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Subsidising rice and sugar? The Public Distribution System and Nutritional Outcomes in Andhra Pradesh, India

Published online by Cambridge University Press:  21 July 2020

JANITA BARTELL ,
JASMINE FLEDDERJOHANN Open the ORCID record for JASMINE FLEDDERJOHANN [Opens in a new window] ,
SUKUMAR VELLAKKAL  and
DAVID STUCKLER
JANITA BARTELL
Affiliation:
University of Oxford
JASMINE FLEDDERJOHANN
Affiliation:
Lancaster University, email: j.fledderjohann@lancaster.ac.uk
SUKUMAR VELLAKKAL
Affiliation:
Birla Institute of Technology and Science, Pilani
DAVID STUCKLER
Affiliation:
Bocconi University
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Abstract

India’s main food and nutrition security programme, the Public Distribution System (PDS), provides subsidised rice and sugar to deprived households. Using longitudinal data from Young Lives for Indian children (n = 2,944) aged 5 to 16 years, we assessed whether PDS subsidies skewed diets towards sugar and rice consumption, increasing risk of stunting (low height-for-age). Linear regression models were used to quantify additional rice and sugar consumption associated with accessing the PDS, and the association with stunting linked to consumption. Controlling for sociodemographics, accessing the PDS was positively, significantly associated with consumption of rice (30g/day) and sugar (7.05g/day). There was no evidence that this increase corresponded to nutritional improvements. Each 100g increase in daily rice intake was associated with a lower height-for-age z-score (HAZ) and no decline in stunting. Results were robust to alternative model specifications. There was no evidence that receipt of PDS rice and sugar was associated with improvements in child nutrition.

Keywords

Public distribution systemnutritionfood aidIndiachild healthricesugarstuntingheight-for-age
Type
Article
Information
Journal of Social Policy , Volume 50 , Issue 4 , October 2021 , pp. 681 - 705
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Aurino, E. (2017), ‘Do boys eat better than girls in India? Longitudinal evidence on dietary diversity and food consumption disparities among children and adolescents’, Economics & Human Biology, 25(Supplement C): 99–111.CrossRefGoogle ScholarPubMed
Aurino, E., Fledderjohann, J. and Vellakkal, S. (2019), ‘Inequalities in adolescent learning: Does the timing and persistence of food insecurity at home matter?’, Economics of Education Review.CrossRefGoogle Scholar
Barnett, I., Ariana, P., Petrou, S., Penny, M., Duc, L. T., Galab, S., et al. (2013), ‘Cohort Profile: The Young Lives Study’, International Journal of Epidemiology, 42: 701–8.CrossRefGoogle ScholarPubMed
Basu, S., Yoffe, P., Hills, N. and Lustig, R. H. (2013), ‘The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data’, PLOS ONE, 8(2): e57873.CrossRefGoogle ScholarPubMed
Black, R. E., Allen, L. H., Bhutta, Z. A., Caulfield, L. E., De Onis, M., Ezzati, M., Mathers, C. and Rivera, J. (2008), ‘Maternal and Child Undernutrition: Global and Regional Exposures and Health Consequences’, The Lancet, 371(9608): 243–260.CrossRefGoogle ScholarPubMed
Central Vigilance Committee (2009), Report on the State of Andhra Pradesh. http://pdscvc.nic.in/AP%20report.htm [5 May 2014].Google Scholar
Chakrabarti, S., Kishore, A. and Roy, D. (2018), ‘Effectiveness of Food Subsidies in Raising Healthy Food Consumption: Public Distribution of Pulses in India’, American Journal of Agricultural Economics, 100(5): 1427–1449.CrossRefGoogle Scholar
Christian, P. (2010), ‘Impact of the economic crisis and increase in food prices on child mortality: exploring nutritional pathways’, The Journal of nutrition, 140(1): 177S–181S.CrossRefGoogle ScholarPubMed
Crookston, B. T., Dearden, K. A., Alder, S. C., Porucznik, C. A., Stanford, J. B., Merrill, R. M., Dickerson, T. T. and Penny, M. E. (2011), ‘Impact of early and concurrent stunting on cognition’, Maternal & Child Nutrition, 7(4): 397–409.CrossRefGoogle ScholarPubMed
Crookston, B. T., Penny, M. E., Alder, S. C., Dickerson, T. T., Merrill, R. M., Stanford, J. B., Porucznik, C. A. and Dearden, K. A. (2010), ‘Children who Recover from Early Stunting and Children who are not Stunted Demonstrate Similar Levels of Cognition’, The Journal of Nutrition, 140(11): 1996–2001.CrossRefGoogle Scholar
Crosby, L., Jayasinghe, D. and McNair, D. (2013), ‘Food for Thought: Tackling child malnutrition to unlock potential and boost prosperity’, Save the Children.Google Scholar
Davidson, W. J., Mackenzie-Rife, K. A., Witmans, M. B., Montgomery, M. D., Ball, G. D., Egbogah, S. and Eves, N. D. (2014), ‘Obesity negatively impacts lung function in children and adolescents’, Pediatric pulmonology, 49(10): 1003–1010.CrossRefGoogle ScholarPubMed
Desai, S. and Vanneman, R. (2015), ‘Enhancing Nutrition Security via India’s National Food Security Act: Using an Axe instead of a Scalpel?’, India Policy Forum Conference Papers. India Policy Forum, 67.Google Scholar
Development Initiatives (2018), Global nutrition report: Shining a light to spur action on nutrition. Bristol, UK: Development Initiatives Poverty Research, 161. https://globalnutritionreport.org/reports/global-nutrition-report-2018/.Google Scholar
Drèze, J. and Sen, A. (2013), An uncertain glory: India and its contradictions. London: Penguin Books.Google Scholar
Drèze, J. and Sen, A. K. (1991), Hunger and Public Action. Oxford Clarendon.CrossRefGoogle Scholar
Ecker, O. and Qaim, M. (2011), ‘Analyzing Nutritional Impacts of Policies: An Empirical Study for Malawi’, World Development, 39: 412–428.CrossRefGoogle Scholar
FAO (2014), State of Food Insecurity in the World 2013. Rome: Food and Agriculture Organization of the United Nations.Google Scholar
FAO, IFAD, UNICEF, WFP and WHO (2019), The State of Food Security and Nutrition in the World 2019: Safeguarding Against Economic Slowdowns and Downturns. Rome: FAO.Google Scholar
Fledderjohann, J., Agrawal, S., Vellakkal, S., Basu, S., Campbell, O., Doyle, P., Ebrahim, S. and Stuckler, D. (2014), ‘Do Girls Have a Nutritional Disadvantage Compared with Boys? Statistical Models of Breastfeeding and Food Consumption Inequalities among Indian Siblings’, PloS One, 9(9): e107172.CrossRefGoogle ScholarPubMed
Fledderjohann, J., Vellakkal, S., Khan, Z., Ebrahim, S. and Stuckler, D. (2016), ‘Quantifying the impact of rising food prices on child mortality in India: a cross-district statistical analysis of the District Level Household Survey’, International journal of epidemiology, 45(2): 554–564.CrossRefGoogle ScholarPubMed
Fotso, J.-C. (2007), ‘Urban–Rural Differentials in Child Malnutrition: Trends and Socioeconomic Correlates in Sub-Saharan Africa’, Health & Place, 13(1): 205–223.CrossRefGoogle ScholarPubMed
Galab, S., Reddy, M. G., Antony, P., McCoy, A., Ravi, C., Raju, D. S., Mayuri, K. and Reddy, P. P. (2003), Young Lives Preliminary Country Report: Andhra Pradesh, India. Young Lives: An International Study of childhood poverty.Google Scholar
Gangopadhyay, S., Lensink, R. and Yadav, B. (2013), ‘Cash or Food Security Through the Public Distribution System? Evidence from a Randomized Controlled Trial in Delhi, India’. http://www.econ.kuleuven.be/eng/ew/seminars/papers2013/paper_lensink.pdf [28 July 2014].CrossRefGoogle Scholar
Garratt, E. (2019), ‘Food insecurity in Europe: Who is at risk, and how successful are social benefits in protecting against food insecurity?’, Journal of Social Policy, 1–25.Google Scholar
Government of India (2005), Performance Evaluation of Targeted Public Distribution System (TPDS).Google Scholar
Griffiths, P., Matthews, Z. and Hinde, A. (2002), ‘Gender, family, and the nutritional status of children in three culturally contrasting states of India’, Social science & medicine, 55(5): 775–790.CrossRefGoogle ScholarPubMed
Himaz, R. (2009), ‘Persistent Stunting in Middle Childhood: The Case of Andhra Pradesh using Longitudinal Data’, IDS Bulletin, 40(4): 30–38.CrossRefGoogle Scholar
IIPS (2017), National Family Health Survey 20015-16 (NFHS-4): India Fact Sheet. Mumbai, India: Government of India Ministry of Health and Family Welfare, 8. https://dhsprogram.com/pubs/pdf/OF31/India_National_FactSheet.pdf.Google Scholar
Jayachandran, S. and Kuziemko, I. (2011), ‘Why do mothers breastfeed girls less than boys? Evidence and implications for child health in India’, The Quarterly Journal of Economics, 126(3): 1485–1538.CrossRefGoogle ScholarPubMed
Jensen, R. and Miller, N. (2011), ‘Do Consumer Price Subsidies Really Improve Nutrition?’, Review of Economics and Statistics, 93(4): 1205–23.CrossRefGoogle ScholarPubMed
Jensen, R. and Miller, N. (2008a), ‘Giffen behavior and subsistence consumption’, American Economic Review, 98(4): 1553–77.CrossRefGoogle ScholarPubMed
Jensen, R. and Miller, N. (2008b), ‘The impact of food price increases on caloric intake in China’, Agricultural Economics, 39: 465–476.CrossRefGoogle ScholarPubMed
Jha, R., Gaiha, R., Pandey, M. K. and Kaicker, N. (2013), ‘Food subsidy, income transfer and the poor: A comparative analysis of the public distribution system in India’s states’, Journal of Policy Modeling, 35(6): 887–908.CrossRefGoogle Scholar
Johnson, R. J., Segal, M. S., Sautin, Y., Nakagawa, T., Feig, D. I, Kang, D.-H., Gersch, M. S., Benner, S. and Sánchez-Lozada, L. G. (2007), ‘Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease’, The American Journal of Clinical Nutrition, 86(4): 899–906.Google ScholarPubMed
Jyoti, D. F., Frongillo, E. A. and Jones, S. J. (2005), ‘Food insecurity affects school children’s academic performance, weight gain, and social skills’, The Journal of nutrition, 135(12): 2831–2839.CrossRefGoogle ScholarPubMed
Kaul, T. (2014), ‘Household responses to policy and social norms’. PhD dissertation, College Park, MD, University of Maryland. https://drum.lib.umd.edu/bitstream/handle/1903/15331/Kaul_umd_0117E_15144.pdf.Google Scholar
Kaushal, N. and Muchomba, F. M. (2015), ‘How consumer price subsidies affect nutrition’, World Development, 74: 25–42.CrossRefGoogle Scholar
Khera, R. (2011a), ‘India’s public distribution system: utilisation and impact’, Journal of Development Studies, 47(7): 1038–1060.CrossRefGoogle Scholar
Khera, R. (2011b), ‘Revival of the public distribution system: evidence and explanations’, Economic & Political Weekly, 46(44): 36–50.Google Scholar
Kishore, A. and Chakrabarti, S. (2015), ‘Is more inclusive more effective? The “New Style” public distribution system in India’, Food Policy, 55: 117–130.CrossRefGoogle Scholar
Kochar, A. (2005), ‘Can Targeted Food Programs Improve Nutrition? An Empirical Analysis of India’s Public Distribution System’, Economic Development and Cultural Change, 54(1): 203–235.CrossRefGoogle Scholar
Krishnamurthy, P., Pathania, V. and Tandon, S. (2017), ‘Food price subsidies and nutrition: evidence from state reforms to India’s public distribution system’, Economic Development and Cultural Change, 66(1): 55–90.CrossRefGoogle Scholar
Lambie-Mumford, H. (2013), ‘“Every Town Should Have One”: Emergency Food Banking in the UK’, Journal of Social Policy, 42(1): 73–89.CrossRefGoogle Scholar
Loopstra, R., Fledderjohann, J., Reeves, A. and Stuckler, D. (2018), ‘Impact of welfare benefit sanctioning on food insecurity: a dynamic cross-area study of food bank usage in the UK’, Journal of Social Policy, 47(3): 437–457.CrossRefGoogle Scholar
Lustig, R. H., Schmidt, L. A. and Brindis, C. D. (2012), ‘Public health: The toxic truth about sugar’, Nature, 482(7383): 27.CrossRefGoogle ScholarPubMed
Maitra, P., Rammohan, A. and Dancer, D. (2006), ‘The link between infant mortality and child nutrition in India: is there any evidence of a gender bias’, European Society for Population Economics Annual Conference, Verona, Italy. http://www.researchgate.net/publication/233115760_The_link_between_infant_mortality_and_child_nutrition_in_India_is_there_any_evidence_of_a_gender_bias/file/d912f50bffc323b9ac.pdf [19 November 2013].Google Scholar
Malik, V. S., Schulze, M. B. and Hu, F. B. (2006), ‘Intake of sugar-sweetened beverages and weight gain: a systematic review’, The American Journal of Clinical Nutrition, 84(2): 274–288.CrossRefGoogle ScholarPubMed
Mohan, V., Spiegelman, D., Sudha, V., Gayathri, R., Hong, B., Praseena, K., et al. (2014), ‘Effect of brown rice, white rice, and brown rice with legumes on blood glucose and insulin responses in overweight Asian Indians: a randomized controlled trial’, Diabetes technology & therapeutics, 16(5): 317–325.CrossRefGoogle Scholar
National Sample Survey Organization (2005), Consumer Expenditure Survey, 61st round 2004–05. New Delhi, India: Ministry of Statistics and Programme Implementation, Government of India.Google Scholar
National Sample Survey Organization (2010), National Sample Survey Organisation. Consumer Expenditure Survey, 66th round 2009–10. New Delhi, India: Ministry of Statistics and Programme Implementation, Government of India.Google Scholar
National Sample Survey Organization (2014), ‘Official Website’. http://mail.mospi.gov.in/index.php/catalog/19 [21 July 2014].Google Scholar
NDTV (2010), ‘“Corrupt” public distribution system, says Supreme Court panel’, NDTV.com. https://www.ndtv.com/india-news/corrupt-public-distribution-system-says-supreme-court-panel-412887 [29 December 2019].Google Scholar
OHCHR (n.d.), ‘Special Rapporteur on the right to food’, OHCHR.org. United Nations. https://www.ohchr.org/EN/HRBodies/CESCR/Pages/CESCRIndex.aspx [30 September 2019].Google Scholar
Oxford Department of International Development (n.d.), ‘Young Lives’. http://www.younglives.org.uk/ [28 January 2015].Google Scholar
Pal, S. (1999), ‘An analysis of childhood malnutrition in rural India: role of gender, income and other household characteristics’, World Development, 27(7): 1151–1171.CrossRefGoogle Scholar
Pandey, G. (2011), ‘India’s immense “food theft” scandal’, BBC News. Lucknow, 22 February. https://www.bbc.com/news/world-south-asia-12502431 [29 December 2019].Google Scholar
Pillay, D. P. K. and Kumar, T. K. M. (2019), ‘Food Security in India: Evolution, Efforts and Problems’, Strategic Analysis, 42(6): 595–611.CrossRefGoogle Scholar
Pont, S. J., Puhl, R., Cook, S. R. and Slusser, W. (2017), ‘Stigma experienced by children and adolescents with obesity’, Pediatrics, 140(6): e20173034.CrossRefGoogle ScholarPubMed
Pottier, J. (1999), Anthropology of Food: the Social Dynamics of Food Security. Polity Press.Google Scholar
Rahman, A. (2016), ‘Universal food security program and nutritional intake: Evidence from the hunger prone KBK districts in Odisha’, Food Policy, 63: 73–86.CrossRefGoogle ScholarPubMed
Ramachandran, P. (2006), ‘The Double Burden of Malnutrition in India’, The Double Burden of Malnutrition: Case Studies from six Developing Countries. Rome: Food and Agriculture Organization of the United Nations, 99–160.Google Scholar
Rubin, D. B. (2004), Multiple imputation for nonresponse in surveys. John Wiley & Sons.Google Scholar
Sandjaja, , Poh, B. K., Rojroonwasinkul, N., Nyugen, B. K. L., Budiman, B., Ng, L. O., et al. (2013), ‘Relationship between anthropometric indicators and cognitive performance in Southeast Asian school-aged children’, British Journal of Nutrition, 110(S3): S57–S64.CrossRefGoogle ScholarPubMed
Sen, A. (2001), Development as Freedom. Oxford ; New York: Oxford Paperbacks.Google Scholar
Sen, A. and Sengupta, S. (1983), ‘Malnutrition of rural children and the sex bias’, Economic and political weekly, 855–864.Google Scholar
Shankar Shaw, T. and Telidevara, S. (2014), ‘Does food subsidy affect household nutrition? Some evidence from the Indian Public Distribution System’, International Journal of Sociology and Social Policy, 34(1/2): 107–132.CrossRefGoogle Scholar
Sharma, V. (2012), ‘Food Subsidy in India: Trends, Causes and Policy Reform Options’. Indian Institute of Management. http://www.iima.edu.in/assets/snippets/workingpaperpdf/5337679172012-08-02.pdf [18 August 2014].Google Scholar
Shobana, S., Kokila, A., Lakshmipriya, N., Subhashini, S., Ramya Bai, M., Mohan, V., et al. (2012), ‘Glycaemic index of three Indian rice varieties’, International journal of food sciences and nutrition, 63(2): 178–183.CrossRefGoogle ScholarPubMed
Smith, L. C., Ruel, M. T. and Ndiaye, A. (2005), ‘Why is Child Malnutrition Lower in Urban than in Rural Areas? Evidence from 36 Developing Countries’, World Development, 33(8): 1285–1305.CrossRefGoogle Scholar
Subramanian, S. V., Kawachi, I. and Smith, G. D. (2007), ‘Income inequality and the double burden of under-and overnutrition in India’, Journal of Epidemiology and Community Health, 61(9): 802–809.CrossRefGoogle ScholarPubMed
Tarozzi, A. (2005), ‘The Indian Public Distribution System as Provider of Food Security: Evidence from Child Nutrition in Andhra Pradesh’, European Economic Review, 49: 1305–30.CrossRefGoogle Scholar
Taubes, G. (2017), The case against sugar. Anchor Books.Google Scholar
United Nations (1948), ‘Universal Declaration of Human Rights’. United Nations. https://www.un.org/en/universal-declaration-human-rights/index.html [30 September 2019].Google Scholar
U.S. Department of Agriculture and U.S. Department of Health and Human Services (2010), Dietary Guidelines for Americans 2010. Washington, DC. http://www.cnpp.usda.gov/sites/default/files/dietary_guidelines_for_americans/PolicyDoc.pdf.Google Scholar
Vellakkal, S., Fledderjohann, J., Basu, S., Agrawal, S., Ebrahim, S., Campbell, O., Doyle, P. and Stuckler, D. (2015), ‘Food Price Spikes Are Associated with Increased Malnutrition among Children in Andhra Pradesh, India’, The Journal of Nutrition, jn211250.CrossRefGoogle ScholarPubMed
Vellakkal, S., Subramanian, S. V., Millett, C., Basu, S., Stuckler, D. and Ebrahim, S. (2013), ‘Socioeconomic inequalities in non-communicable diseases prevalence in India: disparities between self-reported diagnoses and standardized measures’, PloS one, 8(7): e68219.CrossRefGoogle ScholarPubMed
von Grebmer, K., Bernstein, J., Mukerji, R., Patterson, F., Wiemers, M., Ni Cheilleanchair, R., et al. (2019), 2019 Global Hunger Index Report: The challenge ofhunger and climate change. Bonn: Welthungerhilfe & Concern Worldwide. https://www.concernusa.org/wp-content/uploads/2019/10/2019_Global_Hunger_Index.pdf.Google Scholar
Wang, Youfa, Chen, H-J, Shaikh, Saijuddin and Mathur, Prashant (2009), ‘Is obesity becoming a public health problem in India? Examine the shift from under-to overnutrition problems over time’, Obesity Reviews, 10(4): 456–474.CrossRefGoogle ScholarPubMed
WHO (2014), ‘The WHO Child Growth Standards’. http://www.who.int/childgrowth/en/ [19 July 2014].Google Scholar
Wilkinson, R. and Marmot, M. (eds.) (2003), Social Determinants of Health. The Solid Facts. World Health Organization. http://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf.Google Scholar
Wilson, G. (1989), ‘Family Food Systems, Preventive Health and Dietary Change: A Policy to Increase the Health Divide’, Journal of Social Policy, 18(2): 167–185.CrossRefGoogle Scholar
World Health Organization (2015), ‘Sugars intake for adult and children guideline’, WHO. http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/ [28 April 2015].Google Scholar
World Health Organization, UNICEF (2010), Indicators for Assessing Infant and Young Child Feeding Practices: Part 2: Measurement. Geneva: World Health Organization.Google Scholar
Young Lives Study (2006), ‘Household Questionnaire – 5yr old. UK Data Archive, Study Number 6852’. http://www.younglives.org.uk/files/questionnaires/r2/india/r2-in-yc-5yrold-household-questionnaire [19 July 2014].Google Scholar
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