Child height and intergenerational transmission of health: Evidence from ethnic Indians in England

A large literature documents a widespread prevalence of small stature among Indian children as well as adults. We show that a height gap relative to a richer population such as whites in England also exists, although substantially reduced, among adult immigrants of Indian ethnicity in England. This is despite positive height selection into migration, demonstrated by ethnic Indian adults in England being on average 6–7 cm taller than in India. However, the difference between natives and ethnic Indians in England disappears among their younger sons and daughters, although it re-appears among adolescents. We estimate that, conditional on age, gender and parental height, ethnic Indian children of age 2–4 in England are 6–8% taller than in India. Such degree of catch up in one generation is remarkable, also because in England children of ethnic Indians have much smaller birthweight than whites, by about 0.4 kg on average.     

Differences in rate of uptake of immunisation among ethnic groups.

In the Bradford health district ethnic origin is associated with appreciable differences in morbidity and mortality. In view of these differences a study was undertaken to determine whether there were differences among the ethnic groups in utilisation of the National Health Service, as reflected in the rate of uptake of immunisation, which is offered to all children. Significant differences were found between the British group and some other ethnic groups--notably Pakistani, Indian, and half Negro groups. The rate of uptake of immunisation was nearer the optimum in the Indian group than in the British group. The most unsatisfactory rate of uptake of immunisation overall was found in the half Negro group. No clear explanation of the differences has been shown, they are likely to be due to various factors in the National Health Service and in the community.     

Socioeconomic and ethnic group differences in self reported health status and use of health services by children and young people in England: cross sectional study

ObjectivesTo examine whether self reported health status and use of health services varies in children of different social class and ethnic group.DesignCross sectional study from the 1999 health survey for England.Subjects6648 children and young adults aged 2-20 years.SettingPrivate households in England.ResultsLarge socioeconomic differences were observed between ethnic subgroups; a higher proportion of Afro-Caribbean, Indian, Pakistani, and Bangladeshi children belonged to lower social classes than the general population. The proportion of children and young adults reporting acute illnesses in the preceding two weeks was lower in Bangladeshi and Chinese subgroups (odds ratio 0.41, 95% confidence interval 0.27 to 0.61 and 0.46, 0.28 to 0.77, respectively) than in the general population. Longstanding illnesses was less common in Bangladeshi and Pakistani children (0.52, 0.40 to 0.67 and 0.57, 0.46 to 0.70) than in the general population. Irish and Afro-Caribbean children reported the highest prevalence of asthma (19.5% and 17.7%) and Bangladeshi children the lowest (8.2%). A higher proportion of Afro-Caribbean children reported major injuiries than the general population (11.0% v 10.0%), and children from all Asian subgroups reported fewer major and minor injuries than the general population. Indian and Pakistani children were more likely to have consulted their general practitioner in the preceding fortnight than the general population (1.86, 1.35 to 2.57 and 1.51, 1.13 to 2.01, respectively). Indian, Pakistani, Bangladeshi, and Chinese children were less likely to have attended outpatient departments in the preceding three months. No significant differences were found between ethnic groups in the admission of inpatients to hospitals. Acute and chronic illness were the best predictors of children''s use of health services. Social classes did not differ in self reported prevalence of treated infections, major injuries, or minor injuries, and no socioeconomic differences were seen in the use of primary and secondary healthcare services.ConclusionsChildren''s use of health services reflected health status rather than ethnic group or socioeconomic status, implying that equity of access has been partly achieved, although reasons why children from ethnic minority groups are able to access primary care but receive less secondary care need to be investigated.

What is already known on this topic

Children from lower socioeconomic classes and from Indian ethnic subgroups may make more use of general practitioners'' services than other childrenAfro-Caribbean, Indian, Pakistani, and Bangladeshi children are less likely to be referred to outpatient and inpatient services at hospitals than white children

What this study adds

Indian, Pakistani, and Bangladeshi children reported less acute and chronic illness, asthma, and injuries than the general population, whereas Afro-Caribbean children reported moreChildren''s self reported health status and use of health services did not vary by social classIndian and Pakistani children make more use of general practitioners'' services, but Indian, Pakistani, Bangladeshi, and Chinese children are less likely to be referred to outpatient clinicsSelf reported health status rather than socioeconomic status or ethnicity is the best predictor of use of primary and secondary services     

National survey of notifications of tuberculosis in England and Wales in 1983. Medical Research Council Tuberculosis and Chest Diseases Unit.

In a survey of all notifications of tuberculosis in England and Wales for the first six months of 1983 56% of the 3002 newly notified patients who had not been treated before were of white and 37% were of Indian subcontinent (Indian, Pakistani, or Bangladeshi) ethnic origin, findings similar to those of a survey in 1978-9. In the four and a quarter years between the surveys the number of patients notified had declined by 26%, the decline being 28% among those of white and 23% among those of Indian subcontinent ethnic origin. The white patients were on average older than the patients of Indian subcontinent ethnic origin, and a higher proportion of them had respiratory disease (82% compared with 66%). The pulmonary lesions were on average larger and more often bacteriologically positive in the white patients. There were considerable differences between the ethnic groups in the estimated yearly rates of notifications per 100 000 population in England in 1983. The highest rates occurred in the Indian (178) and the Pakistani and Bangladeshi (169) populations and were roughly 25 times the rate in the white population (6 X 9). In the Indian subcontinent ethnic groups the highest rates occurred among those who had arrived in the United Kingdom within the previous five years.     

Acquired myopia in 11-year-old children.

Children who had acquired myopia by the age of 11 years were identified from a nationally representative sample. There were no overall sex differences in its occurrence but myopia was more common in children from non-manual families than in those from manual families. Short-sighted children were more likely to come from small families and to be of higher birth order than children with normal vision, and these associations held within each social class. At 11 years myopic children showed striking advantages in educational performance over their normal-sighted peers, as judged by tests of reading, arithmetic, and general ability. After adjustments had been made for social background, this age gain still amounted to over one year. Findings obtained at 7 years of age showed that superior educational attainments were already apparent before the onset of myopia. Children with myopia read in their leisure time more often than normally sighted children, but despite the visual impairment, they participated in outdoor sports as often as other children.     

National survey of tuberculosis notifications in England and Wales 1978--9. Report from the Medical Research Council Tuberculosis and Chest Diseases Unit.

A survey of all tuberculosis notifications in England and Wales for a six-month period showed that 70% of 3732 newly notified, previously untreated patients had respiratory disease only, 23% had non-respiratory disease only, and 7% had both. Fifty-seven per cent of patients were of white and 35% were of Indian subcontinent (Indian, Pakistani, or Bangladeshi) ethnic origin, the latter group contributing over half the cases of non-respiratory disease. The estimated overall annual notification rate per 100 000 population for 1978--9 was 16.4 for England and 13.5 for Wales. The rates differed considerably between the different ethnic groups in England, the highest rates occurring in the Indian and in the Pakistani and Bangladeshi groups and the lowest in the white group; the differences in the non-respiratory rates were the more striking. Nearly a quarter of patients with respiratory disease had large pulmonary lesions, the proportion being higher for the white group than for the Indian subcontinent group. Over half the patients had positive cultures for tubercle bacilli and over a third had positive smears; both proportions were higher for the white group. This survey has identified many of the problems which tuberculosis presents in England and Wales today. These include the substantial number of patients with sputum-positive disease, the considerable variation in the rates in the different ethnic groups, and the not uncommon occurrence of childhood tuberculosis.     

Neuropsychological consequences of volatile substance abuse: a population based study of secondary school pupils.

OBJECTIVE--To examine the effects of volatile substance abuse on neuropsychological functioning. DESIGN--A sample of index children and matched controls were identified by a two stage procedure. Firstly, over 5000 secondary school pupils completed a screening questionnaire, and, secondly, a sample of those who acknowledged volatile substance abuse and a matched sample of those who denied the practice were assessed in detail by means of (a) individually conducted interviews and (b) toxicological examination of breath samples (to exclude those intoxicated at the time of testing). SETTING--16 Local education authority secondary schools in London. SUBJECTS--160 Pupils aged 13-16: 80 index children who had abused volatile substances to the point of intoxication at least once (confirmed by interview) and 80 controls (confirmed by interview) matched for school year, sex, and ethnic background. MEASUREMENTS AND MAIN RESULTS--Neuropsychological functioning tests provided 35 main outcome measures and were administered blind. Data on educational test performance before substance abuse began were obtained retrospectively. Information on potentially confounding social factors, such as number of siblings, tenure of housing, and parents'' socioeconomic and employment state was also obtained. The index children performed significantly less well than the controls in tests of vocabulary, verbal intelligence quotient, full scale intelligence quotient, and a measure of impulsivity. When background social disadvantage was taken into account these differences were no longer significant. There were no significant associations between performance on psychological testing and frequency of abuse, and relations with other aspects of the children''s history of abuse were generally weak or unsystematic. Comparisons between the results of these tests and of educational tests taken before substance abuse produced equivocal findings. CONCLUSION--Volatile substance abuse, as commonly practised by secondary school pupils, is unlikely to result in neuropsychological impairment.     

Religion and economic activity in the South Asian population

Anthropological and sociological literature points to the importance of religion as a basis for understanding the diverse nature of Britain's South Asian population. Using a rare quantitative source, the 1994 National Survey of Ethnic Minorities, and against a backdrop of relative neglect by quantitative social scientists, this article considers the religious dimension to observed differences in economic activity among South Asians. The analysis reports substantial differences between religious sub-groups (by age and sex) across a range of key measures, including: differences in the proportion who are economically active; differences in the proportion of the economically active who successfully gain employment; among the employed, differences in the type of jobs held and in reported income. The analysis suggests a more complex picture than the Muslim/non-Muslim dichotomy often inferred from analysis using conventional ethnic group classifications, with notable differences between Indian Sikhs and Hindus, and between Indian Muslims and Pakistani and Bangladeshi Muslims.     

Population Differences in Brain Morphology and Microstructure among Chinese,Malay, and Indian Neonates

We studied a sample of 75 Chinese, 73 Malay, and 29 Indian healthy neonates taking part in a cohort study to examine potential differences in neonatal brain morphology and white matter microstructure as a function of ethnicity using both structural T2-weighted magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). We first examined the differences in global size and morphology of the brain among the three groups. We then constructed the T2-weighted MRI and DTI atlases and employed voxel-based analysis to investigate ethnic differences in morphological shape of the brain from the T2-weighted MRI, and white matter microstructure measured by fractional anisotropy derived from DTI. Compared with Malay neonates, the brains of Indian neonates’ tended to be more elongated in anterior and posterior axis relative to the superior-inferior axis of the brain even though the total brain volume was similar among the three groups. Although most anatomical regions of the brain were similar among Chinese, Malay, and Indian neonates, there were anatomical variations in the spinal-cerebellar and cortical-striatal-thalamic neural circuits among the three populations. The population-related brain regions highlighted in our study are key anatomical substrates associated with sensorimotor functions.     

Length and weight in rural Guatemalan Ladino children: birth to seven years of age.

The present study reports 5,029 length and weight measurements as well as percentile distributions for a mixed longitudinal series of 1,119 rural Guatemalan Ladino children. The study sample, birth through seven years, is representative of children in clinically good health, but of suboptimal nutrition. Boys are longer and heavier than girls over the age range. Guatemalan children of both sexes are smaller than American white children from Denver. Differences are least at birth, and increase through two years of age. Between two and five years, differences between the rural Guatemalan Ladino and Denver samples are rather stable, but then increase through seven years. Despite these differences there is a linear weight for length relationship which is the same across all preschool ages, both sexes, and for both the Guatemalan and Denver populations. This implies that age, sex, ethnic differences between the two groups compared, and mild-to-moderate protein-calorie malnutrition do not affect the relationship between weight and length in preschool children.     

Determinants of nutritional status of pre-school children in India

The aim of this paper is to assess the spatial distribution of nutritional status of children of less than three years through Z-scores of weight-for-age, height-for-age and weight-for-height using data collected by the National Family Health Survey (NFHS-2, 1998-99), India. The nutritional status of pre-school children was regressed on different socio-demographic factors after eliminating the effect of age. The data show that there are gender differences and spatial variations in the nutritional status of children in India. Gender difference is not very pronounced and almost disappears when the effects of age and socio-demographic variables are removed. The spatial difference, especially the rural-urban difference, was found to be very large and decreased substantially when the effects of age and socioeconomic variables were removed. However, the differences were not close to zero. All the variables were found to affect significantly the nutritional status of children. However, the literacy of mothers did not affect height-for-age significantly. The weight-for-age and height-for-age scores showed a dismal picture of the health condition of children in almost all states in India. The worst affected states are Bihar, Madhya Pradesh, Orissa and Uttar Pradesh. Assam and Rajasthans are also lagging behind. Weight-for-height scores do not give a clear picture of state-wise variation. Goa, Kerala and Punjab are the three most developed states in India and also have the lowest percentages of underweight children according to the Z-scores. Along with these three states come the north-eastern states where women are well educated. Thus overall development, enhancement of level of education and low gender inequality are the key factors for improvement in the health status of Indian children.     

Behavior problems and personality aspects of 40 children with velo-cardio-facial syndrome

Data are collected with the Child Behavior Check List (CBCL) as well as with the Teacher Report Form (TRF) of 40 VCFS children between 4 and 18 years of age. Half of the group shows very high problem scores in the "clinical" range. The average T-score of the VCFS children as a group are over 60 (one standard deviation above the mean) for the "total problem score" and the "internalising score". The highest scores with the subscales are found with "withdrawn" and "social problems". But also "thought problems" and "attention problems" score over 60. The VCFS children show more behavior problems and personality problems than the matched control children with a craniofacial anomaly. The differences are highly statistically significant.     

Specifying social structures in preschool classrooms: descriptive and functional distinctions between affiliative subgroups

Preschool children attending Head Start programs (N = 586, 296 boys and 290 girls, between 3 and 5 years of age, over 95% African–American) were observed to determine physical proximity to peers as well as rates of visual attention given and received. Sociometric data were used to derive peer acceptance scores, peer friendships, and sociometric status classifications. Three subgroup types (high mutual proximity (HMP), lower mutual proximity (LMP), and ungrouped children) were identified through complete linkage hierarchical clustering and chi-square procedures from the proximity data. HMP subgroups tended to be larger, to have higher sociometric acceptance scores, and children in these subgroups had more reciprocated friendships than was true for the other subgroup types. Significant within-group preferences and out-group biases were observed for both HMP and LMP subgroups using measures of visual attention and sociometric choice data, but these were more marked for HMP subgroups. Results are consistent with previous ethological studies of affiliative structures in preschool classrooms and also show that methods of data collection and analysis from social ethology and child psychology research traditions are mutually informing.     

Gender and ethnic identity among second-generation Indo-Caribbeans

This article discusses second-generation Indo-Caribbean (West Indian of Indian descent) teenagers’ ethnic identities, through a look at their taste preferences and self assertions of identity. Both Indo-Caribbean young men and women draw from multiple influences on their identities. In terms of tastes in clothing and movies, however, girls are more interested in things Indian, and in “Indian culture”. Boys, on the other hand, choose to distance themselves from an Indian identity. Three factors explain these gender differences in choices about ethnic identity: (1) different media images for South Asian men and women; (2) a school context lending different levels of peer symbolic status to perceived Indian boys and girls; and (3) a gendered process of migration by which women maintain stronger cultural roots in the new country. The findings in this article point to the need to pay attention to gender differences when considering ethnic incorporation.     

Coenzyme Q10 and differences in coronary heart disease risk in Asian Indians and Chinese.

Indians or South Asians have been found to be particularly susceptible to coronary heart disease (CHD) in many countries. A novel risk factor for CHD may be coenzyme Q10 (CoQ10). In this study, plasma CoQ10 (including ubiquinol-10, CoQ10H2, and total CoQ10), various lipid parameters, and antioxidant levels were determined in a random sample of Indians and Chinese from the general population of Singapore. The reduced form of coenzyme Q10, CoQ10H2, and total Q10 concentrations in plasma were significantly lower in Indian males than Chinese males. Although no significant differences were found in plasma concentrations of total cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL) between the two ethnic groups, the ratios of ubiquinol and total CoQ10 to triglycerides, total cholesterol, and LDL were significantly lower in Indian males than Chinese males. There were no significant ethnic differences in other antioxidant levels, including trans-retinol, alpha-tocopherol, and ascorbic acid. The consistently lower values of coenzyme Q10, especially its reduced form, in Indian males may contribute to the higher susceptibility of this ethnic group to coronary heart disease.     

How family,immigrant group,and school contexts shape ethnic educational disparities

Scholars have long questioned why average educational attainments among children of immigrants vary greatly by country of origin. Immigrants’ children from the same country share similar contexts of exit and reception and often similar school and family contexts. What is the relative importance of these factors in explaining ethnic differences in educational attainment? Using cross-classified multi-level models, this study shows that family contexts and immigrant group educational selectivity, but not school contexts, help explain ethnic differences. Immigrant selectivity is more decisive in shaping the second-generation’s educational attainment than other group characteristics related to immigrants’ contexts of exit and reception. While school socioeconomic status (SES) only influences the attainment of immigrants’ children from high-SES families, immigrant group selectivity matters regardless of the SES of the family or school, thus shedding light on why members of some national-origin groups tend to complete more education than others despite similar family and school contexts.     

Taste Sensitivity and Aging: High Incidence of Decline Revealed by Repeated Threshold Measures

Contrary to what has often been said about the subject, declinein taste sensitivity with aging characterizes virtually everybodyand is not the artificial result of averaging large losses ofa minority with negligible losses of a majority. This assertionis supported by six repeated measures of sucrose thresholdsin each of 15 older (over 64 years) and 15 younger (under 27years) adult subjects. Threshold was determined by a proceduresimilar to past studies and with the same results: much scatterand considerable overlap between the thresholds of younger andolder subjects. A quite contrasting picture emerges, however,when each subject's six threshold determinations are averaged.Averaging shrinks the individual differences among subjects,as well as the over-lap between younger and older subjects.Although virtually all elderly subjects now revealed taste weakness,reliable individual differences in degree of weakness aboundamong them, suggesting various individual rates of physiologicalaging. In contrast young persons exhibit greater uniformityof sensitivity. These findings were brought out by inter-testcorrelations, which were much higher for the older subjects;i.e. an older subject who tended to score high (low) on onetest tended to score high (low) on the other tests. The studyconfirms the tenuous nature of brief threshold tests as indicesof personal sensitivity as found earlier also in olfactory thresholdsand in concurrent measurement of two-point touch thresholdsin the present study. This revealed correlated losses betweenrepeated taste and touch thresholds from the same 15 older subjects,unrelated to their exact chronological age. Chem. Senses 20:451–459, 1995.     

Associations between physical activity and bone mass in black and white South African children at age 9 yr.

We investigated differences in physical activity (PA) levels between black and white South African 9-yr-old children and their association with bone mineral content (BMC) and density (BMD) by using dual-energy X-ray absorptiometry. PA was analyzed in terms of a metabolic (METPA; weighted metabolic score of intensity, frequency, and duration) and a mechanical (MECHPA; sum of all ground reaction forces multiplied by duration) component. There were significant ethnic differences in patterns of activity. White children expended a significantly greater energy score (METPA of 21.7 +/- 2.9) than black children (METPA of 9.5 +/- 0.5) (P < 0.001). When children were divided into quartiles according to the amount and intensity of sport played, the most active white children (using METPA scores) had significantly higher whole body BMD and higher hip and spine BMC and BMD than less active children. White children in the highest MECHPA quartile also showed significantly higher whole body, hip, and spine BMC and BMD than those children in the lowest quartile. No association between exercise and bone mass of black children was found. In this population, PA has an osteogenic association with white children, but not black children, which may be explained by the lower levels of PA in the black children. Despite this, black children had significantly greater bone mass at the hip and spine (girls only) (P < 0.001) even after adjustment for body size. The role of exercise in increasing bone mass may become increasingly critical as a protective mechanism against osteoporosis in both ethnic groups, especially because the genetic benefit exhibited by black children to higher bone mass may be weakened with time, as environmental influences become stronger.     

Adipokine serum concentrations, anthropometric measurements and socio-economic status in two ethnic groups with different prevalence levels for cardiovascular diseases and type 2 diabetes

Obesity is more common in African than Asian-Indian populations and yet type 2 diabetes and cardiovascular diseases are more common in the latter populations. The main purpose of the current study was therefore to determine whether ethnic differences in body fat distribution, adipokine levels, and socio-economic status may explain population differences in the prevalence of these metabolic disorders. Leptin, IL-6, CRP, visceral fat, education level, and socio-economic status were measured in 50 African and the same number of Indian women residing in Johannesburg, South Africa. Serum leptin levels were significantly higher in Indian than African subjects (41.3±2.0 and 34.2±2.9?ng/ml, respectively; p<0.05). TNF-α levels were significantly higher in the African group, (5.22±0.86 vs. 2.54±0.52?pg/ml; p<0.05), whilst visceral fat levels were significantly lower (56.1±5.5 vs. 77.9±6.5?cm(2); p<0.05). The CRP and IL-6 levels were not different between groups. Education levels (p<0.005) and socio-economic status (p<0.0001) were both lower in the African subjects, however, adjusting for these variables in ANCOVA did not attenuate differences in adipokine or visceral fat levels. We hypothesise that one of the reasons for the higher prevalence of obesity in the African than Indian population may be related to lower leptin levels, whilst ethnic differences in the prevalence of metabolic disorders cannot be explained by differences in adipokine levels, but maybe related to higher visceral adiposity in the Indian group.