To what extent do wealth status, urban/rural place of residence and ethnicity – and their intersection – explain inequalities in education and health? This paper traces the changes that have occurred in these intersecting inequalities in 16 countries over periods of approximately ten years. It finds that people who experience intersecting disadvantages have been left behind by gains in human development over the past 20 years. The paper recommends policy action that goes beyond technical solutions to prioritise those who experience overlapping disadvantage.
This analysis responds to two key gaps in knowledge about intersecting inequalities: a rigorous methodological approach to their measurement, and empirical evidence on their links to human development. The study uses a GE approach of decomposition to identify diversity (rather than uniformity) in the data set. A comparison between the ratio of between-group to total inequality over time is used to determine the share of inequality accounted for by between-group intersections. It draws on DHS data from 16 countries with two survey rounds in the 1990s and the 2000s.
Overall, intersecting inequalities in health and education were found in each of the 16 countries but how these inequalities are experienced and their impact is dependent on context. In the majority of countries examined, people who have the least assets are more likely to live in rural areas. Most countries display a strong relationship between ethnicity and wealth, particularly Bolivia and Peru. However, there is no observable trend across countries on the relationship between ethnicity and place of residence due to the high variability within countries.
A number of other key findings emerge:
- Gaps between the most disadvantaged group and the population average are pronounced in both education and health: years of education ranges from one to nearly six, and the share of children who have died differs between three and 18 percentage points.
- The poorest women from minority ethnic groups had the lowest average outcomes in education in 11 out of the 16 countries and the highest share of child deaths in 14 of 16 countries.
- People in the bottom wealth quintile live largely in rural areas and disproportionately belong to particular ethnic groups. A strong relationship between ethnicity and rural-urban status within the sample is not found.
On the extent to which intersecting inequalities condition inequality in education and health, two main findings emerge:
- The combination of belonging to a disadvantaged ethnic group and living in a rural area has a particularly strong adverse effect on outcomes.
- Inequality based on wealth and ethnicity has changed less over the past 20 years than any other intersecting inequalities explored in this paper.
Policies need to address individuals from disadvantaged groups and also those who face intersecting disadvantages. This requires both technical solutions, such as better targeting, and addressing politically sensitive issues, such as social discrimination. Disaggregated data is key to monitoring and evaluating implementation.