Linear growth failure is the most common form of undernutrition globally. With an estimated 165 million children below 5 years of age affected, stunting has been identified as a major public health priority, and there are ambitious targets to reduce the prevalence of stunting by 40% between 2010 and 2025. We view this condition as a ‘stunting syndrome’ in which multiple pathological changes marked by linear growth retardation in early life are associated with increased morbidity and mortality, reduced physical, neurodevelopmental and economic capacity and an elevated risk of metabolic disease into adulthood. Stunting is a cyclical process because women who were themselves stunted in childhood tend to have stunted offspring, creating an intergenerational cycle of poverty and reduced human capital that is difficult to break. In this review, the mechanisms underlying linear growth failure at different ages are described, the short-, medium- and long-term consequences of stunting are discussed, and th...

https://www.tandfonline.com/doi/pdf/10.1179/2046905514Y.0000000158

The stunting syndrome in developing countries

The author describes the development of demography in Hungary from 1928 to the present with a focus on the contribution of Hungarian demographers to the activities of the International Union for the Scientific Study of Population (IUSSP). This paper is part of an IUSSP project that deals with the history of the Union and involves the preparation of papers on such activities in several countries. (summary in ENG RUS) (ANNOTATION)

Contribution of Hungarian demographic science and Hungarian demographers to the work of the International Union for the Scientific Study of Population

Very few demographic surveys in developing countries have gathered information on household incomes or consumption expenditures. Researchers interested in living standards therefore have had little alternative but to rely on simple proxy indicators. The properties of these proxies have not been analyzed systematically. We ask what hypotheses can be tested using proxies, and compare these indicators with consumption expenditures per adult, our preferred measure of living standards. We find that the proxies employed in much demographic research are very weak predictors of consumption per adult. Nevertheless, hypothesis tests based on proxies are likely to be powerful enough to warrant consideration.

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Measuring living standards with proxy variables

BACKGROUND AND OBJECTIVE: The initial years of life are critical for physical growth and broader cognitive, motor, and socioemotional development, but the magnitude of the link between these processes remains unclear. Our objective was to produce quantitative estimates of the cross-sectional and prospective association of height-for-age z score (HAZ) with child development. METHODS: Observational studies conducted in low- and middle-income countries (LMICs) presenting data on the relationship of linear growth with any measure of child development among children RESULTS: A total of 68 published studies conducted in 29 LMICs were included in the final database. The pooled adjusted standardized mean difference in cross-sectional cognitive ability per unit increase in HAZ for children ≤2 years old was +0.24 (95% confidence interval [CI], 0.14–0.33; I2 = 53%) and +0.09 for children >2 years old (95% CI, 0.05–0.12; I2 = 78%). Prospectively, each unit increase in HAZ for children ≤2 years old was associated with a +0.22-SD increase in cognition at 5 to 11 years after multivariate adjustment (95% CI, 0.17–0.27; I2 = 0%). HAZ was also significantly associated with earlier walking age and better motor scores (P CONCLUSIONS: Observational evidence suggests a robust positive association between linear growth during the first 2 years of life with cognitive and motor development. Effective interventions that reduce linear growth restriction may improve developmental outcomes; however, integration with environmental, educational, and stimulation interventions may produce larger positive effects.

/pdf/linear-growth-and-child-development-in-low-and-middle-income-2c1kji8vy6.pdf

Linear Growth and Child Development in Low- and Middle-Income Countries: A Meta-Analysis

Background: Social support has a strong impact on individuals, not least on older individuals with health problems. A lack of support network and poor family or social relations may be crucial in later life, and represent risk factors for elder abuse. This study focused on the associations between social support, demographics/socio-economics, health variables and elder mistreatment. Methods: The cross-sectional data was collected by means of interviews or interviews/self-response during January-July 2009, among a sample of 4,467 not demented individuals aged 60-84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden). Results: Multivariate analyses showed that women and persons living in large households and with a spouse/partner or other persons were more likely to experience high levels of social support. Moreover, frequent use of health care services and low scores on depression or discomfort due to physical complaints were indicators of high social support. Low levels of social support were related to older age and abuse, particularly psychological abuse. Conclusions: High levels of social support may represent a protective factor in reducing both the vulnerability of older people and risk of elder mistreatment. On the basis of these results, policy makers, clinicians and researchers could act by developing intervention programmes that facilitate friendships and social activities in old age. © 2013 Melchiorre et al.

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Social Support, Socio-Economic Status, Health and Abuse among Older People in Seven European Countries

Background
Women living in every country, irrespective of its development status, have been facing the problem of unintended pregnancy. Unintended pregnancy is an important public health issue in both developing and developed countries because of its negative association with the social and health outcomes for both mothers and children. This study aims to determine the prevalence and the factors influencing unintended pregnancy among currently pregnant married women in Nepal.

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Correlates of unintended pregnancy among currently pregnant married women in Nepal

Nutrition is an important factor in mental development and, as a consequence, in cognitive performance. Malnutrition is reflected in children’s weight, height and BMI curves. The present cross-sectional study aimed to evaluate the association between anthropometric indices and cognitive performance in 6746 school-aged children (aged 6‐12 years) of four Southeast Asian countries: Indonesia; Malaysia; Thailand; Vietnam. Cognitive performance (non-verbal intelligence quotient (IQ)) was measured using Raven’s Progressive Matrices test or Test of Non-Verbal Intelligence, third edition (TONI-3). Height-for-age z-scores (HAZ), weight-for-age z-scores (WAZ) and BMI-for-age z-scores (BAZ) were used as anthropometric nutritional status indices. Data were weighted using age, sex and urban/rural weight factors to resemble the total primary school-aged population per country. Overall, 21 % of the children in the four countries were underweight and 19 % were stunted. Children with low WAZ were 3·5 times more likely to have a non-verbal IQ ,89 (OR 3·53 and 95 % CI 3·52, 3·54). The chance of having a non-verbal IQ ,89 was also doubled with low BAZ and HAZ. In contrast, except for severe obesity, the relationship between high BAZ and IQ was less clear and differed per country. The odds of having non-verbal IQ levels ,89 also increased with severe obesity. In conclusion, undernourishment and non-verbal IQ are significantly associated in 6‐12-year-old children. Effective strategies to improve nutrition in preschoolers and school-aged children can have a pronounced effect on cognition and, in the longer term, help in positively contributing to individual and national development.

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Relationship between anthropometric indicators and cognitive performance in Southeast Asian school-aged children

The ageing of the population is rapidly progressing in Thailand. Self-assessed health status can provide a holistic view of the health of the elderly. This study aims to identify the determinants of self-assessed health among older Thai people. The data for this study were drawn from a national survey of older persons conducted in 2007. Stratified two-stage random sampling was used for data collection. The analysis was restricted to the population aged 60 and above. The study used univariate, bivariate, and multivariate analysis procedures to analyze the data. Bivariate analysis was used to identify the factors associated with self assessment of health status. After controlling for other variables, the variables were further examined using multivariate analysis (binary logistic regression) in order to identify the significant predictors of the likelihood of reporting poor health. Overall, 30,427 elderly people were interviewed in this study. More than half of the sampled respondents (53%) were aged 60-69 years and about one out of seven (13%) were aged 80 years or above. About three in five respondents (56%) reported that their health was either fair or very bad/bad. Logistic regression analysis found that age, education, marital status, working status, income, functional status, number of chronic diseases, and number of psychosocial symptoms are significant predictors in determining health status. Respondents who faced more difficulty in daily life were more likely to rate their health as poor compared to those who faced less such difficulty. For instance, respondents who could not perform 3 or more activities of daily living (ADLs) were 3.3 times more likely to assess their health as poor compared to those who could perform all the ADLs. Similarly, respondents who had 1, 2, or 3 or more chronic diseases were 1.8 times, 2.4 times, and 3.7 times, respectively, more likely to report their health as poor compared to those who had no chronic disease at all. Moreover, respondents who had 1-2, 3-4, or 5 or more psychosocial symptoms in the previous months were 1.6 times, 2.2 times, and 2.7 times, respectively, more likely to report poor health compared to those who did not have any psychosocial symptoms during the same period. Self-assessed poor health is not uncommon among older people in Thailand. No single factor accounts for the self-assessed poor health. The study has found that chronic disease, functional status, and psychosocial symptoms are the strongest determinants of self-assessed poor health of elderly people living in Thailand. Therefore, health-related programs should focus on all the factors identified in this paper to improve the overall well-being of the ageing population of Thailand.

/pdf/self-assessed-health-among-thai-elderly-2q1r1snbh6.pdf

Self-assessed health among Thai elderly

Objective: To examine the relationships among family, friendship networks and supports, health-promoting behaviors, and healthy aging. Method: A sample of 469 Thai elderly persons was recruited using multistage random sampling. A structural equation model based on Berkman’s conceptual model was performed. Results: Family networks did not directly influence health-promoting behaviors but rather had an indirect effect through family support. Friendship networks had both a significant direct effect on the elderly health-promoting behaviors and an indirect effect via friendship support. Interestingly, friendships had both direct and indirect influences on family support to the elderly. Health-promoting behaviors had a powerful influence on healthy aging and play a significant role in mediating the relationship between family and friendship supports and healthy aging. Discussion: Findings demonstrate the importance of family and friendship roles on health-promoting behaviors and healthy aging. Intervention pro...

http://www.ipsr.mahidol.ac.th/ipsr/Contents/Articles/2011/320-social-support-networks-aging-abstract.pdf

Mechanisms by Which Social Support Networks Influence Healthy Aging Among Thai Community-Dwelling Elderly:

In this qualitative study, we provide an in-depth understanding of the views of healthy aging among Thai elderly and explore the ways that contribute to healthy aging. Data were collected using focus groups and in-depth interviews in four selected provinces of Thailand, and were analyzed using content analysis. The results revealed that Thai elderly described being healthy as the result of multiple components involving physical, mental, and social well-being. Healthy aging was viewed as an absence of serious diseases, having functional independence, a positive psycho-emotional outlook, and making a social contribution. The factors considered to contribute to healthy aging included activities promoting physical and psychological health, as well as active engagement in social activities. Understanding how the elderly define healthy aging and identifying the most important components and factors that contribute to being healthy provides insight into possible policy implications and interventions to promote health and well-being among Thai elderly.

Kusol Soonthorndhada

Papers

Correlates of unintended pregnancy among currently pregnant married women in Nepal

Relationship between anthropometric indicators and cognitive performance in Southeast Asian school-aged children

Self-assessed health among Thai elderly

Mechanisms by Which Social Support Networks Influence Healthy Aging Among Thai Community-Dwelling Elderly:

Perspectives on healthy aging among Thai elderly: a qualitative study.