ArticleJournal of racial and ethnic health disparities2023
Explaining Caste-Based Disparities in Enrollment for National Health Insurance Program in India: a Decomposition Analysis.
Article in Journal of racial and ethnic health disparities, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 7 citations in OpenAlex.
- Health system responsiveness to older adults with functional limitations and socio-economic vulnerability in India.Global health action · 2026Article
- Examining Explicit and Implicit Caste Bias Among Healthcare Providers in India.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Intersectionality of cancer disparities in south Asia.The Lancet. Global health · 2026Review
- Bridging the gap between health insurance eligibility and uptake: A multistate quantitative analysis of entitlement-based verification patterns under India's PM-JAY Scheme.PLOS global public health · 2026Article
- Reducing infant and child mortality: assessing the social inclusiveness of child health care policies and programmes in three states of India.BMC public health · 2023Article
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
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Abstract
backgroundCaste plays a significant role in individual healthcare access and health outcomes in India. Discrimination against low-caste communities contributes to their poverty and poor health outcomes. The Rashtriya Swasthya Bima Yojana (RSBY), a national health insurance program, was created to improve healthcare access for the poor. This study accounts for caste-based disparities in RSBY enrollment in India by decomposing the contributions of relevant factors.
methodsUsing the data from the 2015-2016 round of the National Family Health Survey, we compare RSBY enrollment rates of low-caste and high-caste households. We use a non-linear extension of Oaxaca-Blinder decomposition and estimate two models by pooling coefficients across the comparison groups and all caste groups. Enrollment differentials are decomposed into individual- and household-level characteristics, media access, and state-level fixed effects, allowing 2000 replications and random ordering of variables.
resultsThe analysis of 480,766 households show that scheduled tribe households have the highest enrollment (18.85%), followed by 14.13% for scheduled caste, 10.67% for other backward caste, and 9.33% for high caste. Household factors, family head's characteristics, media access, and state-level fixed effects account for a 32% to 52% gap in enrollment. More specifically, the enrollment gaps are attributable to differences in wealth status, educational attainment, residence, family size, dependency ratio, media access, and occupational activities of the households.
conclusionsWeaker socio-economic status of low-caste households explains their high RSBY enrollments.
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