Skip to content


Health and hunger: Can an improving disease environment explain the Indian calorie consumption decline puzzle?

Research, Sanitation1 min read

Authors: Josephine Duh, Dean Spears

Published in: The Economic Journal

Download Paper


India's experience presents a puzzle at odds with a basic fact of household economics: amidst unprecedented economic growth, average per capita daily calorie consumption has declined in recent decades. Does an improving disease environment explain the calorie decline? A diminished burden of infectious disease could lower energy needs by increasing absorption and effective use of calories.

We document a robust effect of disease exposure  measured as infant mortality and as poor sanitation  on calorie consumption. Similar effects are found using multiple datasets and empirical strategies. Disease can account for an important fraction (one-fifth or more) of India's calorie decline.


r.i.c.e. is a non-profit research organization focused on health and well-being in India. Our core focus is on children in rural north India. Our research studies health care at the start of life, sanitation, air pollution, maternal health, social inequality, and other dimensions of population-level social wellbeing.

501(c)(3) Status

Privacy Policy

Research Themes

Content by Category

© 2024 r.i.c.e.