Caste-based social inequalities and childhood anemia in India: results from the National Family Health Survey (NFHS) 2005–2006

BMC Public Health

Research Article

Priya Vart¹  Ajay Jaglan²  Kashif Shafique³ 

[1] Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;Department of Paediatrics, Medical College Guwahati, Guwahati, India;School of Public Health, Dow University of Health Sciences, Karachi, Pakistan;Institute of Health & Wellbeing, Public Health, University of Glasgow, 1-Lilybank Gardens, Glasgow, UK;

关键词: Caste;    Anemia;    Education;    Wealth;    Children;   

DOI  :  10.1186/s12889-015-1881-4

 received in 2014-09-15, accepted in 2015-05-27,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundCaste is one of the traditional measures of social segregation in India and differs from other indicators as it is both, endogamous and hereditary. Evidence suggests that belonging to lower castes exposes one to social inequalities and affects health adversely. We examined the association of caste with childhood anemia in India and explored the effect modifying role of adult education and household wealth.MethodsA cross-sectional analysis of National Family Health Survey (NFHS) data of 43,484 children aged 6–59 months was performed. Poisson regression analysis was conducted to study the association between caste and childhood anemia accounting for various maternal, child, and household related variables. Caste was categorized as “other caste” (least disadvantageous), “other backward caste”, “scheduled tribe” and “scheduled caste” (most disadvantageous). Anemia was defined as mild (hemoglobin level 7-11 g/dL), moderate (hemoglobin level 5-7 g/dL) and severe (hemoglobin level <5 g/dL).ResultsWe found that children in scheduled caste had higher risk of having anemia [mild anemia: RR = 1.10, 95 % CI = 1.05-1.15; moderate anemia: RR = 1.19, 95 % CI = 1.14–1.24; severe anemia: RR = 1.87, 95 % CI = 1.51 – 2.31] after accounting for child, maternal and household covariates including adult education and household wealth. The interaction of caste with adult education and household wealth was not statistically significant for any level of anemia. Sensitivity analyses for children born to mothers of age ≥ 18 years at first child birth and body mass index (BMI) ≥ 18.5 kg/m2, resulted in similar findings.ConclusionCaste is an independent determinant of childhood anemia in India. The level of adult education and household wealth did not modify the association between caste and childhood anemia. The findings may be used for countering childhood anemia and it may be beneficial to target future public health actions towards disadvantageous castes in India.

【 授权许可】

Unknown   
© Vart et al. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.