Selective Mortality and Malnutrition in India

India presents itself as a paradox with low infant mortality and high malnutrition. This paper provides survival bias as an explanation of the paradox. Using pooled health surveys from 1993 to 2005 and a pseudo-panel selection model, this study finds that the change in Height-for-Age Z-Scores (HAZ scores) can be explained by mortality selection. Specifically, children with sample average characteristics that survive have 17.4% less HAZ scores than a child randomly drawn from the population indicating an overestimation of malnutrition in India. This is consistent with the hypothesis of weaker children surviving due to skilled delivery which pulls down the overall HAZ scores. The results are robust to controls for unobservable characteristics of groups of women. Son preference is also apparent in the results. The selection is more evident among male children and in the states where sex selection is historically seen as a problem in India.