PERSISTENT GEOGRAPHIC DISPARITIES IN ADULT HEIGHT ACROSS INDIA: EVIDENCE FROM NATIONAL FAMILY HEALTH SURVEY

Abstract

Objective: The present study aimed to assess regional and interstate variations in average adult height among Indian men and women using National Family Health Survey (NFHS) data across multiple survey rounds. Methods: Secondary analysis, Cross-sectional, observational study using data of NFHS-2 (1998-1999), NFHS-3 (2005 2006), NFHS-4 (2015–2016) and NFHS-5 (2019–2021) in a nationally representative sample of adult men (aged 20 to 54 years) and women (aged 20 to 49 years) was used. Adult men and women from all states and union territories with valid anthropometric measurements were included in the study. Mean height and standard deviation (SD) were calculated separately for men and women across states, regions, and NFHS rounds. Results: Significant regional and interstate differences in adult height were observed among both men and women (p < 0.001). Among men, the highest mean height was observed in Punjab (167.6 ± 6.83 cm), followed by Haryana (167.0 ± 6.57 cm) and Kerala (166.3 ± 6.92 cm), whereas the lowest mean height was recorded in Meghalaya (158.7 ± 6.21 cm). Among women, Jammu and Kashmir reported the highest mean height (155.6 ± 6.37 cm), while Tripura, Bihar, and Jharkhand exhibited the lowest values (149.8–149.9 cm). Regionally, the highest average stature for both men and women was observed in the northern region while relatively lower mean heights were observed in eastern and north-eastern regions. Temporal analysis across NFHS rounds showed modest improvements in women height in several states and regions, whereas men height showed stagnation or slight decline in some areas. Conclusion: The study reveals considerable regional and inter-state differences in adult stature in India. The northern and southern states tended to have taller populations, the eastern and some north-eastern states consistently lower mean height. Although women stature improved slightly over time, differences are still significant across regions.