Choice Not Genes Probable Cause for the India-Africa Child Height Gap

I n his article, " Does India Really Suffer from Worse Child Malnutrition Than Sub-Saharan Africa? " , Arvind Pana-gariya makes an impassioned case against accepting traditional measures that indicate that Indian children suffer from worse malnutrition than their African counterparts. This phenomenon – that Indian children are more stunted despite the coun-try's better performance on an array of other health and development indicators – was dubbed the " South Asian Enigma " in an article by Ramalingaswami et al in 1996. In explaining the enigma, Panagariya comes down squa rely on the genetic side, naming the problem as " the use of common height and weight standards around the world to determine malnourishment, regardless of differences that may arise from genetic, environmental, cultural, and geographical factors ". He suggests that either protein/micronutrient consumption or region-specifi c height norms should be used to gauge malnutrition. In our study, however, the common international height standard reveals patterns of stunting variation within families, suggesting differential allocation of resources within the household as the cause of India's height disadvantage. Using data from the Demographic and Health Surveys (DHS) for Sub-Saharan African countries and India, we show that height-forage is in fact higher in India than Africa for fi rstborns. India's disadvantage only appears with the second-born child and becomes more pronounced for third and higher order births. The birth order gradient in child height-forage is twice as large in India as in Africa, and large enough to account for the entire India-Africa height gap. These facts point to an environmental explanation for I ndia's high rate of child stunting.