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Four decades of socio-economic inequality and secular change in the physical growth of Guatemalans

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journal contribution
posted on 09.12.2019, 11:06 by Liina Mansukoski, Will Johnson, Katherine Brooke-Wavell, J Andres Galvez-Sobral, Luis Furlán, Tim J Cole, Barry Bogin
OBJECTIVE: To investigate changes in socio-economic inequalities in growth in height, weight, BMI and grip strength in children born during 1955-1993 in Guatemala, a period of marked socio-economic-political change. DESIGN: We modelled longitudinal data on height, weight, BMI and hand grip strength using Super-Imposition by Translation and Rotation (SITAR). Internal Z-scores summarising growth size, timing and intensity (peak growth velocity, e.g. cm/year) were created to investigate inequalities by socio-economic position (SEP; measured by school attended). Interactions of SEP with date of birth were investigated to capture secular changes in inequalities. SETTING: Urban and peri-urban schools in the region of Guatemala City, Guatemala. PARTICIPANTS: Participants were 40 484 children and adolescents aged 3-19 years of Ladino and Maya ancestry (nobservations 157 067). RESULTS: The difference in height (SITAR size) between lowest and highest SEP decreased from -2·0 (95 % CI -2·2, -1·9) sd to -1·4 (95 % CI -1·5, -1·3) sd in males, and from -2·0 (95 % CI -2·1, -1·9) sd to -1·2 (95 % CI -1·3, -1·2) sd in females over the study period. Inequalities also reduced for weight, BMI and grip strength, due to greater secular increases in lowest-SEP groups. The puberty period was earlier and shorter in higher-SEP individuals (earlier SITAR timing and higher SITAR intensity). All SEP groups showed increases in BMI intensity over time. CONCLUSIONS: Inequality narrowed between the 1960s and 1990s. The lowest-SEP groups were still >1 sd shorter than the highest. Risks remain for reduced human capital and poorer population health for urban Guatemalans.

Funding

The Osk Huttunen Foundation

Bill & Melinda Gates Foundation (Quantifying healthy birth, growth and development knowledge integration, grant number OPP1125811)

UK Medical Research Council (MRC) supported T.J.C. (grant number MR/R010692/1)

MRC New Investigator Research Grant (grant number MR/P023347/1)

History

School

  • Sport, Exercise and Health Sciences

Published in

Public Health Nutrition

Volume

23

Issue

8

Pages

1381 - 1391

Publisher

Cambridge University Press

Version

VoR (Version of Record)

Rights holder

© the Authors

Publisher statement

This is an Open Access Article. It is published by Cambridge University Press under the Creative Commons Attribution 4.0 Unported Licence (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/

Acceptance date

17/07/2019

Publication date

2019-12-05

Copyright date

2019

ISSN

1368-9800

eISSN

1475-2727

Language

en

Depositor

Dr Katherine Brooke Wavell . Deposit date: 6 December 2019

Licence

Exports