|The mortality divide in India: The differential
contributions of gender, caste, and standard
of living across the life course|
||Subramanian, S.V., S. Nandy, M. Irving, D. Gordon, H. Lambert, G.D.Smith
||American Journal of Public Health, Vol 96, Num 5, Page: 818-825
||Objectives. We investigated the contributions of gender, caste, and standard of
living to inequalities in mortality across the life course in India.
Methods. We conducted a multilevel cross-sectional analysis of individual mortality,
using the 1998–1999 Indian National Family Health Survey data for 529321
individuals from 26 states.
Results. Substantial mortality differentials were observed between the lowest
and highest standard-of-living quintiles across all age groups, ranging from an
odds ratio (OR) of 4.61 (95% confidence interval [CI]=2.98, 7.13) in the age group
2 to 5 years to an OR of 1.97 (95% CI=1.68, 2.32) in the age group 45 to 64 years.
Excess mortality for girls was evident only for the age group 2 to 5 years (OR=1.33,
95% CI=1.13, 1.58). Substantial caste differentials were observed at the beginning
and end stages of life. Area variation in mortality is partially a result of the compositional
effects of household standard of living and caste.
Conclusions. The mortality burden, across the life course in India, falls disproportionately
on economically disadvantaged and lower-caste groups. Residual
state-level variation in mortality suggests an underlying ecology to the mortality
divide in India. (