yet none of the parallel causes of malnutrition are independent of income the overall level of national income is a determinant of the state s availability to pay for key public services while individual incomes also determine the household s uptake of education and its access to health water and sanitation the composition of income growth matters as well as the overall rate as it is increases in the incomes of the poorest that have the greatest impact on nutritional outcomes moreover in many countries the rural poor are discriminated against in terms of the provision of basic public services