Son Preference and Excess Female Disability Among Children of Immigrants from India and China Living in the United States

Background and Purpose

Parents’ preference for sons is a form of discrimination that has been linked to gender disparities in the health of children in India and China where studies find that girls are more likely to be aborted, and if born, less likely to live past childhood, go to school, and receive medical treatment when sick compared to boys. Previous research also finds that Indian and Chinese immigrants in the U.S. have male-female birth sex ratios that exceed what is biologically normal indicating that son preference and sex-selective abortion continues after migration. However, it is not known whether son preference has implications on the health of daughters of Indian and Chinese immigrants in the U.S.

We investigate whether there is excess morbidity among daughters of Indian or Chinese immigrants in the U.S. by studying gender differences in the prevalence of disability among children aged 5-17 years. We also examine whether duration of time spent in the U.S. modifies the gender disparity in disability. We hypothesized that daughters of Indian or Chinese immigrants would have a higher prevalence of disability than would be expected in the absence of son preference, and that longer duration of migration would be associated with a decline in excess female disability.

Methods

Data: we use data from the 2012-2014 American Community Surveys on children aged 5-17 whose mothers were born in India (16,993), and China (11,922). To account for sex differences in the prevalence of disabilities that are due to innate differences between the sexes, we use two comparison groups: children of Philippine-born mothers (11,912), and U.S.-born children of U.S. natives (563,921).

Disability measure: we consider a child had a disability if the child had any serious difficulty hearing, seeing even when wearing glasses, walking or climbing stairs, dressing or bathing, or a cognitive difficulty arising from a physical, mental, or emotional condition.

Analysis: we estimate excess female disability among children of Indian and Chinese immigrants and test for moderation by mother’s duration of migration using regression analyses controlling for child’s age and birth order, and mother’s age, duration of migration, educational attainment, household size, household income, and year of survey.

Results

We find excess female disability among children of Chinese immigrants (p<0.05) but not of Indian immigrants. There is excess female disability among children of Chinese immigrants who have lived in the U.S. for 0-14 years (p<0.05), which disappears among those who have been in the U.S. for 15 or more years. Analyses with and without the controls listed above yield the same results.

Conclusions and Implications

Son preference may influence the health of daughters of recently-arrived immigrants from countries where gender discrimination is prevalent. Efforts to address son preference are therefore called for. Our results suggest that such efforts should not be limited to eliminating discrimination of girls prior to birth, e.g., sex-selective abortion, but also after birth. Since economic conditions, e.g., household income, or education do not appear to reduce the negative effects of son preference, interventions may need to incorporate strategies that address cultural norms.