Social Justice Research

, Volume 32, Issue 3, pp 239–254 | Cite as

The Consequences of Social Inequality for the Health and Development of India’s Children: The Case of Caste, Sanitation, and Child Height

  • Melissa LoPalo
  • Diane Coffey
  • Dean SpearsEmail author


The links among social inequality, economic inequality, and health have long been of interest to social scientists, but causal links are difficult to investigate empirically. In particular, studies examining the impact of social status on one’s own health may overlook important effects of inequality on the health of populations as a whole occurring due to negative externalities of social forces. A recent literature on caste, sanitation, and child net nutrition provides an example of one social context where social inequality makes an entire population less healthy. This paper presents new observational analysis of the India Human Development Survey that provides descriptive evidence of this mechanism. We show that, on average, children in rural India are shorter if they live in villages where more people report practicing untouchability—meaning that they enforce caste hierarchies in their interactions with people from the lowest castes. This association is explained by the association between casteism and the prevalence of rural open defecation.


Social inequality Health Height India Caste Sanitation Open defecation 



Separately from this project, Coffey and Spears have received research funding from the NIH, the IGC, and the Bill and Melinda Gates Foundation. Funding was provided by National Institute of Child Health and Human Development (Grant No. P2CHD042849).

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Human and Animal Rights

This article does not contain any studies with human participants performed by any of the authors, because the IHDS data that we received online are anonymous.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.University of Texas at AustinAustinUSA
  2. 2.Economics and Planning Unit, Indian Statistical Institute – Delhi CentreDelhiIndia

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