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Year : 2011  |  Volume : 133  |  Issue : 6  |  Page : 685-686

Economic growth & health of poor children in India

1 Department of Society, Human Development & Health, Harvard School of Public Health, USA
2 Center for Integrative Approaches to Health Disparities, School of Public Health, University of Michigan, USA

Date of Web Publication5-Jul-2011

Correspondence Address:
S V Subramanian
Associate Professor, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115
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Source of Support: None, Conflict of Interest: None

PMID: 21727672

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How to cite this article:
Subramanian S V, Subramanyam MA. Economic growth & health of poor children in India. Indian J Med Res 2011;133:685-6

How to cite this URL:
Subramanian S V, Subramanyam MA. Economic growth & health of poor children in India. Indian J Med Res [serial online] 2011 [cited 2021 Aug 3];133:685-6. Available from:


The prevailing wisdom to improve the health of Indians, as repeatedly emphasized by the Prime Minister of India Dr Manmohan Singh [1] , is based on economic growth. Can India rely solely on the trickle-down process of economic growth to improve the health of its population, especially its children from socio-economically disadvantaged backgrounds? India experienced substantial economic growth with an average growth rate of 6.4 per cent between 1992/93 and 2005/06 [2] , with approximately a 50 per cent increase in its growth rate. During the same time, the decrease in the prevalence of underweight among children was sluggish with negligible reductions especially in the poorest quintile of household wealth [Figure 1]. At the ecological level, there was no association between per cent increase in per capita income of the state and per cent change in underweight among children in the poorest wealth quintile [Figure 2]. This appears to be in line with a recently published study [3] that examined and found no effect of economic growth on the child's risk of being undernourished in data pooled across all wealth quintiles.
Figure 1: Weighted prevalence of underweight among Indian children aged 0 to 36 months by quintiles of household wealth in 1992/93 and 2005/06. Source: Authors' calculation using data from the Indian National Family Health Surveys of 1992-938 and 2004-059.

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Figure 2: State level ecological association between per cent increase in state per capita income and per cent change in child underweight prevalence between 1992/93 and 2005/06 among Indian children aged 0 to 36 months in the poorest wealth quintiles. Source: Authors' calculation using data from the Indian National Family Health Surveys of 1992-938 and 2004-059. Rate of change calculated using formula: [(value in 2004-05 minus value in 1992-93) / value in 1992-93)] and expressed as a percentage.

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As the economist-philosopher Amartya Sen continues to remind us, economic growth is neither a necessary nor a sufficient condition to improve population health [4] . The discussion of the merits of economic growth as a primary policy instrument to improving the health of the poor has to also consider the questions of what type of economic growth is needed, i.e., is the process generating growth 'inclusive' involving and benefiting all sections (especially its poorer citizens) of the society; and how are the anticipated increases in public revenue that accrues as a result of economic growth being allocated to different programmes? Existing evidence for an inclusive economic growth [5] , or for increased public spending on health [6] , in India is, however, not encouraging. Taken together, the evidence suggests that sole reliance on economic growth as a policy instrument may not be sufficient to reduce the burden of poor health among children from disadvantaged households in India. Simultaneous and direct health investments may be necessary to reduce the high levels of child undernutrition in India, especially given the strong intergenerational effects of poor nutrition in India [6] . [9]

   References Top

1.Zakaria F. GPS: Interview with Manmohan Singh. Available from: 01.html, accessed on February 3, 2011.  Back to cited text no. 1
2.Basu K, Maertens A. The pattern and causes of economic growth in India. Oxford Rev Econ Policy 2007; 23 : 143-67.  Back to cited text no. 2
3.Subramanyam MA, Kawachi I, Berkman LF, Subramanian SV. Is economic growth associated with reduction in child undernutrition in India? PLoS Med 2011; 8 : e1000424.  Back to cited text no. 3
4.Sen A. Learning from others. Lancet 2011; 377 : 200-1.  Back to cited text no. 4
5.Dev MS, Ravi C. Poverty and Inequality: All-India and States, 1983-2005. Econ Polit Wkly 2007; 42 : 509-21.  Back to cited text no. 5
6.Kumar AS, Chen LC, Choudhury M, Ganju S, Mahajan V, Sinha A, et al. Financing health care for all: challenges and opportunities. Lancet 2011; 377 : 668-79.  Back to cited text no. 6
7.Subramanian SV, Ackerson LK, Davey Smith G. Parental BMI and childhood undernutrition in India: an assessment of intrauterine influence. Pediatrics 2010; 126 : e663-71.  Back to cited text no. 7
8.IIPS. National Family Health Survey (MCH and Family Planning), India 1992-93. Bombay: International Institute for Population Sciences;1995.  Back to cited text no. 8
9.IIPS. Macro-International (2007) National Family Health Survey (NFHS-3), 2005-2006: India:, vol. I. Mumbai: International Institute for Population Sciences; 2007.  Back to cited text no. 9


  [Figure 1], [Figure 2]


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