A second puzzle is that the problem of malnutrition/under-nutrition in India
is not just about poverty. Although underweight children are more prevalent
among the poor (47 per cent of the poorest third of the population by income),
the problem is still high among the richer (25 per cent among the highest third
by income). Under-nutrition also varies strikingly even within single house-
holds. Mortality linked to inferior nutrition allocation by parents is higher
among girl children in Indian households (Das Gupta, 1987). For a more
extended discussion on the reasons for this last ‘paradox’ see the section on
missing women in Chapter 4.
In India, 80 per cent of the population do not consume the daily 2,400 calo-
ries in rural and 2,100 calories in urban areas that have long been designated as
the cut-off point for adult poverty. For all India per capita calories specifically
from cereals declined from 1,600 in 1983 to 1,326 in 2004 (Deaton and Drèze,
2009:44). Some argue that calorie consumption is good proxy measure of
poverty so these figures indicate poverty was much higher (80 per cent) in
India by the late 2000s than suggested by the official statistics (20–25 per
cent). The fall in per capita calorie consumption has been explained by the
worsening income distribution and an absolute decline in incomes and
purchasing power for a major part of the population, outweighing the minority
with fast rising incomes; the malnutrition crisis is then a question of distribu-
tion (Patnaik,2007,2010). It is difficult to square these arguments with clear
evidence from other sources, that per-capita consumption of other goods and
services among all expenditure classes in India has been increasing and
surveys showing self-reported ‘hunger’ declining (Deaton and Drèze, 2009,
2010). While Patnaik argues that declining calorie consumption indicates
rising poverty it is difficult to reconcile this argument with evidence that the
decline in per capita calorie consumption is more marked among high-income
households and also that per capita calorie consumption tends to be higher in
poorer states of India (Bihar and Orissa) than in richer states (Punjab and
Haryana).
This debate is at the heart of the discussion about how to judge whether
basic needs (such as nutrition) are being fulfilled. How do we make a value
judgement when a household with sufficient disposable incomes does not
consume a nutritious diet? There is good evidence from consumer surveys that
Indian consumers have been shifting to higher-priced calories such as meat,
sugar and milk and away from more nutritious grains. Are such households
falling into poverty or exercising choice?
There is also good reason to suppose that the consequence of economic
growth has changed nutritional basic needs in India, reducing the need for
calories and making comparisons over time harder, this was a general problem
we discussed with the Basic Needs approach. Improvements in vaccination,
access to drinking water and sanitation have reduced the incidence of health
conditions such as diarrhoea that drain away the nutritional value of calorie
consumption. The total fertility rate in India has declined from 6.6 in the 1960s
to 2.8 average births per woman in 2005, reducing the need for extra calories
36 Sources of Growth in the Modern World Economy since 1950