Socioeconomic variation in the growth status of children in a subsistence agricultural community

Socioeconomic variation in the growth status of 293 children, 6 through 13 years of age, from a rural subsistence agricultural community in southern Mexico was considered. Socioeconomic status was based on an index developed from landholdings, household goods, and occupation, and households were classified as high and low status. Growth measurements included weight, stature, sitting height, estimated leg length, arm and estimated arm muscle circumferences, triceps skinfold, and right gripping strength. The growth status of boys showed a clear socioeconomic differential, while that of girls did not. The results are consistent with the generalization that males are more influenced by environmental stresses than females, including, of course, the favorable stress of improved socioeconomic circumstances, even within seemingly single-class rural communities.     

Health and disease: Exploring the relation between parasitic infections,child nutrition status,and markets

Research in bioarchaeology and among living people provides insight into the biological and biocultural consequences of subsistence, political, and economic transitions. Central to this effort is examining infectious disease, such as diarrheal disease, respiratory infections, and parasitic infections because they are an important source of nutritional and energetic stress in both past and current groups. Although infection may not always result in overt disease, frequent exposure results in biological stress with a negative effect on child growth and, by extension, health. The goal of this article is to examine the association between a common class of infectious disease, soil-transmitted helminth worms, and nutritional status among youth living in communities that vary with respect to their distance from a commercial center. In 2007, anthropometric measurements and parasitological surveys were collected for 338 2–14-year-old children and adolescents living in lowland Bolivia as part of the Tsimane' Amazonian Panel Study. Associations between the presence of helminth infections and markers of both short- and long-term nutritional status were overall weak. Youth living in communities distant from the commercial center were more likely to be positive for multiple parasite species than youth in near communities, but youth in mid-distance communities had lower infection rates. This article demonstrates the challenge of identifying associations between nutritional and disease stress when individual and household factors are nested in a larger context of socioeconomic and environmental change. Increased collaboration between bioarchaeology and human biology should continue to examine the connections between stress and disease across time. Am J Phys Anthropol 155:221–228, 2014. © 2014 Wiley Periodicals, Inc.     

Closing the rural-urban gap in child malnutrition: Evidence from Paraguay, 1997–2012

Between 1997 and 2012, Paraguay achieved not only remarkable improvements in child nutrition, but also a surprising elimination of the rural-urban differential in child height-for-age Z score (HAZ) and stunting. Our decomposition analysis, applied to four rounds of Paraguayan National Household Surveys, allows us to directly infer not only the contributions of changes in determinants of child nutritional status to the improvements in child nutritional status in rural and urban areas, but also their contribution to closing the rural-urban gap. We find that while common determinants of child nutritional status such as income, maternal education, sanitation, and access to piped water are strongly associated with improvements in child nutrition, they have contributed little to reducing the rural-urban gap (10%, p < 0.05). Improvements in health care utilization, family planning, and demographics have been the main drivers in closing the rural-urban gap in child nutritional status in Paraguay (32%, p < 0.05). The results highlight the potential need for multipronged nutritional strategies that consider the distinct needs of rural and urban communities.     

Household and community socioeconomic influences on early childhood malnutrition in Africa

This paper uses multilevel modelling and Demographic and Health Survey data from five African countries to investigate the relative contributions of compositional and contextual effects of socioeconomic status and place of residence in perpetuating differences in the prevalence of malnutrition among children in Africa. It finds that community clustering of childhood malnutrition is accounted for by contextual effects over and above likely compositional effects, that urban-rural differentials are mainly explained by the socioeconomic status of communities and households, that childhood malnutrition occurs more frequently among children from poorer households and/or poorer communities and that living in deprived communities has an independent effect in some instances. This study also reveals that socioeconomic inequalities in childhood malnutrition are more pronounced in urban centres than in rural areas.     

Genetic and environmental effects on growth of children from a subsistence agricultural community in southern Mexico

Sibling correlations for size attained in height, weight, sitting height, estimated leg length, the triceps skinfold, arm circumference, and estimated midarm muscle circumference were compared in 6- through 13-year-old schoolchildren grouped by household socioeconomic status. The children were residents of a Zapotec-speaking, subsistence agricultural community in the Valley of Oaxaca in southern Mexico. Sibling pairs were classified as being from high and low socioeconomic status (SES) households, and sibling correlations were computed within each SES group controlling for environmental effects derived from a factor analysis of information on household demography and land and livestock holdings. Like-sex siblings from lower SES households have significantly different correlations in four instances. Correlations are higher for leg length in lower SES brothers and higher for sitting height and weight in lower SES sisters, while the correlation for sitting height is higher in upper SES brothers. The sibling correlation results are not entirely consistent with observations on growth status by SES, particularly if the power and similarity of a common environment is the only cause of higher sibling correlations. Reduced body size under poorer socioeconomic and presumably nutritional circumstances is apparent, but it is not possible in this analysis to distinguish whether genotypic (developmental) plasticity or genetic adaptation, or both, are involved.     

Nutritional status and mortality of highland children in Nepal: Impact of sociocultural factors

This study investigates the nutritional status of native children in the highlands of Nepal (1,700–3,000 m) and explores the relationship between child mortality and surviving children's nutritional status. A random sample of 145 households from 11 villages in the Koshi Hill Zone in east Nepal was surveyed, and the nutritional status of the 438 children <14 years of age living in these households was assessed by means of anthropometry. We found a severe growth retardation in the Nepalese children compared to lowland reference groups as well as to highland children from the Andes. Child mortality and altitude are not significantly different between higher (Brahman and Chetri) and lower (Baisya and Sudra) caste households. A lower caste status and higher altitude of the household is associated with a significantly better nutritional status in offspring. In multiple regression analyses, improved nutritional status in children is significantly associated with lower caste (P = 0.001), higher altitude (P = 0.009), and less crowding (P = 0.001) but not with sibling mortality (P = 0.11). We thus conclude that nutritional status of children in households in the highlands of Nepal is associated with the household's socioeconomic status and altitude but not with mortality among siblings. © 1996 Wiley-Liss, Inc.     

Retinol assessment among women and children in sahelian mobile pastoralists

Micronutrient deficiencies are widespread in developing countries, particularly in remote communities such as mobile pastoralists. The nutritional and vitamin A status of this population is not well-documented in Chad. This study assessed serum retinol levels among women and children under five-year-old in nomadic and semi-nomadic pastoralist and rural-settled communities, who are similarly exposed to risk factors such as gastrointestinal parasitic infection, anaemia and emaciation. The novel method of portable fluorometry was used for the first time to measure β-carotene and retinol levels in a pastoral nomadic area. Moderate level blood retinol deficiency (<0.7?μmol/L) was observed in 5% (CI 1-11) of nomadic, 29% (CI 13-45) of semi-nomadic and 22% (CI 8-35) of sedentary women. In children, 1% (CI 0.1-4), 17% (CI 9-25) and 28% (CI 18-39), respectively, had moderate level blood retinol deficiency. In nomadic communities, women and children had blood retinol levels close to normal. Deficiency of retinol was strongly linked with lifestyle (nomadic, semi-nomadic and settled) among women and lifestyle and age among children. The results support an ecological linkage between human retinol levels and livestock milk retinol. This study shows the feasibility of portable retinol and β-carotene measurement in human blood as well as human and animal milk under remote field conditions, but the approach requires further validation.     

Uncultivated Foods in Southern Veracruz,Mexico: Establishing the Links between Ecosystem Health,Food Availability,and Human Nutrition

Uncultivated foods have received little attention in the scientific literature and nutrition programs of Mexico because they are usually seen as complementary to agricultural activities, i.e., corn planting and harvesting. Using an ecosystem approach to human health, this article examines the availability, nutritional contribution, and consumption patterns by gender and age of such foods in Ixhuapan and Ocozotepec, two native communities of southern Veracruz, Mexico. The research shows important differences between both communities. Ixhuapan has a more uniform environment and its people have opted for commercial activities and land parceling. Land use changes have led to a decrease in the number of people engaged in subsistence agriculture, environmental degradation, lower corn yields, and the loss of traditional, uncultivated foods. These changes have had a negative impact on the nutritional status of Ixhuapan children and adults, particularly women. Within each community, however, there are also important differences in terms of access to resources based on gender and age. Men catch game and large fish while women catch shrimp. Men gather seasonal plants in the forest while women gather wild weeds in the cornfields and spices in their backyards. Boys, more often than girls, obtain fruits from trees located in their backyard or the town’s public spaces. The article shows that women’s food resources are frequently consumed and constitute good sources of micronutrients.     

Differential mortality in Turkana agriculturalists and pastoralists

Nomadic pastoral populations appear to have much lower rates of growth than the otherwise very high growth rates now characteristic of populations in developing nations. Because dramatic declines in infant mortality have been a primary contributor to increased population growth rates in these countries, it has been assumed that nomadic pastoral populations are still characterized by high levels of mortality in the first few years of life. Few studies, however, have been undertaken to estimate demographic parameters for nomadic pastoral populations, and even fewer of a comparative nature have been undertaken to document the impact of subsistence strategy on demographic processes. This study compares indirect childhood mortality estimates for Turkana nomadic pastoralists with childhood mortality in a settled agricultural group within the same population and finds that pastoralists have substantially higher levels of mortality. Based on the childhood mortality estimates, model life tables are selected for pastoral and agricultural groups from which values for mean life expectancy and infant mortality are estimated and compared. Recent improvements in primary health care for the settled agricultural group are ruled out as being an important cause of their lower mortality levels, and some aspects of life-style associated with subsistence strategy are discussed as likely determinants of the mortality differences.     

Ethnic expansions and between-group differences in children's health: a case study from the Rukwa Valley, Tanzania

The Sukuma ethnic group appears to be expanding across Tanzania at a rate far greater than other ethnic groups in the area. In this paper, the household-level dynamics that may be fueling this expansion are explored by comparing measures of infant mortality and child health with another Tanzanian ethnic group, the Pimbwe. Consistent with expectations, the Sukuma appear to have comparable levels of fertility but lower child mortality. As predicted, compared to the Pimbwe, Sukuma children are also heavier and taller for their age, suggesting better nutritional status. Four hypotheses about why the Sukuma are so successful in this area are addressed. Surprisingly, the results show that household food security and wealth are not related to children's nutritional status, nor can maternal effects account for the observed health differences. Several lines of evidence suggest that different patterns of infant feeding practices may underlie the differences in children's nutritional status.     

Women's social power, child nutrition and poverty in Mali

While the macro-level association between poverty and child malnutrition is well-established, the concept of 'poverty' and its operationalization in terms of measures of socioeconomic status shed little or no light on the mechanisms through which malnutrition is created and/or prevented. This paper investigates a woman's social power, one such mechanism that may mediate the impact of poverty on childhood nutrition. This micro-level factor is examined using survey data on 402 children 5 years of age and younger and their 261 Fulbe mothers in rural Mali. A conceptual model of social power is developed and used to test the hypothesis that a mother's social power can predict her child's nutritional status.     

Nutritional Consequences of Wealth Differentials in East African Pastoralists: The Case of the Datoga of Northern Tanzania

Among African pastoralists evidence that wealth is associated with other measures of household success is scant and the significance of wealth differentials for family welfare remains poorly understood. Predictions that wealth in livestock is associated with increased adequacy of household food supply and with improved child nutrition are tested with longitudinal data on herd size, household composition, food supply, and anthropometric status collected in 1992 for a sample of traditional Datoga households (n = 20) living in the Eyasi basin in northern Tanzania. Although a majority subsisted below poverty cutoffs estimated for east African pastoral populations, there was large variation among households in measures of wealth and resource availability. Individuals in relatively wealthy households did not appear to benefit either in terms of adequacy of household food supply or in terms of average growth performance of young children. Theoretical and methodological challenges in the study of the relationship between wealth and health in nomadic pastoralists are discussed.     

Ethnicity and Child Health in Northern Tanzania: Maasai Pastoralists Are Disadvantaged Compared to Neighbouring Ethnic Groups

The Maasai of northern Tanzania, a semi-nomadic ethnic group predominantly reliant on pastoralism, face a number of challenges anticipated to have negative impacts on child health, including marginalisation, vulnerabilities to drought, substandard service provision and on-going land grabbing conflicts. Yet, stemming from a lack of appropriate national survey data, no large-scale comparative study of Maasai child health has been conducted. Savannas Forever Tanzania surveyed the health of over 3500 children from 56 villages in northern Tanzania between 2009 and 2011. The major ethnic groups sampled were the Maasai, Sukuma, Rangi, and the Meru. Using multilevel regression we compare each ethnic group on the basis of (i) measurements of child health, including anthropometric indicators of nutritional status and self-reported incidence of disease; and (ii) important proximate determinants of child health, including food insecurity, diet, breastfeeding behaviour and vaccination coverage. We then (iii) contrast households among the Maasai by the extent to which subsistence is reliant on livestock herding. Measures of both child nutritional status and disease confirm that the Maasai are substantially disadvantaged compared to neighbouring ethnic groups, Meru are relatively advantaged, and Rangi and Sukuma intermediate in most comparisons. However, Maasai children were less likely to report malaria and worm infections. Food insecurity was high throughout the study site, but particularly severe for the Maasai, and reflected in lower dietary intake of carbohydrate-rich staple foods, and fruits and vegetables. Breastfeeding was extended in the Maasai, despite higher reported consumption of cow''s milk, a potential weaning food. Vaccination coverage was lowest in Maasai and Sukuma. Maasai who rely primarily on livestock herding showed signs of further disadvantage compared to Maasai relying primarily on agriculture. We discuss the potential ecological, socioeconomic, demographic and cultural factors responsible for these differences and the implications for population health research and policy.     

Rural Livelihood Variation and its Effects on Child Growth in Timor-Leste

Economic development introduces opportunities for subsistence households to diversify income sources. Timor-Leste is undergoing this transition; however, little is known about the patterns of household strategies and the effects of rural development on child wellbeing. We derive strategies from 190 households in two rural Timor-Leste communities and examine the links between resource strategies and child growth using linear mixed modeling. Children’s z-height, z-weight, and z-BMI are well below international standards. We find agriculture remains predominantly subsistence-based, with some reliance on cash flow from government pensions and salaries. Households with stable income sources are better able to accumulate wealth, and children living in salaried households have better z-height. However, child growth is best predicted by individual-level factors rather than household ecology. Substantial variation in household strategy and little association of strategy with growth indicates there is no ‘best’ strategy in this transitioning environment.     

Offspring migration and nutritional status of left-behind older adults in rural China

Improvements in nutritional status is a principal pathway to good health. This study examines the effect of migration of adult children on the nutrient intake of left-behind older adults in rural China. We use data from four waves (2004–2011) of the China Health and Nutrition Survey and utilize individual fixed effects methods to panel data. Results show that the migration of offspring is associated with significantly higher nutritional status of their left-behind parents, especially higher intake of proteins, carbohydrates, vitamins B1–B3, phosphorus, magnesium, iron, selenium, and copper. The intake of some of these nutrients is below recommended levels. The magnitude of the estimated effects vary between 4% and 24 %. Older adults who live with their grandchildren in rural households or have a low income benefit more from having adult child migrants in the household. The improvement of nutrition outcomes of left-behind older adults is mainly due to increased consumption of cereals, meat, eggs, and fish.     

Private and public determinants of child nutrition in Nicaragua and Western Honduras

We present a multivariate regression model of nutritional indicators, including interactions between education levels and overall community development, as well as estimates of community fixed effects, for two data sets: the first one is from a 2001 nationwide household survey in Nicaragua while the second set was collected in the Western regions of Honduras in 2002, as part of an evaluation process for a family entitlement program. Maternal stature, age difference with an older sibling, household size and income are seen as the main determinants of anthropometric development. Within the more homogeneous communities of Western Honduras, woman's education is also related to the child's nutritional status. The importance of individual community variables is much lower and the inclusion of community fixed effects does not alter the other parameters. However, in the Honduran sample, overall community development (assessed through the community fixed effects) has a small but significant and synergistic effect on the impact of child and household variables. The characteristics of this study and the complex design of entitlement programs prevent an adequate evaluation of those interventions within the poverty reduction strategies. The improvement of intra-community targeting seems to be a key orientation for redesign. An improved socio-economic situation, sound population and family policies, and an appropriate preventive public health care still are safe investments towards improvement of child health and nutrition.     

Nutritional consequences of the transformation from subsistence to commercial agriculture in Tabasco,Mexico

Recent changes in the area of the Plan Chontalpa in Tabasco have greatly reduced the production of subsistence crops by rural families, resulting in decreased crop diversity and a concomitant increase in the degree of dependence on outside sources of food. Results from a nutrition survey of 149 families demonstrate that dietary diversity, dietary quality, and nutritional status of preschool children are negatively associated with lower crop diversity and increased dependence on purchased foods. Dietary deterioration is illustrated by the negative relationship found between nutritional status and increased sugar consumption. The assumption that a rise in income accompanying the adoption of commercial production will automatically lead to improved nutrition is challenged: income levels were not found to be consistently related to nutritional status. Children of families that have converted to cattle production, despite greater land availability and family incomes, do not have improved nutritional status. In the study area, where wages are low and food prices are very high, the value of a higher degree of self-sufficiency in food is recognized, yet families continue to switch to cash crops due to the environmental, economic, and time constraints imposed by the system of commercial agriculture in which they participate. The solution is not to return to traditional subsistence farming, however, but to determine under what conditions a more progressive form of agricultural change can occur.     

Age-related patterns of urinary gonadotropins (FSH and LH) and E-3-G as measures of reproductive function among Turkana males of northern Kenya

To determine age-related patterns of gonadotropins and their relationship to energetic status in a subsistence population we analyzed urinary FSH, LH, and estrone-3-glucuronide (E-3-G) along with anthropometric measures among Turkana males of northern Kenya. Subjects were 134 nomadic and 109 settled males ages 20 to 80+. FSH, LH and E-3-G were significantly higher among the settled, compared to nomadic, males. LH, but not FSH, showed a significant increase across 10 year age groups among all the men. E-3-G increased across age groups only among the settled males. Controlled for age, FSH was inversely related to measures of fat free and body mass among the settled men. These findings suggest an unusual age profile of gonadotropins and estrogen metabolites that may reflect the impact of fluctuating food availability. More research is needed to address the impact of energetic and social factors on the male reproductive axis among energetically stressed populations.     

The effect of the health care supply environment on children's nutritional status in rural Nepal

This article examines the effect of access to health infrastructure, personnel and services on children's nutritional status in rural Nepal. Data for the study come from the 1996 Nepal Living Standards Survey, which includes individual- and household-level information on children's nutritional status and its environmental and socioeconomic determinants, and community-level information on the availability of health care infrastructure, personnel and services. The study uses a structural modelling approach to assess the relative contributions of the health care supply environment on children's anthropometric status via the pathway of maternal and child health (MCH) service use. The findings suggest that improvements in the availability of outreach clinics and the structural quality of the closest public facility would be expected to have statistically significant and large effects on the use of MCH services, and that increases in MCH service use would have a statistically significant impact on weight-for-age, but not weight-for-height or height-for-age. The overall impact of the heath care supply environment on nutritional status is assessed through a series of policy simulations.     

Women's changing economic roles with pastoral sedentarization: Varying strategies in alternate Rendille communities

The trend of pastoral sedentarization in Africa presents new economic opportunities to women through the sale of dairy products, agricultural produce, and labor. This study of Rendille of northern Kenya shows a variety of economic strategies pursued by women in nomadic pastoral, settled agro-pastoral, and town communities. Results of household budgets and interviews with married women indicate that urban centers attract both wealthier Rendille women selling milk and poorer women engaged in wage-labor and petty commodity trade; time allocation data shows that women living in towns work as strenuously as those in pastoral communities, while men in towns work less than in pastoral communities and less than women in both communities; and anthropometric data of women and children suggest that increases in women's income may have a beneficial effect on the nutrition and well-being of their children.