Beyond Risk Factors: Identifying Population Subgroups That Account for India’s Child Stunting Burden

Using data from India’s National Family Health Survey-5 (NFHS-5, 2019–21), this study identifies subgroups of children who share combinations of social position and estimates how much of the national stunting burden each subgroup carries. A two-step latent class analysis (LCA) of four binary indicators of social position (household poverty, urban residence, Muslim religion, maternal education) was applied to 230,011 children, and stunting (HW70) was cross-tabulated within each class for 203,379 children with valid measurements. Three classes emerged: High-Risk Poor, Rural Advantaged, and Muslim-Concentrated Mixed-Residence. The High-Risk Poor class (31.8% of children; 76.1% in the poorest wealth quintile, 58.2% with mothers lacking secondary education) carried the highest burden (45.3% stunted, 21.2% severely stunted), with relative risks of 1.50 (95% CI 1.47–1.53) for total and 1.80 (95% CI 1.75–1.87) for severe stunting versus the Rural Advantaged reference. Only this class’s posterior membership discriminated stunting better than chance, and weakly (AUC = 0.580), supporting population targeting rather than individual screening. Within this class, Scheduled Caste and Scheduled Tribe children (15.4% of children) were stunted at 46.4% (RR = 1.54). Targeted, multi-sectoral interventions for socioeconomically disadvantaged households, rather than population-wide or religiously targeted programs, are needed to reduce stunting equitably.