Skip to main content Accessibility help


  • A. Mushfiq Mobarak (a1) (a2), Theresa Chaudhry (a3), Julia Brown (a4), Tetyana Zelenska (a5), M. Nizam Khan (a6), Shamyla Chaudry (a3), Rana Abdul Wajid (a3), Alan H. Bittles (a7) (a8) and Steven Li (a9)...


The effects of marriage between biological relatives on the incidence of childhood genetic illness and mortality are of major policy significance, as rates of consanguinity exceed 50% in various countries. Empirical research on this question is complicated by the fact that consanguinity is often correlated with poverty and other unobserved characteristics of households, which may have independent effects on mortality. This study has developed an instrumental variables empirical strategy to re-examine this question, based on the concept that the availability of unmarried cousins of the opposite gender at the time of marriage creates quasi-random variation in the propensity to marry consanguineously. Using primary data collected in Bangladesh in 2006–07 and Pakistan in 2009–10, the study found that previous estimates of the impact of consanguinity on child health were biased and falsely precise. The study also empirically investigated the social and economic causes of consanguinity (including marital quality) and concludes that marrying a cousin can have positive economic effects for one’s natal family, by allowing deferral of dowry payments until after marriage.


Corresponding author

*Corresponding author. Email:


Hide All
Angrist, JD, Imbens, GW Rubin, DB (1996) Identification of causal effects using instrumental variables. Journal of the American Statistical Association 91(434), 444455.
Barakat, B Basten, S (2014) Modelling the constraints on consanguineous marriage when fertility declines. Demographic Research 30(9), 277312.
Bener, A, Dafeeah, EE Samson, N (2012) Does consanguinity increase the risk of schizophrenia? Study based on primary health care centre visits. Mental Health in Family Medicine 9(4), 241248.
Bhopal, RS, Petherwick, ES, Wright, J Small, N (2014) Potential social, economic and general health benefits of consanguineous marriage: results from the Born in Bradford cohort study. European Journal of Public Health, 24(5), 862869.
Bishop, C, Small, N, Mason, D, Corry, P, Wright, J, Parslow, R et al. (2017) Improving case ascertainment of congenital anomalies: findings from a prospective birth cohort with detailed primary care record linkage. BMJ Paediatrics Open (1), doi:10.1136/bmjpo–2017–000171.
Bittles, AH (1994) The role and significance of consanguinity as a demographic variable. Population and Development Review 20(3), 561584.
Bittles, AH (2012) Consanguinity in Context. Cambridge University Press, Cambridge.
Bittles, AH Black, ML (2010) Consanguinity, human evolution, and complex diseases. Proceedings of the National Academy of Sciences 107 (Supplement 1), 17791786.
Bittles, AH, Mason, WM, Greene, J Rao, NA (1991) Reproductive behavior and health in consanguineous marriages. Science 252(5007), 789794.
Bittles, AH Neel, JV (1994) The costs of human inbreeding and their implications for variations at the DNA level. Nature Genetics 8(2), 117.
Bound, J, Jaeger, DA Baker, RM (1995) Problems with instrumental variables estimation when the correlation between the instruments and the endogenous explanatory variable is weak. Journal of the American Statistical Association 90(430), 443450.
Bowden, RJ Turkington, DA (1990) Instrumental Variables (Vol. 8). Cambridge University Press, Cambridge.
Do, QT, Iyer, S Joshi, S (2013) The economics of consanguineous marriages. Review of Economics and Statistics 95(3), 904918.
Durkin, MS, Khan, NZ, Davidson, LL, Huq, S, Munir, S, Rasul, E Zaman, SS (2000) Prenatal and postnatal risk factors for mental retardation among children in Bangladesh. American Journal of Epidemiology 152(11), 10241033.
Grant, JC Bittles, AH (1997) The comparative role of consanguinity in infant and childhood mortality in Pakistan. Annals of Human Genetics 61, 143149.
Hamamy, H, Antonarakis, SE, Cavalli-Sforza, LL, Temtamy, S, Romeo, G, Kate, LP et al. (2011) Consanguineous marriages, pearls and perils: Geneva international consanguinity workshop report. Genetics in Medicine 13(9), 841842.
Heckman, JJ, Urzua, S Vytlacil, E (2006) Understanding instrumental variables in models with essential heterogeneity. Review of Economics and Statistics 88(3), 389432.
Hussain, R (1999) Community perceptions of reasons for preference for consanguineous marriages in Pakistan. Journal of Biosocial Science 31(4), 449461.10.1017/S0021932099004496
Hussain, R Bittles, AH (1998) The prevalence and demographic characteristics of consanguineous marriages in Pakistan. Journal of Biosocial Science 30(2), 261275.
Hussain, R Bittles, AH (2000) Sociodemographic correlates of consanguineous marriage in the Muslim population of India. Journal of Biosocial Science 32(4), 433442.
Inhorn, MC, Kobeissi, L, Nassar, Z, Lakkis, DA Fakih, MH (2009) Consanguinity and family clustering of male factor infertility in Lebanon. Fertility and Sterility 91(4), 11041109.
Ismail, J, Jafar, TH, Jafary, FH, White, F, Faruqui, AM Chaturvedi, N (2004) Risk factors for non–fatal myocardial infarction in young South Asian adults. Heart 90(3), 259263.10.1136/hrt.2003.013631
Jacoby, HG Mansuri, G (2010) Watta Satta: Bride exchange and women’s welfare in rural Pakistan. American Economic Review 100(4), 18041825.
Khan, N, Wojtyniak, B Shaha, SK (1997) Effects of Parental Consanguinity on Offspring Mortality in Bangladesh. International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
Mansour, H, Fathi, W, Klei, L, Wood, J, Chowdari, K, Watson, A et al. (2010) Consanguinity and increased risk for schizophrenia in Egypt. Schizophrenia Research 120(1–3), 108112.
Mobarak, AM, Kuhn, R Peters, C (2013) Consanguinity and other marriage market effects of a wealth shock in Bangladesh. Demography 50(5), 18451871.
Murray, MP (2006) Avoiding invalid instruments and coping with weak instruments. Journal of Economic Perspectives 20(4), 111132.
National Institute of Population Studies Islamabad and ICF International (2013) Pakistan Demographic and Health Survey 2012–13. NIPS and ICF International Inc., Calverton, MD, USA.
Rudan, I, Rudan, D, Campbell, H, Carothers, A, Wright, A, Smolej-Narancic, N et al. (2003a) Inbreeding and risk of late onset complex disease. Journal of Medical Genetics 40(12), 925932.
Rudan, I, Smolej-Narancic, N, Campbell, H, Carothers, A, Wright, A, Janicijevic, B Rudan, P (2003b) Inbreeding and the genetic complexity of human hypertension. Genetics 163(3), 10111021.
Sanawar, S, Islam, M, Majumdar, S Misu, F (2018) Women’s empowerment and intimate partner violence in Bangladesh: investigating the complex relationship. Journal of Biosocial Science, doi:10.1017/S0021932018000068
Sheridan, E, Wright, J, Small, N, Corry, PC, Oddie, S, Whibley, C et al. (2013) Risk factors for congenital anomaly in a multiethnic birth cohort: an analysis of the Born in Bradford study. The Lancet 382(9901), 13501359.
Shieh, JT, Bittles, AH Hudgins, L (2012) Consanguinity and the risk of congenital heart disease. American Journal of Medical Genetics Part A, 158(5), 12361241.
Small, N, Bittles, AH, Petherwick, ES Wright, J (2017) Endogamy, consanguinity and the health implications of changing marital choices in the UK Pakistani community. Journal of Biosocial Science 49(4), 435446.



  • A. Mushfiq Mobarak (a1) (a2), Theresa Chaudhry (a3), Julia Brown (a4), Tetyana Zelenska (a5), M. Nizam Khan (a6), Shamyla Chaudry (a3), Rana Abdul Wajid (a3), Alan H. Bittles (a7) (a8) and Steven Li (a9)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed