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Why are adult women missing ? son preference and maternal survival in India

  • Milazzo, Annamaria

This paper is the first to show that excess mortality among adult women can be partly explained by strong preference for male children, the same cultural norm widely known to cause excess mortality before birth or at young ages. Using pooled individual-level data for India, the paper compares the age structure and anemia status of women by the sex of their first-born and uncovers several new findings. First, the share of living women with a first-born girl is a decreasing function of the women's age at the time of the survey. Second, while there are no systematic differences at the time of birth, women with a first-born girl are significantly more likely to develop anemia when young (under the age of 30) and these differences disappear for older women. Moreover, among those in the older age group, they appear to be significantly better off in terms of various predetermined characteristics. These findings are consistent with a selection effect in which maternal and adult mortality is higher for women with first-born girls, especially the poor and uneducated with limited access to health care and prenatal sex diagnostic technologies. To ensure the desired sex composition of children, these women resort to a fertility behavior medically known to increase their risk of death. The observed sex ratios for first births imply that 2.2-8.4 percent of women with first-born girls are'missing'because of son preference between the ages of 30 and 49.

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Paper provided by The World Bank in its series Policy Research Working Paper Series with number 6802.

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Date of creation: 01 Mar 2014
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Handle: RePEc:wbk:wbrwps:6802
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  1. Jason Abrevaya, 2009. "Are There Missing Girls in the United States? Evidence from Birth Data," American Economic Journal: Applied Economics, American Economic Association, vol. 1(2), pages 1-34, April.
  2. Deon Filmer & Jed Friedman & Norbert Schady, 2009. "Development, Modernization, and Childbearing: The Role of Family Sex Composition," World Bank Economic Review, World Bank Group, vol. 23(3), pages 371-398, October.
  3. Silvia Helena Barcellos & Leandro Carvalho & Adriana Lleras-Muney, 2010. "Child Gender and Parental Investments in India: Are Boys and Girls Treated Differently?," Working Papers 756, RAND Corporation Publications Department.
  4. Akbulut-Yuksel, Mevlude & Rosenblum, Daniel, 2012. "The Indian Ultrasound Paradox," IZA Discussion Papers 6273, Institute for the Study of Labor (IZA).
  5. Luojia Hu & Analía Schlosser, 2010. "Prenatal sex selection and girls’ well-being? evidence from India," Working Paper Series WP-2010-11, Federal Reserve Bank of Chicago.
  6. Waldron, Ingrid, 1983. "Sex differences in human mortality: The role of genetic factors," Social Science & Medicine, Elsevier, vol. 17(6), pages 321-333, January.
  7. Daniel Rosenblum, 2013. "The effect of fertility decisions on excess female mortality in India," Journal of Population Economics, Springer, vol. 26(1), pages 147-180, January.
  8. Prashant Bharadwaj & Leah K. Lakdawala, 2013. "Discrimination Begins in the Womb: Evidence of Sex-Selective Prenatal Investments," Journal of Human Resources, University of Wisconsin Press, vol. 48(1), pages 71-113.
  9. Siwan Anderson & Debraj Ray, 2010. "Missing Women: Age and Disease," Review of Economic Studies, Oxford University Press, vol. 77(4), pages 1262-1300.
  10. Jean Drèze & Mamta Murthi, 2001. "Fertility, Education, and Development: Evidence from India," Population and Development Review, The Population Council, Inc., vol. 27(1), pages 33-63.
  11. Stephan Klasen & Sebastian Vollmer, 2013. "Missing Women: Age and Disease: A Correction," Courant Research Centre: Poverty, Equity and Growth - Discussion Papers 133, Courant Research Centre PEG.
  12. Seema Jayachandran & Ilyana Kuziemko, 2011. "Why Do Mothers Breastfeed Girls Less than Boys? Evidence and Implications for Child Health in India," The Quarterly Journal of Economics, Oxford University Press, vol. 126(3), pages 1485-1538.
  13. Milazzo, Annamaria, 2014. "Son preference, fertility and family structure : evidence from reproductive behavior among Nigerian women," Policy Research Working Paper Series 6869, The World Bank.
  14. Shelley Clark, 2000. "Son preference and sex composition of children: Evidence from india," Demography, Springer, vol. 37(1), pages 95-108, February.
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