The purpose of this systematic review is firstly to critically appraise and summarize the peerreviewed
published evidence on the relationship between the caste system and risk factors
for poor health status in India and secondly, to discuss the concept of the social gradient
and policies that have been developed to address social inequalities of healthcare in India.
Studies explored the relationship between caste membership and health-related risk factors
such as mortality, health behaviors, and nutritional status. Review revealed odds of mortality;
poor health behaviors and poor nutritional status were higher and in some cases were
significantly higher in lower caste groups in comparison to reference groups. Odds ratios reported
for mortality and poor health behaviors were significantly higher in older populations.
Odds ratios reported for nutritional status and mortality were significantly higher in younger
populations. Further research on the independent effects of wealth and education would
broaden the scope of the social gradient health equation in India.