Young H, Jaspars S
Disasters. 1995 Jun;19(2):94-109. doi: 10.1111/j.1467-7717.1995.tb00361.x.
In this article we review the relationship between malnutrition and mortality, and the interaction of morbidity, with the aim of clarifying the health risks of malnutrition in situations of famine and food insecurity. Apart from reviewing what is known about this relationship, we highlight areas where further research is needed. Among refugee and famine affected populations living in camps, there appears to be a close association between high rates of malnutrition and excess mortality. Results from community-based prospective studies of malnutrition and mortality among individuals conclude that as nutritional status declines the risk of death increases, although the discriminating power of different nutritional indices and the strength of the association varies considerably in different locations and at different times. These differences are attributed mainly to the different prevailing patterns of morbidity and growth failure, which are influenced by both environmental and social factors. In situations of famine and population displacement, the deterioration in the health environment increases exposure to infection and is likely to raise the threshold of nutritional status which corresponds to an increased risk of mortality. This has important implications for nutritional assessments and interventions.
在本文中，我们回顾了营养不良与死亡率之间的关系，以及发病率的相互作用，目的是阐明在饥荒和粮食不安全情况下营养不良对健康的风险。除了回顾关于这种关系的已知情况外，我们还强调了需要进一步研究的领域。在居住在营地的难民和受饥荒影响的人群中，营养不良率高与超额死亡率之间似乎存在密切关联。基于社区的个体营养不良与死亡率前瞻性研究结果表明，随着营养状况下降，死亡风险增加，尽管不同营养指标的鉴别能力以及这种关联的强度在不同地点和不同时间有很大差异。这些差异主要归因于发病率和生长发育不良的不同流行模式，而这些模式受到环境和社会因素的影响。在饥荒和人口流离失所的情况下，健康环境的恶化增加了感染风险，并且可能提高与死亡率增加相对应的营养状况阈值。这对营养评估和干预具有重要意义。
