What Explains Differences in Child Health between Rural, Urban, and Slum Areas? Evidence from India

Claus C. Pörtner, Seattle University
Yu-hsuan Su, University of Washington

The developing world is rapidly becoming more urban, but our understanding of the differences in child health between urban and rural areas is still limited. Simple averages show that average child health in India is worst in rural areas and best in urban areas—with slums in between—but it is unclear what accounts for these differences. We examine the determinants of child health across areas using data from NFHS-3. Once we control for wealth status or observed health environmental conditions the urban advantage in height-for-age disappears and slum children fare significantly worse than rural children. Potential explanations, such as mortality selection and migration, are explored, but are unlikely to explain these results. The implication is that the composition of households across the three areas hides the substantial negative effect slums have on child health. We argue that the worse health environment in slums–insufficiently captured by the available information–is the main culprit.