Female house ownership drives the positive association between matriliny and women’s health in Meghalaya (India)

Matrilineal kinship, which traces descent through the mother's lineage, has been shown to have health benefits for both women and children, but the specific practices by which matriliny enhances female health outcomes remain unclear. In this study, we analysed the 2015 Demographic and Health Survey data from Meghalaya, India (4,109 women, 809 men, 3,197 children), a region where matrilineal and non-matrilineal communities coexist with a mixed combination of post-marital residence and inheritance transmission. We considered three practices usually associated with matrilineal systems (i) female house ownership, (ii) matrilocal post-marital residence and (iii) daughter-biased investment. We find no evidence for daughter-biased parental investment in medical care nor improved health with spatial proximity with kin. Instead, we demonstrate that female (vs. male) ownership correlates with substantial health benefits for women, including reduced risks of being anemic (OR = 0.72, SE = 0.093, p<0.001) and underweight (OR = 0.59, SE = 0.135, p<0.001), a benefit which extend to men, albeit to a lesser extent, and children. Boys and girls living in households owned by women are more likely to receive medical care when sick (+ 200%). The associations between female house ownership and better health outcomes remain after adjusting for age, wealth disparities, geographical area, fertility, or time since last birth. This results strongly suggest that female economic empowerment surpasses other matrilineal dimensions in improving health outcomes, providing novel insights to bridge the gender health gap.