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The Intersection of Gender, Caste and Class Inequalities in Child Nutrition in

Rural India

Article in Asian Population Studies · January 2015

DOI: 10.1080/17441730.2015.995150

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The Intersection of Gender, Caste and

Class Inequalities in Child Nutrition in
Rural India
Simantini Mukhopadhyay
Published online: 03 Jan 2015.

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 Asian Population Studies, 2014
http://dx.doi.org/10.1080/17441730.2015.995150

THE INTERSECTION OF GENDER, CASTE

AND CLASS INEQUALITIES IN CHILD
NUTRITION IN RURAL INDIA
Downloaded by [Inst of Development Studies], [Simantini Mukhopadhyay] at 21:50 06 January 2015

Simantini Mukhopadhyay

While studies have investigated inequalities in child nutrition along single axes of social power
such as, gender, caste and class, there has not been any study that has examined the intersection
of the different axes in determining nutritional outcomes of children. This paper examines the
intersection of gender, class and caste in determining children’s nutritional outcomes for rural
north, rural south and rural India as a whole. The paper investigates the intersectionality of the
three axes in rural India and focuses on regional differences. The results show that children with
particular disadvantageous group affiliations often find significant compensatory benefits from
other beneficial identities. Class inequality dominates caste inequality and caste inequality
dominates gender inequality in rural North India for all levels of stunting. In contrast, caste
inequality dominates class inequality which in turn dominates gender inequality for severe
stunting in rural South India.

KEYWORDS: child nutrition; gender; caste; class; intersectionality; inequality

Introduction
India accounts for more than one-fifth of global child deaths and about 36 per cent
of underweight children worldwide live in India (UNICEF, 2011). India has one of the
highest levels of child undernutrition—even surpassing the levels in much poorer sub-
Saharan African countries. Based on the 2006 WHO standards, nearly 48 per cent of Indian
children below the age of five are stunted, 43 per cent underweight and 20 per cent
wasted (International Institute of Population Studies [IIPS] & ORC Macro, 2007). About 24,
16 and six per cent of children below the age of five suffer from severe forms of stunting,
underweight and wasting respectively (International Institute of Population Studies [IIPS] &
ORC Macro, 2007). The high levels of undernutrition despite economic growth have
received wide scholarly attention (see, Bharati, Pal, & Bharati, 2008; Borooah, 2005;
Mukhopadhyay, 2013). Studies have also examined the disproportionate burden of
undernutrition borne by the economically weaker groups (Joe, Mishra, & Navaneetham,
2009; Mazumdar, 2010; Mukhopadhyay, 2011) and backward castes (Van de Poel &
Speybroeck, 2009). Gender inequality in nutritional outcomes of children in India has also
been researched with studies showing that while overall nutritional status improved for

© 2014 Taylor & Francis

 2 SIMANTINI MUKHOPADHYAY

children between 1992–93 and 1998–99, substantially greater improvements were seen
for boys relative to girls (Tarozzi & Mahajan, 2007).
Inequality in nutritional outcomes assumes particular significance when it corre-
sponds to group affiliation in which groups are defined, as Subramaniam (2010) notes
‘with an eye to their social, cultural and historical pertinence to the society under review’.
This paper considers three groups: two of the group identities—gender and caste—are
invariant and the third group identity—economic class—serves as a proxy for many other
consequential variables affecting child nutrition (Mazumdar, 2010). Instead of treating
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these axes of social power as three separate dimensions, this study examines the complex
and simultaneous interactions among these three axes and their effect on child nutrition
in India. Applying the broad framework proposed by Sen, Iyer, and Mukherjee (2009), with
certain modifications to suit the Indian context, the study analyses intersectional
inequalities in child nutrition in rural India. The influence of these three axes is examined
in the context of regional—north/south—variations. It is important to consider the
regional dimension as there are key differences in caste, kinship and gender roles in the
two regions. The North Indian kinship system based on village exogamy and lower
autonomy of women is often contrasted with the South Indian kinship system in which
women have greater autonomy (Chakraborty & Kim, 2010; Dyson & Moore, 1983). The
study focuses exclusively on rural children in these two regions. The rates of under-
nutrition are high in rural India and so are levels of poverty. Also inequalities in nutritional
status of children are much starker in rural India compared to urban India. In addition to
investigating intersectionality along the three axes, the study specifically examines
whether children who are disadvantaged in one of the axes can derive any positive
benefits from other advantageous identities.

From Single Axis Framework to Intersectionality

While the last few decades have witnessed a surge in health equity research, most
studies have analysed health inequalities along particular (single) dimensions of social
power, implicitly assuming that these dimensions are inherently separable and mutually
exclusive. There are, however, some studies that have considered the complex interactions
of multiple identities on inequalities (Davis, 2008). Different axes of social power, such as
gender, economic class, ethnicity and caste often operate simultaneously with significant
interactions with each other. Crenshaw (1989) coined the term ‘intersectionality’ to capture
the multifaceted discriminations associated with gender and race. The concept of
intersectionality can be extended beyond gender and race to include any group identity.
In the context of India, while there have been many studies that have applied the ‘single
axis framework’ to measure inequalities in children’s nutritional status along specific
dimensions of social power such as wealth, income or gender (see Das Gupta, 1987; Pande
& Astone, 2007), studies on the intersection of different inequalities in determining child
health outcomes are limited.

The Single-Axis Framework

Several studies have examined inequality in health outcomes across different groups
and in different contexts (Kunst et al., 1994). Kakwani, Wagstaff, and van Doorslaer (1997)
present methods to quantitatively examine health inequalities along specific social
 THE INTERSECTION OF GENDER, CASTE AND CLASS INEQUALITIES 3

dimensions such as socioeconomic status, social class, levels of educational attainment or

income. There are several measures of inequality in health outcomes. Such measures
range from simple statistical tools such as the rate-ratio or the rate-difference in health
outcomes to more sophisticated indices based on ranking, such as the slope index of
inequality, the relative index of inequality, the concentration index, and the extended
concentration index (Wagstaff, Paci, & van Doorslaer, 1991). For India, Joe et al. (2009) have
estimated wealth-related inequality in child undernutrition across the Indian states.
Mukhopadhyay (2011) used a modified version of the concentration index to investigate
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the extent of socioeconomic inequality in children’s nutrition (defined as a composite

concept incorporating the dimensions of level, depth and severity). Tarozzi and Mahajan
(2007) analysed gender differences in nutritional status of young children (0–3 years) in
India and found that while overall nutritional status improved between 1992–93 and
1998–99, boys benefited substantially more than girls. Van de Poel and Speybroeck (2009)
studied the magnitude of caste inequalities in child malnutrition by decomposing the gap
in nutritional outcomes of children by caste and found that children of lower caste and
tribe were particularly disadvantaged.

Intersectionality
A growing body of research has addressed the issue of intersectionality using
qualitative methodologies. These studies have noted that different axes of social power
are interrelated, they intersect and mutually reinforce each other (Collins, 1991; Glenn,
1999; Greene, 1997; Östlin, 2002; Whittle & Inhorn, 2001). Iyer, Sen, and Östlin’s (2008)
study of intersectionality of gender and class in determining health outcomes shows how
a single dimension of inequality is altered when considered in light of intersecting
processes. Recent studies have used the quantitative technique developed by Sen et al.
(2009) to analyse inequalities in healthcare (Sen & Iyer, 2012; Sen et al., 2009; Sen, Iyer, &
George, 2007). As Sen and Iyer (2012) note, many of the quantitative techniques compare
groups at the extreme. While such comparisons might reveal significant differences
between the groups at the extreme, they do not explain the extent of inequality.
Importantly, such techniques would not be suitable for analysing groups in the middle
who while facing certain disadvantages may also benefit from some advantages based on
their group status.

Data and Methods

The analyses presented in this paper are based on the third round of National Family
Health Survey (NFHS-3). NFHS are nationwide surveys conducted with a representative
sample of households. There have been three rounds of NFHS: NFHS-1 (1992–93), NFHS-2
(1998–99) and NFHS-3 (2005–06). The surveys broadly follow the format of Demographic
and Health Surveys (DHS) and use standardised questionnaires, sample designs, and field
procedures. NFHS-3 collected information from a nationally representative sample of
109,041 households, and interviewed 124,385 women age 15–49, and 74,369 men age 15–
54 living in all the 29 states of India. Anthropometric data was collected for 46,655 children
who stayed in the household the night before the interview (see IIPS & ORC Macro, 2007
for further details on survey design and collection).
 4 SIMANTINI MUKHOPADHYAY

Three measures of undernutrition—stunting or low height-for-age, underweight or

low weight-for-age, and wasting or low weight-for-height—are commonly used. These
measures are usually expressed in standard deviation units (z-scores) from the median of
the reference population. Stunting is a cumulative or long-term indicator of nutritional
deprivation from birth. It is relatively independent of current conditions, and is an
indicator of permanent or chronic undernutrition. Wasting, by contrast, measures body
mass in relation to body length and describes current nutritional status. Underweight is a
comprehensive measure, capturing both long-term and short-term dimensions.
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For the analyses, stunting in children is used as measure of child nutrition. As

stunting is a cumulative indicator of child nutrition, it would allow for the examination of
intersectional inequalities over the course of child’s development. The stunting variable
has three categories—not stunted, moderately stunted and severely stunted—to measure
the presence and magnitude of stunting. If the z-score is above minus two standard
deviations (2 SD) from the median of the reference population, the child is considered to
be not stunted. Children below minus three standard deviations (−3 SD) from the median
of the reference population are considered to be severely stunted. Those between −2 SD
and −3 SD from the median of the reference population are considered as moderately
stunted.
The analyses presented in the paper are broadly based on the method developed by
Sen et al. (2009) with certain modifications to suit the context of the study. The method
requires the creation of a set of dummy variables for each intersecting category. With two
dimensions, for example, gender and economic class (taken as a dichotomous variable,
with two classes, poor and non-poor), there would be four categories in the heuristic
matrix: d1 = non-poor men; d2 = non-poor women, d3 = poor men and d4 = poor women.
Treating d1 (non-poor men) as the reference category, each of the dummies (d2, d3
and d4) can be treated as a separate variable and assigned a unique identity. For example,
d2 = 1 if non-poor and women, and 0 otherwise; d3 = 1 if poor and men, and 0 otherwise;
d4 = 1 if poor and women, and 0 otherwise. The differences between the dummies can be
then tested using multivariate analyses. As the dependent variable has three ordered
categories—no, moderate and severe stunting—it is analysed using generalised ordinal
logistic regression. The variable is coded as 1 for severe, 2 for moderate and 3 as no
stunting. The estimates are based on gologit procedure in STATA.
The model includes a number of covariates that have been shown to have an
impact on child nutrition (Charmarbagwala, Ranger, Waddington, & White, 2004). Child-
specific factors include age and birth order. Maternal factors include mother’s health
(measured using BMI—mothers with BMI of less than 18.5 and the rest), age at child birth
(classified into three categories: less than 20, between 20 and 30, and more than 30) and
education. The analyses also includes community covariates for water, sanitation and child
health facilities. For water and sanitation, villages are classified into two categories based
on whether at least 50 per cent of the households in the village have piped drinking water
or toilet facilities. Presence of an Integrated Child Development Services (ICDS) facility is
used as a measure of availability of health facility. ICDS facilities typically provide
nutritional and health support for pregnant women and children below the age of six.
Economic status is measured using a dichotomous variable with poor and non-poor
as categories. Those in the bottom two wealth quantiles are considered poor and the rest
as non-poor. For caste, Scheduled Caste and Scheduled Tribes (SC/ST) are combined and
compared with the other caste groups. Region is classified as north and south based on
 THE INTERSECTION OF GENDER, CASTE AND CLASS INEQUALITIES 5

Jayaraj and Subramaniam (2010). North includes the states of Jammu and Kashmir, Punjab,
Himachal Pradesh, Uttaranchal, Haryana, Delhi, Rajasthan, Gujarat, Madhya Pradesh, Uttar
Pradesh, Bihar, Jharkhand, West Bengal, Chhattisgarh, Orissa, Sikkim, Meghalaya, Manipur,
Mizoram, Tripura, Nagaland, Assam, Arunachal Pradesh and south includes the states of
Andhra Pradesh, Karnataka, Kerala, Maharashtra, Goa and Tamil Nadu).
To analyse the intersection of the three axes—gender, caste, class—eight groups are
compared. These groups are: poor SC/ST boys (PSB), poor SC/ST girls (PSG), poor other
boys (POB), poor other girls (POG), non-poor SC/ST boys (NBSB), non-poor SC/ST girls
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(NPSG), non-poor other boys (NPOB) and non-poor other girls (NPOG).There are 8C2 = 28
pair-wise comparisons of groups.

Findings
Table 1 shows that there are large differences in nutritional outcomes between poor
and non-poor and between backward castes/tribes and others. There is no apparent
difference by gender and between SC and ST. The framework proposed by Sen et al.
(2009) is used to better understand the intersectionality of caste, class and gender on child
stunting.
Table 2 presents odds ratios of stunting at two levels—severe (1) versus moderate or
no stunting (2 & 3) and severe or moderate (1 & 2) versus no stunting (3). While Model 1
includes region of residence as a covariate and finds it to be significant, Model 2 considers
the intersection of region with gender (Model 2A), caste (Model 2B) and class (Model 2C).
Model 1 shows that the effects of covariates are largely similar at both levels of stunting,
not only in terms of the level of significance, but also with respect to the magnitude of the

TABLE 1
Child stunting (%) in Rural India by class, gender and caste.

Social Dimensions Severe Moderate Any

Class Poor 31.5 26.0 57.5

Non-Poor 17.9 24.0 41.9
Gender Girl 25.7 25.5 51.2
Boy 26.1 24.9 50.0
Caste ST 30.9 24.9 55.8
SC 29.5 26.3 55.8
Others 24.0 24.8 48.8
Caste, Class and Gender ST Poor Girl 30.3 25.9 56.2
Boy 35.6 23.1 58.7
Non-Poor Girl 24.7 25.6 49.8
Boy 17.3 28.4 45.7
SC Poor Girl 32.3 26.0 58.3
Boy 32.0 28.4 60.4
Non-Poor Girl 22.0 24.8 46.8
Boy 24.1 23.3 47.4
Other castes Poor Girl 30.6 25.9 56.5
Boy 31.0 25.7 56.7
Non-Poor Girl 16.6 24.8 41.4
Boy 16.8 23.0 39.8

Source: Calculated from NFHS-3 Data.

 6
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SIMANTINI MUKHOPADHYAY
TABLE 2
Odds ratio for stunting in Rural India: Intersection of region of residence with caste, class and gender.

Odds Ratio of Being in a Higher Category

Severe Stunting (1 Vs. 2 & 3) Any Stunting (1 & 2 Vs. 3)

Model 2(Intersection of Model 2(Intersection of

Region) Region)

Independent Variables Model 1 (Overall) A B C Model 1 (Overall) A B C

Girl 1.01 - 1.01 1.01 0.97*** - 0.97*** 0.97***

Age (Base Category: 0–1) 1–2 0.29*** 0.30*** 0.29*** 0.29*** 0.27*** 0.27*** 0.27*** 0.27***
2–3 0.25*** 0.25*** 0.25*** 0.25*** 0.22*** 0.22*** 0.22*** 0.22***
3–4 0.28*** 0.28*** 0.28*** 0.28*** 0.25*** 0.25*** 0.25*** 0.25***
4–5 0.34*** 0.34*** 0.34*** 0.34*** 0.30*** 0.30*** 0.30*** 0.30***
Birth Order (Base Category: 1) 2 0.90*** 0.90*** 0.90*** 0.90*** 0.85*** 0.85*** 0.85*** 0.85***
3 0.76*** 0.77*** 0.77*** 0.76*** 0.80*** 0.80*** 0.80*** 0.80***
Higher 0.66*** 0.67*** 0.67*** 0.67*** 0.76*** 0.76*** 0.76*** 0.76***
Mother’s age at birth: Base Category <20 years 0.75*** 0.75*** 0.75*** 0.75*** 0.75*** 0.74*** 0.74*** 0.74***
Mother’s age at birth: (Base Category >30 years) 0.97** 0.97** 0.97** 0.97** 1.00 1.00 1.00 1.00
Mother’s BMI: (Base Category <18) 0.86*** 0.86*** 0.86*** 0.86*** 0.83*** 0.83*** 0.83*** 0.83***
Mother’s Education (Base : None) Prim 1.25*** 1.25*** 1.25*** 1.25*** 1.20*** 1.20*** 1.20*** 1.20***
Sec 1.63*** 1.63*** 1.63*** 1.63*** 1.42*** 1.42*** 1.42*** 1.42***
Higher 3.16*** 3.16*** 3.12*** 3.19*** 2.33*** 2.33*** 2.31*** 2.34***
Father’s Education (Base : None) Prim 1.12*** 1.12*** 1.12*** 1.12*** 1.03*** 1.03*** 1.03*** 1.03***
Sec 1.16*** 1.16*** 1.17*** 1.16*** 1.12*** 1.12*** 1.12*** 1.12***
Higher 1.41*** 1.42*** 1.42*** 1.41*** 1.59*** 1.59*** 1.60*** 1.59***
Female Household Head 0.96*** 0.96*** 0.96*** 0.96*** 0.96*** 0.95*** 0.95*** 0.95***
Poverty (Base Category: Poor) 0.73*** 0.73*** 0.73*** - 0.73*** 0.77*** 0.77*** -
Caste (Base Category: SC/ST) 0.89*** 0.89*** - 0.89*** 0.90*** 0.90*** - 0.90***
Community Water 1.01 1.01 1.01 1.01 1.05*** 1.05*** 1.05*** 1.05***
Community Toilet 1.29*** 1.29*** 1.29*** 1.30*** 1.23*** 1.22*** 1.22*** 1.23***
ICDS 1.04*** 1.05*** 1.05*** 1.04*** 0.95*** 0.95*** 0.95*** 0.95***
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TABLE 2 (Continued)

South 1.23*** - - - 1.21*** - - -

Region-Gender Intersections (Base : North Girl) North Boy - 1.03*** - - - 1.08 - -
South Girl - 1.42*** - - - 1.24*** - -

THE INTERSECTION OF GENDER, CASTE AND CLASS INEQUALITIES

South Boy - 1.13*** - - - 1.22*** - -
Region-Caste Intersections (Base : North SC/ST) North Others - - 1.06*** - - - 1.09*** -
South SC/ST - - 1.09*** - - - 1.08*** -
South Others - - 1.47*** - - - 1.39*** -
Region-Class Intersections (Base : North Poor) North Non-Poor - - - 1.39*** - - - 1.31***
South Non-Poor - - - 1.31*** - - - 1.23***
South Non-Poor - - - 1.62*** - - - 1.56***

Note: Severely Stunted = 1, Moderately Stunted = 2, Not Stunted = 3.

**p<0.05, ***p<0.01.

7
 8 SIMANTINI MUKHOPADHYAY

odds ratios. While girls and boys are equally likely to be severely stunted, the likelihood of
any stunting is significantly greater among girls. The likelihood of stunting is greater
among those from SC/ST households and among those from poor households. The
likelihood of child stunting is significantly lower at all levels of parental education
compared to children of parents with no education. At the community level, the
availability of piped water in the community though significant for severe stunting, is
not significant for any stunting. The existence of an ICDS centre in the community reduces
the likelihood of severe stunting. However, likelihood of any stunting is higher in villages
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with an ICDS centre. This might be a reflection of targeting of the programme with a focus
on areas with already high undernutrition. Controlling for all other factors, children in
South India are less likely to be stunted than their northern counterparts.
Results from Chi-Square test of the differences in the odds ratios for the relevant
pairs of dummies are presented in Table 3. This analysis reveals the differences in the
effect of gender on stunting. While girls have worse long-term health status than boys in
the north, both in terms of severe and any stunting, southern girls have significantly better
outcomes in terms of severe stunting and are in similar conditions as southern boys with
respect to any stunting. Northern children are more likely to be stunted than southern
children irrespective of gender. Children belonging to lower caste/tribe households are
more likely to be stunted than those from non-SC/ST households in both regions. But, the
lower caste/tribe have significantly better outcomes in south compared to north. The
regional advantage of being in the south offsets the disadvantages faced by SC/ST
children in the south. As expected, non-poor children are less likely to be stunted than

TABLE 3
Likelihood of rural children not being stunted.

Difference in Odds Ratio of Not

Having

Intersection Pairs of Groups Severe Stunting Any Stunting

By Region and Gender North Boy Vs. North Girl 0.03 (A***) 0.04 (A***)
North Boy Vs. South Boy −0.10 (D***) -0.18 (D***)
North Boy Vs. South Girl −0.39 (D***) −0.20 (D***)
South Boy Vs. North Girl 0.13 (A***) 0.22 (A***)
South Boy Vs. South Girl −0.29 (D***) −0.02 (D NS)
North Girl Vs. South Girl −0.42 (D***) −0.24 (D***)
By Region and Caste North Others Vs. North SC/ST 0.09 (A***) 0.09 (A***)
North Others Vs. South Others −0.38 (D***) −0.20 (D***)
North Others Vs. South SC/ST 0.30 (A NS) 0.01 (A NS)
South Others Vs. North SC/ST 0.47 (A***) 0.39 (A***)
South Others Vs. South SC/ST 0.41 (A***) 0.31 (A***)
North SC/ST Vs. South SC/ST −0.06 (D***) −0.08 (D***)
By Region and Class North Non-Poor Vs. North Poor 0.39 (A***) 0.31 (A***)
North Non-Poor Vs. South Non-Poor −0.23 (D***) 0.25 (D***)
North Non-Poor Vs. South Poor 0.08 (A***) 0.08 (A***)
South Non-Poor Vs. North Poor 0.62 (A***) 0.56 (A***)
South Non-Poor Vs. South Poor 0.32 (A***) 0.33 (A***)
North Poor Vs. South Poor −0.31 (D***) −0.23 (D***)

Note: This table is based on Table 3.

***p<0.01.
 THE INTERSECTION OF GENDER, CASTE AND CLASS INEQUALITIES 9

poor children in both northern and southern states. Both poor and non-poor northern
children have worse outcomes than their southern counterparts.
Given the importance of region in determining child stunting outcomes, separate
analyses were conducted for north, south and all India. Table 4 presents the differences in
intersectionality in different social settings by making 8C2 = 28 pair-wise comparisons
among the eight groups (PSG, PSB, POG, POB, NPSG, NPSB, NPOG, NPOB) at three levels of
geography: north, south and the entire country (results from the full analyses is not
presented here). The pairs can be classified into three classes: pairs with uni-dimensional
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differences in positionality (ones that are similar in two dimensions but differ in a single
dimension, such as non-poor girls and non-poor boys); pairs with two-dimensional
differences in positionality (ones that are similar in a single dimension but differ in the rest,
such as poor other boys and non-poor SC/ST boys). Finally, pairs that differ in all
dimensions (such as poor SC/ST girls versus non-poor non-SC/ST boys). A group may have
only advantages in both differing dimensions (such as non-poor non-SC/ST girls versus
poor SC/ST girls), or a mix of advantage and disadvantage vis-à-vis the other group in the
pair (such as non-poor SC/ST girls versus poor non-SC/ST girls).

Pairs of Groups with Uni-dimensional Differences in Positionality

The results show that in poor SC/ST households, girls have significantly better
outcomes than boys, both in terms of severe and any level of stunting. This is observed
throughout India and for both levels of stunting, with the exception of North India. Among
poor children belonging to non-SC/ST families, girls face a significant disadvantage
compared to boys for any level of stunting in North India. However, poor girls have
significantly better outcomes in both levels of stunting in South India. While non-poor
Northern boys and girls are equally likely to be stunted (both severe and any), the only
group in South India for which girls have worse outcomes than boys is non-poor SC/ST. It
might be that while poor boys seem to benefit if they are from a higher caste, poor girls
do not derive any benefit from their caste status. The findings also show that non-poor
children have better outcomes (in terms of both levels of stunting) than poor children with
similar caste and gender in both regions.

Pairs of Groups with Two-dimensional Differences in Positionality

Pair-wise comparisons between groups yield expected results when one group is
better than the other with respect to both of the different dimensions. For instance,
significantly worse outcomes are observed for poor SC/ST boys relative to non-poor non-
SC/ST boys, poor SC/ST girls relative to non-poor SC/ST boys, poor SC/ST girls relative to
non-poor non-SC/ST girls, poor non-SC/ST girls relative to non-poor non-SC/ST boys and
non-poor SC/ST girls relative to non-poor non-SC/ST boys. However, more interesting
dynamics are revealed when we consider groups in the middle of the social scale who
have a mix of benefits and disadvantages in the different dimensions. The effect of higher
caste more than offsets the disadvantages associated with being a girl for poor non-SC/ST
girls who fare better than poor SC/ST boys in South India. But such caste-benefits are not
evident in North India. Again, the benefit from the economic status is greater than the
gender disadvantages for SC/ST households throughout India. Economic advantages
compensate for caste-disadvantages (SC/ST versus non-SC/ST) for girls in North India,
 10
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SIMANTINI MUKHOPADHYAY
TABLE 4
Likelihood of rural children in India not being stunted.

All-India North South

Differences Severe Any Severe Any Severe Any

Groups With Uni-Dimensional PSG Vs. PSB 0.06 (A***) 0.07 (A***) 0.01 (A NS) 0.05 (A***) 0.38 (A***) 0.16 (A***)
Difference in Positionality POG Vs. POB 0.00 (A NS) −0.01 (D NS) −0.01 (D NS) −0.03 (D**) 0.12 (A***) 0.11 (A**)
NPSG Vs. NPSB −0.07 (D*) −0.10 (D*) −0.05 (D NS) −0.03 (D NS) −0.11 (D**) −0.25 (D***)
NPOG Vs. NPOB −0.01 (D NS) −0.15 (D***) −0.14 (D***) −0.18 (D***) 0.36 (A***) −0.02 (D NS)
PSG Vs. POG −0.01 (D NS) −0.01 (D NS) −0.00 (D NS) 0.03 (A*) 0.06 (A NS) −0.34 (D***)
PSB Vs. POB −0.06 (D***) −0.09 (D***) −0.02 (D NS) −0.05 (D***) −0.31 (D***) −0.39 (D***)
NPSG Vs. NPOG −0.47 (D***) −0.28 (D***) −0.36 (D***) −0.25 (D***) −0.72 (D***) −0.37 (D***)
NPSB Vs. NPOB −0.40 (D***) −0.33 (D***) −0.45 (D***) −0.40 (D***) −0.24 (D***) −0.14 (D***)
PSG Vs. NPSG −0.03 (D NS) −0.05 (D**) −0.12 (D***) −0.05 (D**) −0.27 (D***) −0.11 (D**)
PSB Vs. NPSB −0.15 (D***) −0.21 (D***) −0.18 (D***) −0.11 (D***) −0.23 (D***) −0.52 (D***)
POG Vs. NPOG −0.48 (D***) −0.32 (D***) −0.47 (D***) −0.33 (D***) −0.39 (D***) −0.13 (D***)
POB Vs. NPOB −0.50 (D***) −0.45 (D***) −0.61 (D***) −0.49 (D***) −0.16 (D***) −0.27 (D***)
Groups With Two-Dimensional PSB Vs. POG −0.06 (D***) −0.08 (D***) −0.00 (D NS) −0.02 (D *) −0.43 (D***) −0.51 (D***)
Difference in Positionality PSB Vs. NPSG −0.09 (D***) −0.11 (D***) −0.13 (D***) −0.11 (D***) −0.11 (D***) −0.27 (D***)
PSB Vs. NPOB −0.56 (D***) −0.54 (D***) −0.62 (D***) −0.54 (D***) −0.47 (D***) −0.66 (D***)
PSG Vs. POB −0.00 (D NS) −0.02 (D NS) −0.01 (D NS) −0.00 (D NS) −0.07 (D NS) −0.23 (D***)
PSG Vs. NPSB −0.09 (D***) −0.14 (D***) −0.17 (D***) −0.09 (D***) −0.15 (D***) −0.36 (D***)
PSG Vs. NPOG −0.49 (D***) −0.33 (D***) −0.47 (D***) −0.30 (D***) −0.45 (D***) −0.48 (D***)
POG Vs. NPSG −0.01 (D NS) −0.03 (D***) −0.12 (D***) −0.09 (D***) 0.36 (A***) 0.24 (A***)
POG Vs. NPOB −0.48 (D***) −0.45 (D***) −0.62 (D***) 0.52 (D***) −0.03 (D NS) −0.15 (D***)
POB Vs. NPSB −0.08 (D***) −0.12 (D***) −0.16 (D***) −0.09 (D***) 0.08 (A*) −0.13 (D***)
POB Vs. NPOG −0.49 (D***) −0.20 (D***) −0.46 (D***) −0.30 (D***) −0.52 (D***) −0.25 (D***)
NPSB Vs. NPOG −0.40 (D***) −0.18 (D***) −0.31 (D***) −0.21 (D***) −0.60 (D***) −0.12 (D***)
NPSG Vs. NPOB −0.47 (D***) −0.43 (D***) −0.50 (D***) −0.43 (D***) −0.39 (D***) −0.39 (D***)
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TABLE 4 (Continued)

Groups With Three- PSG Vs. NPOB −0.50 (D***) −0.47 (D***) −0.62 (D***) −0.49 (D***) −0.09 (D*) −0.50 (D***)
Dimensional Difference in PSB Vs. NPOG −0.55 (D***) −0.39 (D***) −0.49 (D***) −0.35 (D***) −0.83 (D***) −0.64 (D***)

THE INTERSECTION OF GENDER, CASTE AND CLASS INEQUALITIES

Positionality POG Vs. NPSB −0.08 (D***) −0.13 (D***) −0.17 (D***) −0.12 (D***) 0.21 (A***) −0.01 (D NS)
POB Vs. NPSG −0.03 (D NS) −0.02 (D NS) −0.11 (D***) −0.06 (D***) 0.20 (A***) 0.12 (A**)

Note: This table is based on Table 5.

D: Disadvantage, A: Advantage NS: Non-Significant.
*p<0.1, **p<0.05, ***p<0.01.

11
 12 SIMANTINI MUKHOPADHYAY

while the opposite is true for girls in South India. However, for boys we find that economic
advantage dominates caste disadvantage in both North and South India. Among non-
backward castes, economic advantage dominates gender disadvantage; while among the
non-poor, caste-advantage dominates gender disadvantage.

Pairs of Groups with Three-dimensional Differences in Positionality

As expected, the group worse off in all three dimensions (economic status, caste
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status and gender) has worse stunting outcomes than the best-off group (non-poor, non-
SC/ST boys). Again, simultaneous advantages in terms of caste and class more than
compensate for gender disadvantage throughout India. Economic and gender advantages
jointly outperform caste disadvantage throughout India, with the exception for severe
stunting in South India. In fact economic advantage has a significantly greater impact than
the combined disadvantages related to gender and caste in North India.

Relative Importance of Inequalities

The results presented above show the inequalities in child stunting. The relative
importance of these inequalities can be estimated using the method proposed by Sen
et al. (2009). In this method

W ¼ ðNPSB þ NPOB  PSB  POBÞ þ ðNPSG þ NPOG  PSG  POGÞ

G ¼ ðNPSB þ NPOB  NPSG  NPOGÞ þ ðPSB þ POB  PSG  POGÞ
Thus; G ¼ W þ 2ðPSB þ POB  NPSG  NPOGÞ
And Similarly; C ¼ ðNPOB þ NPOG  NPSB  NPSGÞ þ ðPOB þ POG  PSB  PSGÞ
Or; C ¼ W þ 2ðPOB þ POG  NPSB  NPSGÞ

where W, G and C are class, gender and caste differences respectively.

The differences are tested using Chi-Square tests at one per cent level of
significance. The results show that W>G for all levels of stunting for north, south and all
India. However, while W>C in North India, there is no significant difference in South India
for any level of stunting. In contrast, W<C for severe stunting in South India. Again, G<C for
all levels of stunting in both North and South India. Thus, while in North India and for the
country as a whole G<C<W for both levels of stunting, in South India G<C~W for any
stunting and G<W<C for severe stunting. While class inequalities dominate caste
inequalities and caste inequalities dominate gender inequalities in all levels of stunting
in rural North India, the importance of caste and wealth inequalities is similar for any
stunting in South India. In contrast, caste inequalities dominate class inequalities and class
inequalities dominate gender inequalities in severe stunting in rural South India. However,
the results should not interpreted to suggest that gender inequalities and caste
inequalities should receive lesser policy attention relative to class inequalities.

Conclusion
The findings presented in the paper have implications for policies on child nutrition.
Scholars have argued that nutritional policies for children must focus on groups that have
 THE INTERSECTION OF GENDER, CASTE AND CLASS INEQUALITIES 13

systematically worse outcomes. The groups that are disadvantaged in several dimensions
would require greater policy attention. The results presented show the inequalities in child
nutrition and how they differ across different groups. Children who are disadvantaged
in one dimension may reap benefits from their position in other dimensions of social
and economic status. The complex relationship between gender, caste and class and
how they differ in north and South India caution against any simplistic formulation of
policy targeting a particular group. The paper has highlighted how different dimensions of
social and economic status intersect and affect child nutrition levels and this will help to
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sharpen policy formulation.

ACKNOWLEDGEMENT
I am immensely grateful to Achin Chakraborty, Director and Professor of Economics at
Institute of Development Studies Kolkata for his scrupulous comments on the paper.
Thanks are also due to the Associate Editor and two anonymous reviewers, whose
suggestions have been instrumental in revising the paper.

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Simantini Mukhopadhyay, Assistant Professor, Institute of Development Studies Kolkata

(IDSK), 538 Jodhpur Park, Kolkata-700068, West Bengal, India. Email: simantinihalder@
gmail.com

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