Does increased access increase equality? Gender and child health investments in India

Increases in access to social services are often thought to decrease inequality in the level of these services between advantaged and disadvantaged groups. This is an issue in the developing world, where policymakers often argue that increasing the level of health care, for example, will decrease gender inequality. However, increases in access to services often haven empirically ambigous effects in inequality, increasing it in some cases and decreasing it in others. This paper argues that this is not surprising, and simple economic theory suggests that we should expect a non-monotonic relationship between access and inequality. At low levels of access to investments. there is no investment for either the advantaged or disadvantaged group, producing equality. Increases in access increase investment for the advantage group first, generating inequality. Further increases in access increase investment in the disadvantaged group, decreasing inequality. I test the predictions of this theory using data on the availability of health camps (or distance to health centers) and gender differences in vaccinations in India. I find strong support for a non-monotonic relationship between access and gender equality. (C) 2008 Elsevier B.V. All rights reserved.