Protein and calorie malnutrition among preschool Navajo Indian children, a follow-up.

A follow-up study was conducted on the infant and child-feeding programs to determine the prevalence of protein and calorie malnutrition among preschool Navajo Indian children. These programs were introduced on the reservation in 1968. The numbers of patients admitted to the Public Health Service Indian Hospital, in Tuba City, Arizona, with deficits in weight for their chronological ages, marasmus, and kwashiorkor were compared during two 5-year-periods, 1963 to 1967 and 1969 to 1973. The results show an 18% reduction in the total number of patients under 5 years of age admitted to the hospital and a 39% reduction in the number of patients admitted with deficits in weight for their chronological ages. Marasmus has practically disappeared, with only two cases described since the end of fiscal 1969. The number of cases of kwashiorkor has also decreased by 50%, mainly in the last 4 years. The height and weight data on 1,462 Head Start children from all over the reservation were measured in September 1973, and these measurements were compared with data obtained in September 1967. While they still show a significant deviation from the Boston growth curves, there is a definite improvement from 1967 to 1973. This improvement was especially noticeable in height. Thirty percent of the girls and 30% of the boys fell below the 3rd percentile for Boston in 1967. In 1973, these figures were 11% and 16%, respectively. In the case of the girls in 1973, the numbers below the 3rd percentile are significantly smaller for younger girls than for the older girls, suggesting that the growth retardation occurred in the first 2 years of life, and that the older children had not received the full benefit of the free infant formula feeding programs. This trend, however, was not present in boys. It is concluded that the infant and child feeding programs have contributed to improved growth among Navajo preschool children. At the same time, concern is expressed that these feeding programs will be replaced by a Food Stamp Program and that the gains made will be reversed. Concern is also expressed for the regressive effects of inflation and rising food prices and the effects they will have on the nutritional status of the Navajo people.