Gender Discrimination and Excess Female Under-5 Mortality in India: A New Perspective Using Mixed-Sex Twins

Ridhi Kashyap,Julia Behrman

doi:10.1007/s13524-020-00909-0

Abstract

Son preference has been linked to excess female under-5 mortality in India, and considerable literature has explored whether parents invest more resources in sons relative to daughters—which we refer to as explicit discrimination—leading to girls’ poorer health status and, consequently, higher mortality. However, this literature has not adequately controlled for the implicit discrimination processes that sort girls into different types of families (e.g., larger) and at earlier parities. To better address the endogeneity associated with implicit discrimination processes, we explore the association between child sex and postneonatal under-5 mortality using a sample of mixed-sex twins from four waves of the Indian National Family Health Survey. Mixed-sex twins provide a natural experiment that exogenously assigns a boy and a girl to families at the same time, thus controlling for selectivity into having an unwanted female child. We document a sizable impact of explicit discrimination on girls’ excess mortality in India, particularly compared with a placebo analysis in sub-Saharan Africa, where girls have a survival advantage. We also show that explicit discrimination weakened for birth cohorts after the mid-1990s, especially in northern India, but further weakening has stalled since the mid-2000s, thus contributing to understandings of how the micro-processes underlying the female mortality disadvantage have changed over time.

Highlights

Son preference continues to be a defining feature of family life in India, shaping the well-being of Indian women and girls throughout the life course
We propose a novel strategy to better address the endogeneity associated with implicit discrimination processes by leveraging mixed-sex twins as a natural experiment in which both a boy and a girl are assigned to a family at the same time, allowing us to control for implicit discrimination processes, such as differential family selectivity into having an unwanted female child
To better address the endogeneity associated with implicit discrimination processes, we explore the association between child sex and postneonatal under-5 mortality using a sample of mixed-sex twins

Summary

Introduction

Son preference continues to be a defining feature of family life in India, shaping the well-being of Indian women and girls throughout the life course. In seeking to reconcile these mixed findings, which on one hand show a female disadvantage in mortality linked to son preference but weaker evidence for sex differences in resources and anthropometric measures, studies have argued that the female disadvantage is not generalized but rather concentrated among certain subsets of girls, those born at later parities and without brothers These birth order and sibling composition effects have been found both in terms of health inputs and outcomes (Mishra et al 2004; Pande 2003) as well as in mortality (Arnold et al 1998; Muhuri and Preston 1991). Uneven access to technology enabling sex selection may imply that wealthier families are better able to avoid unwanted female births, and girls may be differentially sorted into households with overall fewer resources because these households cannot afford to opt out of having daughters even if sons are preferred (Hu and Schlosser 2015; Kashyap 2019) We rerun our mixed-sex twin fixed-effects models stratifying by number of older sisters because explicit discrimination may be more common in families where there are multiple older sisters (Arnold et al 1998; Mishra et al 2004; Pande 2003)

Results

India Female

Other Regions Female

Sub-Saharan Africa Female

Limitations

Discussion