This paper is concerned with examining the changes in health status that occurred during the years following major economic reforms in India and exploring to what extent and how they were related to the policy changes instituted under the new regime.
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In an important paper, Cornia (2018, p.1), argued that there have been “episodes of political, economic and social transformation that were expected to generate greater political freedom, economic prosperity, and individual wellbeing, but that instead generated substantial increases in death rates, particularly among low-income groups.” Cornia identified various mechanisms for such outcomes, including “the unexpected effects of rural-urban migration combined with an inelastic supply of public infrastructure; political reforms carried out in the absence of adequate administrative, legal and redistributive institutions; the introduction of economic reforms under conditions of incomplete or distorted markets and institutions; and the unchecked contact between socio-economic groups characterized by different disease profiles.” In this paper, we focus specifically on one of these mechanisms, the introduction of economic reforms, to consider the impact on changing health status in India over the past three decades. We ask whether the various reforms introduced in India since the early 1990s had any impact on changing the environment for achieving better health outcomes and explore the extent to which they can be linked to the relatively poor progress in the health status of the bulk of the population.
We begin with a brief description of the main economic reforms in India since 1991, followed in the next section by an examination of the trends in the important indicators of health since 1991. The fourth section considers the differential behaviour of health indicators in some Indian states, given that there is wide interstate disparity in both levels and trends of health indicators, and a significant part of both health policy and public health expenditure is the responsibility of state governments within India’s federal system. The fifth section takes up one particular issue in which public policy appears to be directly related to mortality: agrarian distress and farmers’ suicides.
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