Quantitative Estimates of the Relative Contributions of Secular Trend and Community Type to Variation in Adolescent Growth in the Andean Highlands

Abstract

In high altitude populations, children's growth is affected by several factors including poor nutrition, genetics, and hypoxia. In the Andean altiplano, subsistence agropastoralism in rural areas is associated with heavy physical labor and seasonal food shortage, stressors less likely to be experienced in urbanized communities.

Such persistent rural poverty drove increasing rural out-migration to urban and peri-urban communities throughout the 1980s and 1990s. During these periods and since there have been efforts by governmental and other entities to improve living conditions, economic options, and children's nutrition and overall health. However, it is rarely the case that such programs are implemented either continuously or evenly across communities.

Over time, various reports suggest that child growth is improving in the Andes. But site-specific longitudinal studies are rare, making it difficult to disentangle the relative benefits of different community types (rural versus urbanized) from the impacts of regional secular (i.e., time dependent) trends in children's growth.

In this analysis we investigate the relative contributions of rural-urban community differences versus wider regional improvements that have occurred over time in living conditions and economic opportunities, to Andean children's growth (height-for-age). We use height (often called the "biological standard of living") to assess children's growth because this anthropometric is notably sensitive to socioeconomic conditions

We focus on adolescents (ages 11-14 years), who have been less studied than adults or younger children.