Is Economic Growth Associated with Reduction in Child Undernutrition in India?
Publication Date
March 08, 2011
Journal
PLOS Medicine
Authors
Malavika A. Subramanyam, Ichiro Kawachi, Lisa F. Berkman & S. V. Subramanian
Volume
8
Issue
3
Pages
e1000424
DOI
https://dx.plos.org/10.1371/journal.pmed.1000424
Publisher URL
http://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1000424
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/21408084
PubMed Central
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050933
Europe PMC
http://europepmc.org/abstract/MED/21408084
Web of Science
000288945200005
Scopus
79953700583
Mendeley
http://www.mendeley.com/research/economic-growth-associated-reduction-child-undernutrition-india-1
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Mendeley | Further Information

{"title"=>"Is economic growth associated with reduction in child undernutrition in India?", "type"=>"journal", "authors"=>[{"first_name"=>"Malavika A.", "last_name"=>"Subramanyam", "scopus_author_id"=>"15059569000"}, {"first_name"=>"Ichiro", "last_name"=>"Kawachi", "scopus_author_id"=>"7103096477"}, {"first_name"=>"Lisa F.", "last_name"=>"Berkman", "scopus_author_id"=>"7005551894"}, {"first_name"=>"S. V.", "last_name"=>"Subramanian", "scopus_author_id"=>"55433328900"}], "year"=>2011, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491277", "scopus"=>"2-s2.0-79953700583", "sgr"=>"79953700583", "pui"=>"361559652", "isbn"=>"1549-1277", "pmid"=>"21408084", "doi"=>"10.1371/journal.pmed.1000424"}, "id"=>"3cf7c604-0f3c-3fa3-94f7-96c8ca137519", "abstract"=>"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.\\n\\nMETHODS 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.\\n\\nCONCLUSIONS: 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.", "link"=>"http://www.mendeley.com/research/economic-growth-associated-reduction-child-undernutrition-india-1", "reader_count"=>105, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>4, "Librarian"=>1, "Researcher"=>17, "Student > Doctoral Student"=>8, "Student > Ph. D. Student"=>29, "Student > Postgraduate"=>6, "Student > Master"=>18, "Other"=>3, "Student > Bachelor"=>7, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>3, "Professor"=>4}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>4, "Librarian"=>1, "Researcher"=>17, "Student > Doctoral Student"=>8, "Student > Ph. D. Student"=>29, "Student > Postgraduate"=>6, "Student > Master"=>18, "Other"=>3, "Student > Bachelor"=>7, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>3, "Professor"=>4}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Environmental Science"=>2, "Nursing and Health Professions"=>3, "Medicine and Dentistry"=>25, "Agricultural and Biological Sciences"=>12, "Arts and Humanities"=>3, "Business, Management and Accounting"=>4, "Psychology"=>3, "Social Sciences"=>30, "Earth and Planetary Sciences"=>1, "Economics, Econometrics and Finance"=>19}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>25}, "Social Sciences"=>{"Social Sciences"=>30}, "Psychology"=>{"Psychology"=>3}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>19}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>12}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>4}, "Unspecified"=>{"Unspecified"=>3}, "Environmental Science"=>{"Environmental Science"=>2}, "Arts and Humanities"=>{"Arts and Humanities"=>3}}, "reader_count_by_country"=>{"Canada"=>1, "United States"=>2, "Mexico"=>1, "United Kingdom"=>1, "Germany"=>1, "India"=>3}, "group_count"=>2}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/793066"], "description"=>"<p>All estimates conditional on random effects.</p>", "links"=>[], "tags"=>["ratios", "associations", "sociodemographic", "factors", "indicators", "undernutrition", "from", "multilevel", "logistic"], "article_id"=>463424, "categories"=>["Medicine", "Cancer"], "users"=>["Malavika A. Subramanyam", "Ichiro Kawachi", "Lisa F. Berkman", "S. V. Subramanian"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000424.t006", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Odds_ratios_95_confidence_intervals_for_associations____between_sociodemographic_factors_and_indicators_of_undernutrition_from____multilevel_logistic_models_/463424", "title"=>"Odds ratios (95% confidence intervals) for associations\n between sociodemographic factors and indicators of undernutrition from\n multilevel logistic models.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-03-08 00:57:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/793111"], "description"=>"<p>All estimates conditional on random effects.</p><p>*Additionally adjusted for state as <i>random</i>\n effect.</p><p>**Adjusted for state (as <i>random</i> effect),\n survey year, age, sex, birth order, maternal age, marital status,\n maternal education, paternal education, household wealth, caste,\n religion, and urban/rural residence.</p>", "links"=>[], "tags"=>["ratios", "associations", "inr", "indicators", "undernutrition", "multilevel", "logistic", "models", "24", "states"], "article_id"=>463469, "categories"=>["Medicine", "Cancer"], "users"=>["Malavika A. Subramanyam", "Ichiro Kawachi", "Lisa F. Berkman", "S. V. Subramanian"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000424.t005", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Odds_ratios_95_confidence_intervals_for_associations____between_economic_growth_in_5_000_INR_over_a_6_5_year_period_and_indicators____of_undernutrition_from_multilevel_logistic_models_using_data_from_24_states____in_1998_8211_99_and_2004_8211_05_/463469", "title"=>"Odds ratios (95% confidence intervals) for associations\n between economic growth (in 5,000 INR over a 6.5-year period) and indicators\n of undernutrition from multilevel logistic models (using data from 24 states\n in 1998–99 and 2004–05).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-03-08 00:57:49"}
  • {"files"=>["https://ndownloader.figshare.com/files/793218"], "description"=>"<p>Change  =  Slope of change in PCSDP in\n Indian Rupees per year, over the 1993–2005 period.</p>", "links"=>[], "tags"=>["2005", "change", "1993", "capita", "2008", "indian"], "article_id"=>463579, "categories"=>["Medicine", "Cancer"], "users"=>["Malavika A. Subramanyam", "Ichiro Kawachi", "Lisa F. Berkman", "S. V. Subramanian"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000424.t002", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_State_wise_distribution_in_1993_1999_and_2005_of_and_rate_of_change____between_1993_and_2005_in_per_capita_net_state_domestic_product_calculated____in_2008_Indian_Rupees_/463579", "title"=>"State-wise distribution in 1993, 1999, and 2005 of, and rate of change\n between 1993 and 2005 in, per capita net state domestic product (calculated\n in 2008 Indian Rupees).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-03-08 00:59:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/793145"], "description"=>"a<p>Level and change in per capita income measured in 5,000 INR. Percent\n change in per capita income measured in units of 60 percentage\n units.</p>b<p>None  =  Includes state random effects.\n All  =  Age, gender, birth order,\n maternal age, maternal education, paternal education, religion, caste,\n urban residence, marital status, household wealth.</p>c<p>Beta(s.e.) or OR (95% CI).</p><p>*<i>p</i><0.05,</p><p>**<i>p</i><0.01,</p><p>***<i>p</i><0.001.</p>", "links"=>[], "tags"=>["multilevel", "models", "examining", "of", "capita"], "article_id"=>463511, "categories"=>["Medicine", "Cancer"], "users"=>["Malavika A. Subramanyam", "Ichiro Kawachi", "Lisa F. Berkman", "S. V. Subramanian"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000424.t004", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Results_of_ecological_and_multilevel_models_examining_the_association_of____economic_growth_or_per_capita_income_with_underweight_/463511", "title"=>"Results of ecological and multilevel models examining the association of\n economic growth or per capita income with underweight.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-03-08 00:58:31"}
  • {"files"=>["https://ndownloader.figshare.com/files/792867"], "description"=>"<p>Scheme of application of exclusion criteria to data from the three\n rounds of Indian NFHS surveys (1992–93, 1998–99, and\n 2005–06).</p>", "links"=>[], "tags"=>["exclusion", "three", "rounds", "indian", "nfhs", "surveys", "and"], "article_id"=>463232, "categories"=>["Medicine", "Cancer"], "users"=>["Malavika A. Subramanyam", "Ichiro Kawachi", "Lisa F. Berkman", "S. V. Subramanian"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000424.g002", "stats"=>{"downloads"=>1, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Scheme_of_application_of_exclusion_criteria_to_data_from_the_three____rounds_of_Indian_NFHS_surveys_1992_8211_93_1998_8211_99_and____2005_8211_06_/463232", "title"=>"Scheme of application of exclusion criteria to data from the three\n rounds of Indian NFHS surveys (1992–93, 1998–99, and\n 2005–06).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-03-08 00:53:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/396613", "https://ndownloader.figshare.com/files/396670", "https://ndownloader.figshare.com/files/396702", "https://ndownloader.figshare.com/files/396745", "https://ndownloader.figshare.com/files/396794", "https://ndownloader.figshare.com/files/396834"], "description"=>"<div><h3>Background</h3><p>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.</p> <h3>Methods and Findings</h3><p>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.</p> <h3>Conclusions</h3><p>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.</p> <h3></h3><p> <em>Please see later in the article for the Editors' Summary</em></p> </div>", "links"=>[], "tags"=>["undernutrition"], "article_id"=>138351, "categories"=>["Medicine", "Cancer"], "users"=>["Malavika A. Subramanyam", "Ichiro Kawachi", "Lisa F. Berkman", "S. V. Subramanian"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000424.s001", "https://dx.doi.org/10.1371/journal.pmed.1000424.s002", "https://dx.doi.org/10.1371/journal.pmed.1000424.s003", "https://dx.doi.org/10.1371/journal.pmed.1000424.s004", "https://dx.doi.org/10.1371/journal.pmed.1000424.s005", "https://dx.doi.org/10.1371/journal.pmed.1000424.s006"], "stats"=>{"downloads"=>6, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Is_Economic_Growth_Associated_with_Reduction_in_Child_Undernutrition___in_India_/138351", "title"=>"Is Economic Growth Associated with Reduction in Child Undernutrition\n in India?", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2011-03-08 02:19:11"}
  • {"files"=>["https://ndownloader.figshare.com/files/793245"], "description"=>"<p>Economic growth  =  Slope of change in\n PCSDP (Indian Rupees) per year, over the 1993–2005 period.</p><p>*Change  =  (Prevalence in\n 2005– prevalence in 1992)/13, in percentage point units.</p>", "links"=>[], "tags"=>["prevalence", "correlations", "children", "states", "india"], "article_id"=>463616, "categories"=>["Medicine", "Cancer"], "users"=>["Malavika A. Subramanyam", "Ichiro Kawachi", "Lisa F. Berkman", "S. V. Subramanian"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000424.t001", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Weighted_prevalence_of_and_rate_of_change_in____underweight_stunting_and_wasting_with_correlations_with_economic_growth____among_children_under_age_3_for_the_states_of_India_in_1992_8211_93____1998_8211_99_and_2005_8211_06_/463616", "title"=>"Weighted prevalence (%) of, and rate of change in,\n underweight, stunting, and wasting, with correlations with economic growth,\n among children under age 3, for the states of India in 1992–93,\n 1998–99, and 2005–06.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-03-08 01:00:16"}
  • {"files"=>["https://ndownloader.figshare.com/files/792981"], "description"=>"<p>Error bars are 95% confidence intervals.</p>", "links"=>[], "tags"=>["prevalence", "wasting"], "article_id"=>463353, "categories"=>["Medicine", "Cancer"], "users"=>["Malavika A. Subramanyam", "Ichiro Kawachi", "Lisa F. Berkman", "S. V. Subramanian"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000424.g003", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Weighted_prevalence_of_underweight_stunting_and_wasting____in_1992_1998_and_2005_/463353", "title"=>"Weighted prevalence (%) of underweight, stunting, and wasting\n in 1992, 1998, and 2005.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-03-08 00:55:53"}
  • {"files"=>["https://ndownloader.figshare.com/files/793180"], "description"=>"<p>All estimates conditional on random effects.</p>a<p>Additionally adjusted for state as <i>random</i> effect.</p>b<p>Adjusted for state (as <i>random</i> effect), survey year, age,\n sex, birth order, maternal age, marital status, maternal education,\n paternal education, household wealth, caste, religion, and urban/rural\n residence.</p>c<p>Adjusted for state (as <i>fixed</i> effect), survey year, age,\n sex, birth order, maternal age, marital status, maternal education,\n paternal education, household wealth, caste, religion, and urban/rural\n residence.</p>", "links"=>[], "tags"=>["ratios", "associations", "inr", "indicators", "undernutrition", "multilevel", "logistic"], "article_id"=>463543, "categories"=>["Medicine", "Cancer"], "users"=>["Malavika A. Subramanyam", "Ichiro Kawachi", "Lisa F. Berkman", "S. V. Subramanian"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000424.t003", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Odds_ratios_95_confidence_intervals_for_associations____between_economic_growth_in_5_000_INR_over_a_6_5_year_period_and_indicators____of_undernutrition_from_multilevel_logistic_models_/463543", "title"=>"Odds ratios (95% confidence intervals) for associations\n between economic growth (in 5,000 INR over a 6.5-year period) and indicators\n of undernutrition from multilevel logistic models.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-03-08 00:59:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/792763"], "description"=>"<p>Pathways connecting state-level economic growth and child\n undernutrition.</p>", "links"=>[], "tags"=>["connecting", "state-level", "child"], "article_id"=>463129, "categories"=>["Medicine", "Cancer"], "users"=>["Malavika A. Subramanyam", "Ichiro Kawachi", "Lisa F. Berkman", "S. V. Subramanian"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000424.g001", "stats"=>{"downloads"=>2, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Pathways_connecting_state_level_economic_growth_and_child___undernutrition_/463129", "title"=>"Pathways connecting state-level economic growth and child\n undernutrition.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-03-08 00:52:09"}

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Relative Metric

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