Dalit women in India die younger than upper caste women, face discrimination in accessing healthcare and lag behind on almost all health indicators. While violence against Dalits may be the main form of discrimination visible to the outside world, there are many other ways in which caste prejudice manifests itself, one of them being health. This is borne out by recent data from the from the National Family Health Survey (NFHS).
For Dalits, who make 16.6% of the total population, health inequalities are the result of both past and ongoing discrimination, including limited educational opportunities, high health risk occupations they are forced to take up, discrimination in access to land, employment, housing and other resources, reports Livemint. According to the recent data from the National Family Health Survey (NFHS), among the women in the age group 25-49 who have anaemia, 55.9 % are Dalits. The national average among Indians is 53%. Even though anaemia is a widespread problem faced by women in India, for Dalit women the problem is compounded. The average age of death for Dalit women is 14.6 years younger than for higher caste women, according to the report, Turning promises into action: gender equality in the 2030 Agenda, which cites a finding from the Indian Institute of Dalit Studies in 2013. According to that finding, the average age at death for Dalit women was 39.5 years against 54.1 years for higher-caste women. Under Indian law, it is a punishable offence to refuse to admission to hospital, dispensary, etc on the basis of “untouchability.” Still in 2016, the nursing staff of the Puranpur community health centre in Uttar Pradesh allegedly refused to admit a pregnant Dalit woman. The woman delivered the baby unassisted and the child died a few hours after being born. This wasn’t the only case. Dalits are refused admission to hospitals, or access to health care and treatment. In a number of cases those who are admitted receive discriminatory treatments.
According to the NFHS data, among Dalits, 70.4 % of women reported problems with accessing healthcare when they knew they are sick. Among the reasons cited, getting permission to go to the hospital facility, or distance to the health facility, or money were stated as the reasons. Among Dalits, 52.2 % women in the age group 15-49 years had a live birth in the presence of a doctor in the preceding five years. For the upper castes it is 66.8%. One in four women among the Dalits in the 15-49 age bracket are undernourished according to their Body Mass Index (BMI), while one in six women among upper castes have a similar nutritional profile.
The NFHS finding backs up a 2015 Lancet report ‘Health and the Indian caste system’, by Paul Kowal and Sara Afshar, which says at least three factors are associated with how the caste system affects health—genetics, early environment, and opportunities due to social mobility.