Burris Mecca E, Caceres Esperanza, Chester Emily M, Hicks Kathryn A, McDade Thomas W, Sikkink Lynn, Spielvogel Hilde, Thornburg Jonathan, Vitzthum Virginia J
Department of Anthropology, Indiana University, Bloomington, IN 47405, USA.
Instituto Boliviano de Biología de Altura (IBBA), La Paz, Bolivia.
Evol Med Public Health. 2022 Aug 22;10(1):409-428. doi: 10.1093/emph/eoac033. eCollection 2022.
BACKGROUND/OBJECTIVES: We evaluated potential socioeconomic contributors to variation in Andean adolescents' growth between households within a peri-urban community undergoing rapid demographic and economic change, between different community types (rural, peri-urban, urban) and over time. Because growth monitoring is widely used for assessing community needs and progress, we compared the prevalences of stunting, underweight, and overweight estimated by three different growth references.
Anthropometrics of 101 El Alto, Bolivia, adolescents (Alteños), 11.0-14.9 years old in 2003, were compared between households (economic status assessed by parental occupations); to one urban and two rural samples collected in 1983/1998/1977, respectively; and to the WHO growth reference, a representative sample of Bolivian children (MESA), and a region-wide sample of high-altitude Peruvian children (Puno).
Female Alteños' growth was positively associated with household and maternal income indices. Alteños' height averaged ∼0.8SD/∼0.6SD/∼2SDs greater than adolescents' height in urban and rural communities measured in 1983/1998/1977, respectively. Overweight prevalence was comparable to the WHO, and lower than MESA and Puno, references. Stunting was 8.5/2.5/0.5 times WHO/MESA/Puno samples, respectively.
CONCLUSIONS/IMPLICATIONS: Both peri-urban conditions and temporal trends contributed to gains in Alteños' growth. Rural out-migration can alleviate migrants' poverty, partly because of more diverse economic options in urbanized communities, especially for women. Nonetheless, Alteños averaged below WHO and MESA height and weight medians. Evolved biological adaptations to environmental challenges, and the consequent variability in growth trajectories, favor using multiple growth references. Growth monitoring should be informed by community- and household-level studies to detect and understand local factors causing or alleviating health disparities.
背景/目的：我们评估了在经历快速人口和经济变化的城郊社区内，不同家庭之间、不同社区类型（农村、城郊、城市）之间以及不同时间内，可能导致安第斯青少年生长差异的社会经济因素。由于生长监测被广泛用于评估社区需求和进展情况，我们比较了三种不同生长参考标准所估计的发育迟缓、体重不足和超重的患病率。
对2003年年龄在11.0 - 14.9岁的101名玻利维亚埃尔阿尔托青少年（阿尔特尼奥人）进行人体测量，并在家庭之间进行比较（根据父母职业评估经济状况）；与分别在1983年/1998年/1977年收集的一个城市样本和两个农村样本进行比较；并与世界卫生组织生长参考标准、玻利维亚儿童代表性样本（MESA）以及秘鲁高海拔地区儿童区域样本（普诺）进行比较。
女性阿尔特尼奥人的生长与家庭和母亲收入指数呈正相关。与分别在1983年/1998年/1977年测量的城市和农村社区青少年相比，阿尔特尼奥人的身高平均高出约0.8标准差/约0.6标准差/约2标准差。超重患病率与世界卫生组织参考标准相当，低于MESA和普诺参考标准。发育迟缓患病率分别是世界卫生组织/MESA/普诺样本的8.5/2.5/0.5倍。
结论/启示：城郊环境条件和时间趋势都对阿尔特尼奥人的生长增加有贡献。农村人口外流可以缓解移民的贫困，部分原因是城市化社区有更多样化的经济选择，尤其是对女性而言。尽管如此，阿尔特尼奥人的身高和体重中位数平均低于世界卫生组织和MESA标准。对环境挑战的进化生物学适应以及随之而来的生长轨迹变化，支持使用多种生长参考标准。生长监测应以社区和家庭层面的研究为依据，以检测和理解导致或缓解健康差距的当地因素。
