Beegle Kathleen, De Weerdt Joachim, Dercon Stefan
Development Research Group, World Bank, USA.
Int J Epidemiol. 2009 Apr;38(2):561-8. doi: 10.1093/ije/dyn197. Epub 2008 Sep 16.
In sub-Saharan Africa, the prevalence of orphanhood among children has been greatly exacerbated by the HIV/AIDS pandemic. If orphanhood harms a child's development and these effects perpetuate into adult life, then the African orphan crisis could seriously jeopardize the continent's future generations. Whether or not there exists an adverse, causal and intergenerational effect of HIV/AIDS on development is of crucial importance for setting medical priorities. This study is the first to empirically investigate the impact of orphanhood on health and schooling using long-term longitudinal data following children into adulthood.
We examined a cohort of 718 children interviewed in the early 1990s and again in 2004. Detailed survey questionnaires and anthropometric measurements were administered at baseline and during a follow-up survey. Final attained height and education (at adulthood) between children who lost a parent before the age of 15 and those who did not were compared.
On average, children who lose their mother before the age of 15 suffer a deficit of around 2 cm in final attained height (mean 1.96; 95% CI 0.06-3.77) and 1 year of final attained schooling (mean 1.01; 95% CI 0.39-1.81). This effect is permanent and the hypothesis that it is causal cannot be rejected by our study. Although father's death is a predictor of lower height and schooling as well, we reject the hypothesis of a causal link.
The African orphan crisis, exacerbated by the HIV/AIDS epidemic will have important negative intergenerational effects.
在撒哈拉以南非洲地区，艾滋病疫情极大地加剧了儿童成为孤儿的比例。如果成为孤儿会损害儿童的发育，且这些影响持续到成年生活，那么非洲的孤儿危机可能会严重危及该大陆的后代。艾滋病对发育是否存在不利、因果及代际影响，对于确定医疗重点至关重要。本研究首次利用跟踪儿童至成年的长期纵向数据，实证调查成为孤儿对健康和学业的影响。
我们考察了一组718名儿童，他们在20世纪90年代初接受过访谈，并于2004年再次接受访谈。在基线和随访调查期间，进行了详细的调查问卷和人体测量。比较了15岁前失去双亲的儿童与未失去双亲的儿童最终的成年身高和受教育程度（成年时）。
平均而言，15岁前失去母亲的儿童最终成年身高约低2厘米（均值1.96；95%置信区间0.06 - 3.77），最终受教育年限少1年（均值1.01；95%置信区间0.39 - 1.81）。这种影响是永久性的，我们的研究无法拒绝其具有因果关系的假设。虽然父亲的死亡也是身高和学业较低的一个预测因素，但我们拒绝因果联系的假设。
由艾滋病疫情加剧的非洲孤儿危机将产生重要的负面代际影响。
