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Does economic inequality affect child malnutrition? The case of Ecuador

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  • Larrea, Carlos
  • Kawachi, Ichiro

Abstract

Economic inequality has been hypothesized to be a determinant of population health, independent of poverty and household income. We examined the association between economic inequality and child malnutrition in Ecuador. Economic inequality was measured by the Gini coefficient of household per capita consumption, estimated from the 1990 Census. Childhood stunting, assessed from height-for-age z scores, was obtained from the 1998 Living Standards Measurement Survey (LSMS). We controlled for a range of individual and household covariates, including per capita food consumption, education, housing, ethnicity, fertility, access to health services, diarrhea morbidity, child care, mother's age and diet composition. Stunting still affects 26% of children under five in Ecuador, with higher prevalence in the rural Highlands and among indigenous peoples. Maternal education, basic housing conditions, access to health services, ethnicity, fertility, maternal age and diet composition were independently associated with stunting. However, after controlling for relevant covariates, economic inequality at the provincial scale had a statistically significant deleterious effect on stunting. At municipal or local levels, inequality was not associated with stunting.

Suggested Citation

  • Larrea, Carlos & Kawachi, Ichiro, 2005. "Does economic inequality affect child malnutrition? The case of Ecuador," Social Science & Medicine, Elsevier, vol. 60(1), pages 165-178, January.
  • Handle: RePEc:eee:socmed:v:60:y:2005:i:1:p:165-178
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    Cited by:

    1. Farrow, Andrew & Larrea, Carlos & Hyman, Glenn & Lema, German, 2005. "Exploring the spatial variation of food poverty in Ecuador," Food Policy, Elsevier, vol. 30(5-6), pages 510-531.
    2. Mesbah Fathy Sharaf & Ahmed Shoukry Rashad, 2016. "Regional inequalities in child malnutrition in Egypt, Jordan, and Yemen: a Blinder-Oaxaca decomposition analysis," Health Economics Review, Springer, vol. 6(1), pages 1-11, December.
    3. Bhagowalia, Priya & Chen, Susan E. & Masters, William A., 2011. "Effects and determinants of mild underweight among preschool children across countries and over time," Economics & Human Biology, Elsevier, vol. 9(1), pages 66-77, January.
    4. Ahmed Rashad & Mesbah Sharaf, 2017. "Does Maternal Employment Affect Child Nutrition Status? New Evidence From Egypt," Working Papers 1149, Economic Research Forum, revised 11 Jan 2003.
    5. Priya Bhagowalia & Susan E. Chen & William A. Masters, 2008. "The Distribution Of Child Nutritional Status Across Countries And Over Time," Working Papers 08-04, Purdue University, College of Agriculture, Department of Agricultural Economics.
    6. Godoy, Ricardo A. & Reyes-García, Victoria & McDade, Thomas & Huanca, Tomás & Leonard, William R. & Tanner, Susan & Vadez, Vincent, 2006. "Does village inequality in modern income harm the psyche? Anger, fear, sadness, and alcohol consumption in a pre-industrial society," Social Science & Medicine, Elsevier, vol. 63(2), pages 359-372, July.
    7. Agee, Mark D., 2010. "Reducing child malnutrition in Nigeria: Combined effects of income growth and provision of information about mothers' access to health care services," Social Science & Medicine, Elsevier, vol. 71(11), pages 1973-1980, December.
    8. repec:pra:mprapa:59643 is not listed on IDEAS
    9. -, 2010. "Population and health in Latin America and the Caribbean: outstanding matters, new challenges," Libros y Documentos Institucionales, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), number 2946 edited by Eclac, February.
    10. Chowa, Gina & Ansong, David & Masa, Rainier, 2010. "Assets and child well-being in developing countries: A research review," Children and Youth Services Review, Elsevier, vol. 32(11), pages 1508-1519, November.
    11. Sweeney, Stuart & Davenport, Frank & Grace, Kathryn, 2013. "Combining insights from quantile and ordinal regression: Child malnutrition in Guatemala," Economics & Human Biology, Elsevier, vol. 11(2), pages 164-177.
    12. Kondo, Naoki & Kawachi, Ichiro & Subramanian, S.V. & Takeda, Yasuhisa & Yamagata, Zentaro, 2008. "Do social comparisons explain the association between income inequality and health?: Relative deprivation and perceived health among male and female Japanese individuals," Social Science & Medicine, Elsevier, vol. 67(6), pages 982-987, September.
    13. Salti, Nisreen, 2010. "Relative deprivation and mortality in South Africa," Social Science & Medicine, Elsevier, vol. 70(5), pages 720-728, March.
    14. Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
    15. Karlsson, Martin & Nilsson, Therese & Lyttkens, Carl Hampus & Leeson, George, 2010. "Income inequality and health: Importance of a cross-country perspective," Social Science & Medicine, Elsevier, vol. 70(6), pages 875-885, March.
    16. Ragui Assaad & Caroline Krafft & Hanan Nazier & Racha Ramadan & Atiyeh Vahidmanesh & Sami Zouari, 2017. "Estimating Poverty and Inequality in the Absence of Consumption Data: An Application to the Middle East and North Africa," Working Papers 1100, Economic Research Forum, revised 05 2017.
    17. -, 2008. "Millennium development goals: progress towards the right to health in Latin america and the Caribbean," Libros y Documentos Institucionales, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), number 2919 edited by Eclac, February.
    18. Hatt, Laurel E. & Waters, Hugh R., 2006. "Determinants of child morbidity in Latin America: A pooled analysis of interactions between parental education and economic status," Social Science & Medicine, Elsevier, vol. 62(2), pages 375-386, January.
    19. Pickett, Kate E. & Wilkinson, Richard G., 2015. "Income inequality and health: A causal review," Social Science & Medicine, Elsevier, vol. 128(C), pages 316-326.
    20. Bühler, Dorothee & Hartje, Rebecca & Ulrike Grote, 2017. "Can household food security predict individual undernutrition? Evidence from Cambodia and Lao PDR," Hannover Economic Papers (HEP) dp-594, Leibniz Universität Hannover, Wirtschaftswissenschaftliche Fakultät.
    21. Rafael Laurenti & Jagdeep Singh & Rajib Sinha & Josepha Potting & Björn Frostell, 2016. "Unintended Environmental Consequences of Improvement Actions: A Qualitative Analysis of Systems' Structure and Behavior," Systems Research and Behavioral Science, Wiley Blackwell, vol. 33(3), pages 381-399, May.
    22. Paraje, Guillermo, 2009. "Child stunting and and socio-economic inequality in Latin America and the Caribbean," Revista CEPAL, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), December.

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