child undernutrition in India?
PG  - e1000424
LID - 10.1371/journal.pmed.1000424 [doi]
LID - e1000424
AB  - BACKGROUND: Economic growth is widely perceived as a major policy instrument in 
      reducing childhood undernutrition in India. We assessed the association between 
      changes in state per capita income and the risk of undernutrition among children 
      in India. METHODS AND FINDINGS: Data for this analysis came from three 
      cross-sectional waves of the National Family Health Survey (NFHS) conducted in 
      1992-93, 1998-99, and 2005-06 in India. The sample sizes in the three waves were 
      33,816, 30,383, and 28,876 children, respectively. After excluding observations 
      missing on the child anthropometric measures and the independent variables 
      included in the study, the analytic sample size was 28,066, 26,121, and 23,139, 
      respectively, with a pooled sample size of 77,326 children. The proportion of 
      missing data was 12%-20%. The outcomes were underweight, stunting, and wasting, 
      defined as more than two standard deviations below the World Health 
      Organization-determined median scores by age and gender. We also examined severe 
      underweight, severe stunting, and severe wasting. The main exposure of interest 
      was per capita income at the state level at each survey period measured as per 
      capita net state domestic product measured in 2008 prices. We estimated fixed and 
      random effects logistic models that accounted for the clustering of the data. In 
      models that did not account for survey-period effects, there appeared to be an 
      inverse association between state economic growth and risk of undernutrition 
      among children. However, in models accounting for data structure related to 
      repeated cross-sectional design through survey period effects, state economic 
      growth was not associated with the risk of underweight (OR 1.01, 95% CI 0.98, 
      1.04), stunting (OR 1.02, 95% CI 0.99, 1.05), and wasting (OR 0.99, 95% CI 0.96, 
      1.02). Adjustment for demographic and socioeconomic covariates did not alter 
      these estimates. Similar patterns were observed for severe undernutrition 
      outcomes. CONCLUSIONS: We failed to find consistent evidence that economic growth 
      leads to reduction in childhood undernutrition in India. Direct investments in 
      appropriate health interventions may be necessary to reduce childhood 
      undernutrition in India. Please see later in the article for the Editors' 
      Summary.
FAU - Subramanyam, Malavika A
AU  - Subramanyam MA
AD  - Center for Integrative Approaches to Health Disparities, School of Public Health, 
      University of Michigan, Ann Arbor, MI, USA. svsubram@hsph.harvard.edu
FAU - Kawachi, Ichiro
AU  - Kawachi I
FAU - Berkman, Lisa F
AU  - Berkman LF
FAU - Subramanian, S V
AU  - Subramanian SV
LA  - eng
GR  - K25 HL081275/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20110308
PL  - United States
TA  - PLoS Med
JT  - PLoS medicine
JID - 101231360
SB  - IM
CIN - PLoS Med. 2011 Mar;8(3):e1000426. PMID: 21423585
MH  - Body Height
MH  - Child, Preschool
MH  - Cross-Sectional Studies
MH  - *Economic Development
MH  - Female
MH  - Gross Domestic Product
MH  - Growth Disorders/economics/*epidemiology
MH  - Health Surveys
MH  - Humans
MH  - *Income
MH  - India
MH  - Infant
MH  - Logistic Models
MH  - Male
MH  - Malnutrition/complications/economics/*epidemiology
MH  - *Nutritional Status
MH  - Prevalence
MH  - Risk Factors
MH  - Thinness/economics/*epidemiology/etiology
MH  - Wasting Syndrome/economics/*epidemiology
PMC - PMC3050933
COIS- The authors have declared that no competing interests exist.
EDAT- 2011/03/17 06:00
MHDA- 2011/06/23 06:00
PMCR- 2011/03/08
CRDT- 2011/03/17 06:00
PHST- 2010/05/18 00:00 [received]
PHST- 2011/01/25 00:00 [accepted]
PHST- 2011/03/17 06:00 [entrez]
PHST- 2011/03/17 06:00 [pubmed]
PHST- 2011/06/23 06:00 [medline]
PHST- 2011/03/08 00:00 [pmc-release]
AID - 10-PLME-RA-5009R4 [pii]
AID - 10.1371/journal.pmed.1000424 [doi]
PST - ppublish
SO  - PLoS Med. 2011 Mar;8(3):e1000424. doi: 10.1371/journal.pmed.1000424. Epub 2011 
      Mar 8.