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Disentangling basal and accrued height‐for‐age for cross‐population comparisons

Bibliographic Data

ID8314760
AuthorsJoseph V Hackman (0000-0003-4018-7490, Department of Anthropology University of Utah Salt Lake City Utah, corresponding author), Daniel J Hruschka (0000-0003-2188-7782, School of Human Evolution and Social Change Arizona State University Tempe Arizona)
Year2020
Volume171
Issue3
Pages481-495
Publication date2020-03-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAmerican Journal of Physical Anthropology (JOURNAL)
Journal identifiersISSN: 0002-9483 • E-ISSN: 1096-8644
PublisherWiley (PUBLISHER • GB)
DOI10.1002/ajpa.23990
PMID31886899
OpenAlexW2968887389
LanguageEN
Citations received7
References cited65

OBJECTIVES: Current standards for comparing stunting across human populations assume a universal model of child growth. Such comparisons ignore population differences that are independent of deprivation and health outcomes. This article partitions variation in height-for-age that is specifically associated with deprivation and health outcomes to provide a basis for cross-population comparisons. MATERIALS AND METHODS: Using a multilevel model with a sigmoid relationship of resources and growth, we partition variation in height-for-age z-scores (HAZ) from 1.5 million children across 70 countries into two components: (1) "accrued HAZ" shaped by environmental inputs (e.g., undernutrition, infectious disease, inadequate sanitation, poverty) and (2) a country-specific "basal HAZ" independent of such inputs. We validate these components against population-level infant mortality rates and assess how these basal differences may affect cross-population comparisons of stunting. RESULTS: Basal HAZ differs reliably across countries (range of approximately 1.5 SD) and is independent of measures of infant mortality. By contrast, accrued HAZ captures stunting as impaired growth due to deprivation and is more closely associated with infant mortality than observed HAZ. Assessing stunting prevalence by accrued HAZ suggest that populations in West Africa and Haiti suffer much greater levels of stunting than indicated by observed HAZ. DISCUSSION: Current universal standards may dramatically underestimate stunting in populations with taller basal HAZ. Relying on observed HAZ rather than accrued HAZ may also lead to inappropriate cross-population comparisons, such as concluding that Haitian children enjoy better conditions for growth than do Indian or Guatemalan children

Biology · Developing country · Economics · Environmental health · Geography · Infant mortality · Malnutrition · Population · Poverty · Birth, Development, and Health · Child Nutrition and Water Access · Demography · Ecology · Global Maternal and Child Health · Medicine

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Unique citing works7
Citations per year1,4
Citation span2021 - 2026 (6)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 6
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