Political Economy, Capability Development, and Fundamental Cause: Integrating Perspectives on Child Health in Developing Countries
Keywords:multi-level analysis, health inequalities, child malnutrition, child diarrhea, economic development, trade, sanitation, clean water, health care, education, household socioeconomic status
Several dominant theoretical perspectives attempt to account for health disparities in developing countries, including political economy, the capability approach, and fundamental cause. This study combines the perspectives in a multi-level analysis of child malnutrition and diarrhea in order to gain a more comprehensive understanding of who faces increased health risks and who is shielded from them. Using the Demographic and Health Surveys and World Bank data, I estimate a series of models that predict the likelihood of child malnutrition and diarrhea, based on a set of country- and individual-level explanatory variables. Results suggest that at the individual-level, household wealth and maternal education are the most robust predictors of child health. These social factors are even more important than more proximate factors like clean water or sanitation. At the country-level, gross domestic product (GDP) per capita reduces malnutrition, but does not significantly affect incidence of diarrhea. Contrary to the predominant economic development paradigm, health care and education are more important in accounting for the prevalence of diarrhea than GDP. Finally, trade in and of itself is not harmful to well-being in developing countries. It is when countries become too dependent on one or a few commodities that trade starts to have detrimental costs. Thus, a synthesis of theoretical frameworks best illustrates the complex web of social structural factors that manifest as unequal life chances for children.
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