Early Divergence: Rural-Urban Child Health Inequalities over Time in Four Developing Countries

Laura B. Nolan, Princeton University

The large literature on health differentials between rural and urban areas relies almost exclusively on cross-sectional data. Bringing together the demographic literature on area-level health inequalities with the economic and bio-physiological literature on children’s catch-up growth over time, this paper uses panel data to investigate the stability and origins of rural-urban health differentials. Using data from the Young Lives longitudinal study of child poverty, I present evidence of large level differences but similar trends in rural versus urban children’s height for age in four developing countries. Further, children’s birthweight and mothers’ health endowments indicate that persistently poorer rural health is present to a large extent already at birth, suggesting that initial endowments play a substantial role in explaining large rural-urban child health inequalities in developing countries. The results imply that prioritizing maternal nutrition and health is essential, and that interventions to reduce area-level health inequalities must begin before birth.