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For more than a century, cultural norms and traditions in India and elsewhere have favored sons over daughters—a preference based on age-old beliefs that male children add to household wealth, provide for parents and relatives in their old age, and carry the family name. Female children are viewed as financial burdens that add little value to the family and deplete income come wedding time. But while researchers have tracked the ramifications of son preference and male-biased sex ratios at birth, little is known of the effects of the bias on adult female mortality.

Previous research has shown that parents in communities where sons are preferred over daughters do not support their unborn and living female children. Sex-selective abortions in India have risen sharply in the past decade, a development thought to be correlated with the emergence of technologies that enable parents to know earlier whether they are having a boy or a girl. Surprising to many is the fact that studies have shown that “sex-selective abortion is more common among educated women and after the first child is born.”

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