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.
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.
Authors: S V Subramanian; Shailen Nandy; Michelle Irving; David Gordon; George Davey Smith Journal: Bull World Health Organ Date: 2005-11-10 Impact factor: 9.408
Authors: Martijn Huisman; Anton E Kunst; Matthias Bopp; Jens-Kristian Borgan; Carme Borrell; Giuseppe Costa; Patrick Deboosere; Sylvie Gadeyne; Myer Glickman; Chiara Marinacci; Christoph Minder; Enrique Regidor; Tapani Valkonen; Johan P Mackenbach Journal: Lancet Date: 2005 Feb 5-11 Impact factor: 79.321