Does a Rising Tide Lift All Boats Evenly?Health Investments and Gender Inequality in India

Gender inequality in South Asia is an important policy issue; gender imbalances in mortality have been of particular concern. Policy makers often argue that increasing the level of development and access to health care are crucial to addressing this inequality. This paper analyzes the relationship between access to child health investments and gender inequality in those investments in India. The ¯rst part of the paper explores the proximate causes of the gender imbalance in mortality in India. I ¯nd that a large share of the gender imbalance (about 30%) can be explained by differential access to vaccination. The second part of the paper estimates the effect of changes in access to vaccination on gender inequality. I argue that the direction of these effects is not obvious. A simple model of (gender-biased) parental investments, and empirical work using variation in access to vaccination, both suggest that initial increases in vaccination availability from low levels will increase gender inequality; further increases will then decrease inequality. This non-monotonic pattern is also reflected in differences in mortality. This result may shed light on the contrast between the cross-sectional and time series evidence on gender and development. For other related papers: http://home.uchicago.edu/~eoster