Risk factors in childhood stunting in Karnataka, India, vary by geography

Childhood stunting remains a public health concern in India. In Karnataka, the districts vary substantially in stunting prevalence. Using the NFHS-4 and AidData GEO datasets, we tested the hypothesis that ‘wet’ and ‘dry’ districts in Karnataka show different contribu-tions to stunting. We found that for 30 environmental and health factors, Bengaluru appears to be distinct from the other districts. Using a mixed linear model approach, we found that for the entire state, and in both wet and dry districts, preceding birth interval, altitude-adjusted haemoglobin level and child age showed significant correlations with height for age (HFA). The wet districts showed an additional associa-tion between maternal age and child HFA. However, interaction effects also differed among the three con-ditions. Our results suggest that subtle variations should not be ignored when considering factors im-pacting child health outcomes.