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Sex differences in early age mortality have been explained in priorliterature by differences in biological make-up and gender discrimination inthe allocation of household resources. Studies estimating the effects of thesefactors have generally assumed that offspring sex ratio is random, which isimplausible in view of recent evidence that the sex of a child is partlydetermined by prenatal environmental factors. These factors may also affectchild health and survival in utero or after birth, which implies thatconventional approaches to explaining sex differences in mortality are likelyto yield biased estimates. We propose a methodology for decomposing thesedifferences into the effects of prenatal environment, child biology, andparental preferences. Using a large sample of twins, we compare mortality ratesin male-female twin pairs in India, a region known for discriminating againstdaughters, and sub-Saharan Africa, a region where sons and daughters arethought to be valued by their parents about equally. We find that: (1) prenatalenvironment positively affects the mortality of male children; (2) biologicalmake-up of the latter contributes to their excess mortality, but its effect hasbeen previously overestimated; and (3) parental discrimination against femalechildren in India negatively affects their survival; but failure to control forthe effects of prenatal and biological factors leads conventional approaches tounderestimating its effect by 237 percent during infancy, and 44 percent duringchildhood.

Twin Estimates of the Effects of Prenatal Environment, Child Biology, and Parental Bias on Sex Differences in Early Age Mortality