Darrouzet-Nardi Amelia F, Masters William A
Department of Global Health Studies, Allegheny College, Meadville, Pennsylvania, United States of America.
Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America.
PLoS One. 2017 Jan 3;12(1):e0168759. doi: 10.1371/journal.pone.0168759. eCollection 2017.
A large literature links early-life environmental shocks to later outcomes. This paper uses seasonal variation across the Democratic Republic of the Congo to test for nutrition smoothing, defined here as attaining similar height, weight and mortality outcomes despite different agroclimatic conditions at birth. We find that gaps between siblings and neighbors born at different times of year are larger in more remote rural areas, farther from the equator where there are greater seasonal differences in rainfall and temperature. For those born at adverse times in places with pronounced seasonality, the gains associated with above-median proximity to nearby towns are similar to rising one quintile in the national distribution of household wealth for mortality, and two quintiles for attained height. Smoothing of outcomes could involve a variety of mechanisms to be addressed in future work, including access to food markets, health services, public assistance and temporary migration to achieve more uniform dietary intake, or less exposure and improved recovery from seasonal diseases.
大量文献将早期生活中的环境冲击与后期结果联系起来。本文利用刚果民主共和国的季节变化来检验营养平滑效应，这里将营养平滑效应定义为尽管出生时的农业气候条件不同，但仍能获得相似的身高、体重和死亡率结果。我们发现，在更偏远的农村地区，不同年份出生的兄弟姐妹和邻居之间的差距更大，这些地区离赤道更远，降雨和温度的季节性差异更大。对于那些在季节性明显的地区出生在不利时期的人来说，与靠近附近城镇的中位数以上距离相关的收益，对于死亡率而言，类似于在全国家庭财富分布中上升一个五分位数，对于达到的身高而言，则类似于上升两个五分位数。结果的平滑可能涉及未来工作中要探讨的多种机制，包括进入食品市场、获得医疗服务、获得公共援助以及临时迁移以实现更均衡的饮食摄入，或者减少接触季节性疾病并改善从季节性疾病中恢复的能力。
