Social Networks and Health Knowledge in India: Who You Know or Who You Are?

Addressing several methodological shortcomings of the previous literature, this paper explores the relationship among health knowledge and caste and religion and a number of important mediating factors in India, estimating causal impacts through a combination of instrumental variables and matching methods. The results indicate the presence of a substantively large caste and religion health knowledge gap in the context of proper treatment of diarrhea in children favoring high caste women relative to low caste and Muslim women. We also provide evidence that while observed individual characteristics such as education and access to social networks explain part of the gap, a substantial part of the health knowledge gap is left unexplained. All groups have greater health knowledge in urban than in rural areas, but the gap is even wider in urban than in rural areas. Additionally, high caste women benefit more in terms of health knowledge from having health networks than women from other groups; except if the health person is of the same caste/religion, in which case low caste and Muslim women sometimes benefit by as much as double that of high caste women, or even more. It may therefore not be enough to give individuals access to high quality networks if caste and religion-related gaps in health knowledge are to be reduced; such networks also have to be homophilous, to have the maximum effect. Improved treatment from and confidence in the medical profession is found to be part of the mechanism linking health social network formation with improved health knowledge about the treatment of diarrhea in children.