Exposure to open defecation can account for the Indian enigma of child height

Abstract

Physical height is an important measure of human capital. However, differences in average height across developing countries are poorly explained by economic differences. Children in India are shorter than poorer children in Africa, a widely studied puzzle called “the Asian enigma.” This paper proposes and quantitatively investigates the hypothesis that differences in sanitation — and especially in the population density of open defecation — can statistically account for an important component of the Asian enigma, India's gap relative to sub-Saharan Africa. The paper's main result computes a demographic projection of the increase in the average height of Indian children, if they were counterfactually exposed to sub-Saharan African sanitation, using a non-parametric reweighting method. India's projected increase in mean height is at least as large as the gap. The analysis also critically reviews evidence from recent estimates in the literature. Two possible mechanisms are effects on children and on their mothers.