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  • Title: Social inequality and children's growth in Guatemala.
    Author: Pebley AR, Goldman N.
    Journal: Health Transit Rev; 1995 Apr; 5(1):1-20. PubMed ID: 10150528.
    Abstract:
    This paper is an investigation of the effects of social inequality in Guatemala on children's health and nutritional status as measured by attained height. Guatemala remains a highly stratified and poor society. We examine the association of land distribution, land tenure, occupation, and other aspects of family social and economic status with children's height between the ages of three months and 36 months, using data from a cross-sectional survey. An important consequence of the poverty and poor living conditions of the majority of the Guatemalan population is substantial deficits in children's growth. Our results suggest that children's growth is affected by ethnicity, their father's occupation, land distribution in the area where they live, and maternal education. Substantial growth deficits are observed among children living at altitudes above 1500 metres; we hypothesize that this is because, in Guatemala, higher altitude is associated with land scarcity, poorer agricultural conditions, and greater remoteness from transport networks and other public services. Population researchers used data from the 1987 National Survey of Maternal and Child Health, 1981 census of population and housing, and the 1979 agricultural census to examine the relationship between land distribution, land tenure, occupation, and other characteristics of family socioeconomic status with children's growth between the ages of 3 months to 36 months in Guatemala. 57.8% of the children were stunted. 71.9% of the children lived in rural areas characterized as poor and in inferior living conditions. Characteristics influencing children's growth included ethnicity (indigenous children shorter than ladinos), father's occupation (agriculture or unskilled occupations had a negative effect on growth), land distribution (the smaller the farm, the greater the deficit in height), and maternal education. Children living at altitudes greater than 1500 meters were shorter than those living at elevations less than 1500 meters (p 0.05). Land scarcity, poorer agricultural conditions, and greater distance from transport networks and other public services were likely responsible for the association between altitude and growth. Indigenous populations were more likely to live at higher elevations than ladinos, partly because, over the last 200 years, ladinos appropriated the more productive, accessible, and desirable lands at moderate elevations. Father's occupation, land ownership, housing quality, possession of consumer goods, residency, and size of farms in area accounted for about 24% of the variation in height-for-age. These findings show that poverty and poor living conditions for most of the population adversely affect children's growth.
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