Saving the Next Generation: Political Capacity and Infant Mortality Decline in India's States

Abstract

National political development and its effect on economic and demographic changes are topics extensively addressed by power transition theory. Studies in political demography demonstrate that the political capacity of national governments plays a critical role in altering mortality and fertility patterns in developing nations. We test the effects of political capacity on infant mortality rates in fifteen Indian states in the period 1981 to 2000. We find that the political capacity of a state government lowers infant mortality in the low and middle income states. This effect gets weaker across higher income levels. We also find that the wealthier states tend to be healthier. Female education exerts a negative effect on infant mortality within urban populations but its effects diminish in rural populations. A key implication of our study is that the politically capable states in India are positioned to complete the demographic transition and are likely to emerge as the regional drivers of economic growth. Sustained gains in economic productivity will eventually determine India's role in world politics in the twenty-first century.

KEYWORDS:

• Power transition theory
• political capacity
• infant mortality
• India

We thank Michelle Benson, Jacek Kugler, Glenn Palmer, and two anonymous reviewers for suggestions. Christopher Estay and Jason Fowler provided excellent research assistance.

Notes

1. The other key element of PTT is the extent to which a nation is satisfied or dissatisfied with the international and/or regional status quo. (Dis) Satisfaction interacts with the relative power status of a nation producing higher or lower likelihoods of war. For an extensive review, theoretical extensions, empirical evidence, and implications see the works cited here as well as Lemke and Reed (1996), Kugler and Lemke (2000), and Kugler (2006) among others.

2. The chapters in Arbetman and Kugler (1997) show political capacity as having significant effects in attracting foreign investments, stabilizing monetary flows, reducing seigniorage and lowering inflation, and promoting economic growth.

3. The demographic transition theory grew out of a description of demographic change in the late eighteenth-century Europe. With theoretical refinements over time, distinguishing demographic transition as a theory from the historical generalizations based on the European experience has become difficult. According to this theory, the emergence of stable populations is associated with higher levels of modernization. Low socioeconomic development engenders high birth and death rates that roughly balancing, result in slow population growth. Industrialization and urbanization provide impetus to a general improvement in socioeconomic conditions resulting in relatively rapid declines in mortality. Birth rates remain at high levels as fertility decisions are not directly affected in the short-run. Population explosions are likely as the gap between fertility and mortality widens. At relatively high levels of socioeconomic development factors such as medical technologies, greater availability of family planning alternatives, and the high marginal costs of additional children directly affect fertility decisions leading to lowered birth rates and smaller families at replacement levels. Empirical research indicates a greater variation in mortality and fertility decline within European nations than demographic transition theory would suggest (Easterlin, 2005; Gillis, Tilly, and Levine, 1992).

4. All of these studies conclude that India has witnessed a substantial decline in infant mortality rates in the past two decades. Total infant mortality has decreased from 110 to 68 deaths per 1,000 live births, urban infant mortality from 62 to 43, and rural mortality from 119 to 74 in the period 1981–2000. The decline in infant mortality in India has been relatively faster than the average decline in other developing nations (with the exception of China) during the same period (Cleason et al., 1999). Urban infant mortality has been lower than rural rates and changes in the former have been slower than the latter. Studies also show that the reduction in total infant mortality has not been uniform. Rapid declines have preceded periods of stagnation, a pattern distinct in the 1980s. In the 1990s, the decline in infant mortality has been slower and the periods of stagnation longer. While the general pattern of decline in the aggregate rates reflect changes at the state level, variation across the states is considerable.

5. The states include: Andhra Pradesh (AP), Assam, Bihar, Gujarat, Haryana, Karnataka, Kerala, Madhya Pradesh (MP), Maharashtra, Orissa, Punjab, Rajasthan, Tamil Nadu (TN), Uttar Pradesh (UP), and West Bengal (WB).

6. The SRS is a large demographic survey that provides annual estimates of the birth rate, the death rate, and other fertility and mortality indicators at the federal, state, and district levels. The field investigation consists of continuously enumerating births and deaths with follow-up surveys every six months. The data obtained from these two surveys are matched and the unmatched and partially matched events are reverified to arrive at an unduplicated and complete count of births and deaths. The SRS originated in 1964–1965 with a pilot study and became fully operational in 1969–1970. The sample covers 1.1 million households and 6.33 million populations in India including all the States and Union territories in India. The coverage of births and deaths registration was reported to be approximately 98 percent (SRS Bulletin, October 2002). Comparisons of SRS estimates with alternate infant mortality estimates, the NFHS implemented across India in 1992–1993 and 1998–1999, indicate consistency (IIPS-ORC Macro, 2000).

7. We use natural log transformations of IMR and SDP in all models.

8. The coefficients on PC and SDP do not capture the average effects of political capacity and income on IMR. The coefficient on PC (−0.18 from model 2) captures the effect on IMR of a one percent increase in PC when SDP = 0. Similarly, the coefficient on SDP represents the percent change in IMR for a one percent increase in SDP when PC = 0. We get no information from these coefficients when SDP≠0 (in the former) and when PC≠0 (in the latter). Since the range of data in our sample does not include values of zero for either PC or SDP, the unconditional effects of these variables and their statistical significance are not considered as meaningful (Brambor, Clark, and Golder 2005).

9. The marginal effect of PC conditional on SDP is given by SDP and the standard error of PC conditional on SDP is

10. We find that enrollment levels for males and females across age groups are typically correlated with income per capita. Using lagged values of enrollment somewhat alleviates this problem.

11. Note that the sum of the coefficients of the lagged values of IMR is less than 1 for all models presented here (Keele and Kelly, 2006).

12. The vaccination against the six diseases has been an important component of the child health policy in India. Guidelines specify that infants should receive full immunization by the end of the first year of life. The Expanded Program on Immunization was initiated by the Government of India in 1978 with the goal of reducing mortality from these diseases by making free vaccination services available to all eligible children. The Universal Immunization Program (1985–1986) introduced in every district of the country aims at covering 100 percent of all infants.

Bahl, Roy (1971). “A Regression Approach to Tax Effort and Tax Ratio Analysis.” IMF Papers 18.

Chelliah, Raja, Hansel Bass, and Margaret Kelly (1975). “Tax Ratios and Tax Effort in Developing Countries 1969–71.” IMF Staff Papers 22.

Wilson, Dominic and Roopa Purushothaman 2003. “Dreaming With BRICs: The Path to 2050.” Global Economics Paper 99, Goldman Sachs.