ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Data for Research into Health Inequality in India

Do We Have Enough?

India has a long history of collecting data on population and health, but it is neither integrated nor systematic, especially in small geographical areas. The National Population Register should be completed, completeness of the coverage of the Civil Registration System should be ensured, and their linkage should be established with census and other household surveys in India to document health disparities by class, caste, and region.

The authors are grateful to the anonymous reviewer for constructive comments on the earlier version of this article.

Since the initiation of the millennium development goals (MDGs), India has become a locus of global health research, because its enormous population can let it play a major role in shaping global health indicators, and because health inequality across class, caste, religion, and regions is extreme. Health inequality is the main challenge for national and subnational public health policies. Special policies and programmes have been introduced over the years to address the health needs of backward regions and socio-economically deprived populations. In the light of these policies and programmes, demographers, public health researchers, and other social scientists are continually attempting to assess the tempo and quantum of health inequality.

What do we know of the magnitude of health inequality in India? Life expectancy at birth (LEB), a basic measurement of health inequality, varies from 77.9 years in rural Kerala to 64.1 years in rural Assam over the 2009–13 period (Office of Registrar General India 2014). Similarly, the child mortality rate (4q1) among mothers with no education is more than 10 times the child mortality among mothers with 12 years of schooling (IIPS 2007). However, do we know (i) What is the life expectancy gap between a high-caste woman in a well-off family in urban Kerala and a woman from a deprived caste and poor family in rural Uttar Pradesh? (ii) What are the adult mortality rates in districts of India? (iii) What causes the unacceptably high adult mortality in the north-eastern state of Assam? (iv) Does the burden of non-communicable disease (NCD) fall disproportionately across different socio-economic groups in India? (v) What are the predominant causes of death among the urban poor in India? Unfortunately, after almost 69 years of independence, these basic questions remain largely unanswered due to the lack of high quality data at appropriate levels of disaggregation.

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