Female house ownership drives the positive association between matriliny and women's health in Meghalaya (India)

Matrilineal kinship, which traces descent through the mother's lineage, has been shown to have health benefits for both women and children, but the specific practices by which matriliny enhances female health outcomes remain unclear. In this study, we analyzed the 2015 Demographic and Health Survey data from Meghalaya, India (4,109 women, 809 men, 3,197 children), a region where matrilineal and non-matrilineal communities coexist with a mixed combination of post-marital residence and inheritance transmission. We considered two practices usually associated with matrilineal systems (i) female house ownership and (ii) matrilocal post-marital residence. We find no evidence for improved health with spatial proximity with kin. Instead, we demonstrate that female (vs. male) ownership correlates with substantial health benefits for women, including reduced risks of being anemic (OR = 0.72, SE = 0.093, p < 0.001) and underweight (OR = 0.59, SE = 0.135, p < 0.001), for men, albeit to a lesser extent, and for children. Boys and girls living in households owned by women are more likely to receive medical care when sick (+200 %). The associations between female house ownership and better health outcomes remain after adjusting for age, wealth disparities, geographical area, fertility, or time since last birth. These results suggest that in Meghalaya, female economic status is a key pathway for explaining diversity in health outcomes, providing novel insights to bridge the gender health gap.