Inequality of Opportunity in Child Health in the Arab World and Turkey

Health and nutrition during a child’s first years are crucial to his/her health and wellbeing later in life. Growth and development in childhood is determined by both genotype (nature) and phenotype (nurture), with the influence of the latter being particularly crucial during a child’s first few years (Martorell and Habicht 1986). In this paper, we examine the patterns of inequality of opportunity in health and nutrition outcomes, such as height-for-age and weight-for-height, for children under five in selected Arab Countries and Turkey, using Demographic and Health Survey (DHS) data. Our objective is to decompose inequality into a portion that is due to inequality of opportunity, and a portion due to other factors, such as random variations in health. Inequality of opportunity is defined as in Romer (1998) as the inequality that is due to differences in circumstances, such as parental characteristics, household wealth, place of birth and gender. We measure inequality using decomposable general entropy measures, such as Theil’s-L and Theil’s-T indices. We use both parametric and non-parametric decomposition methods to determine the share of inequality of opportunity in total inequality. The results show that different levels and trends are evident across countries in both overall inequality and in the share of inequality of opportunity. Inequality of opportunity is shown to contribute substantially to the inequality of child health outcomes, but its share in total inequality varies significantly, both across and within countries over time. To further highlight the relative contribution of circumstances to the inequality of child health outcomes in different countries, we simulate height and weight outcomes for a most and least advantaged child in each context. Since these simulations observed circumstances at their best and worst levels, the larger the difference in predicted outcomes between the most and least advantaged child, the greater the inequality of opportunity facing children in that country.  

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