Socioeconomic gradients in early childhood health: evidence from Bangladesh and Nepal.

Satis Devkota,Bibhudutta Panda

doi:10.1186/s12939-016-0364-2

Abstract

BackgroundA large literature has developed researching the origins of socioeconomic gradients in child health in developed countries. Particularly, this research examines the age at which these gradient effects emerge and how they change across different stages of childhood. However, similar research on developing countries is limited.MethodsThis paper examines the socioeconomic gradients in early childhood health in two developing countries, Bangladesh and Nepal using the 2011 Demographic and Health Surveys. The paper separately studies two measures of household socioeconomic status: household wealth and maternal educational attainment. Two anthropometric measures of early childhood health, height-for-age and weight-for-age Z scores for 0–59 months of children, are used for our empirical exercise. The paper uses both non-parametric and multivariate ordinary least squares approaches to examine at what age socioeconomic disparities in health emerge, and investigates if these disparities increase with age in early childhood.ResultsThe paper provides significant evidence of age-specific socioeconomic gradients in early childhood health in both countries. Health disparities in household wealth exist in both countries. This disparity emerges in the first 11 months of life, and is particularly severe for children from the poorest quintile. On the other hand, while the emergence of maternal education gradients during the first 11 months is sensitive to the choice of childhood health measure, the study finds the children of mothers with higher education to enjoy significantly higher health outcomes in comparison to those with lower education. However, controlling for father’s education weakens the effects of maternal education on child health in both countries. Further, the paper does not find statistically significant evidence where socioeconomic gradients in health increase with age in early childhood.ConclusionsOur study concludes that socioeconomic disparities in health outcomes exist even in very early childhood in Bangladesh and Nepal. This has important implications for targeted policy interventions in the form of food security and nutrition supplement programs, free provision of health care, and maternal education in both countries.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-016-0364-2) contains supplementary material, which is available to authorized users.

Highlights

A large literature has developed researching the origins of socioeconomic gradients in child health in developed countries
A large literature has evolved researching the origins of socioeconomic gradients in child health, examining the age at which these gradient effects emerge and how they change across different stages of childhood
Given that our analysis focuses on the children up to 59 months, it is unlikely that childhood health would directly contribute to household wealth via its effect on the earning potential of the child

Summary

Introduction

A large literature has developed researching the origins of socioeconomic gradients in child health in developed countries. A large literature has evolved researching the origins of socioeconomic gradients in child health, examining the age at which these gradient effects emerge and how they change across different stages of childhood. Case et al [1] and Currie and Stabile [5] found that the effect of household income on child health accumulates with age in the U.S and Canada, respectively. In other words, this effect is stronger among

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