ArticleFrontiers in nutrition2026
State-level nutritional disparities and policy priorities in India.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Nutritional inequality persists in India despite sustained economic growth, expanding healthcare infrastructure, and large-scale social welfare programs. National averages mask substantial subnational disparities, concealing deep inequalities that continue to shape nutritional outcomes across States and Union Territories. This study quantifies nutritional inequality across Indian States and Union Territories using the latest NFHS-6 factsheet (2023-24) data, integrating multidimensional and spatial methods to provide a comprehensive evidence base for geographically targeted nutrition policy. Methods: Data from 36 States/UTs (excluding Manipur) were analyzed using an ecological, cross-sectional, and comparative research design. Outcome indicators included child stunting, wasting, and underweight prevalence, which were standardized and aggregated into a Child Undernutrition Burden Index (CUBI). A Dietary Vulnerability Index (DVI) was also constructed using standardized indicators of dietary diversity, nutrient-rich food consumption, and household food insecurity. Inequality was assessed via coefficient of variation, Theil decomposition, and Moran's Results: National prevalence was 29.3% for stunting, 19.0% for wasting, and 31.8% for underweight. Jharkhand (CUBI = 1.35), Gujarat (0.94), and Bihar (0.81) had the highest burden, while Goa (-1.45), Kerala (-1.32), and Tamil Nadu (-1.21) had the lowest. Significant spatial autocorrelation (Moran's Conclusion: India's nutritional transition remains characterized by persistent spatial clustering and substantial within-region inequality. State-level priorities should focus on female education, sanitation, dietary diversity, and women's empowerment, while CUBI, quantile regression, and spatial spillover evidence can guide targeted interventions and coordinated regional nutrition policies.
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