Why do children become stunted?

Stunting—a condition in which children’s physical growth is lower-than-normal for their age—afflicts approximately 160 million children under age five around the world. It can diminish children’s cognitive development and put them at a higher risk for degenerative diseases. The condition is broadly understood to be a consequence of growing up undernourished and in poverty, but Harvard T.H. Chan School of Public Health researchers have been working to create a more detailed picture of which children are at greatest risk so that interventions can be better targeted.

Their latest findings add surprising new evidence to the link between parental education and stunting. While previous studies have shown that mothers’ education is an important contributing factor, a new study by first author Sebastian Vollmer, adjunct assistant professor of global health, and colleagues at Harvard Chan and the University of Göttingen, in Germany, suggests that fathers’ education is just as important.

The study was published August 8, 2016, in the International Journal of Epidemiology.

In their analysis of survey data from more than a million children and their parents from 62 low- and middle-income countries, the researchers controlled for household wealth to reduce its potential distorting effect on the results. This caused the greater importance previously seen for mothers’ education to diminish, showing both sexes as equally significant.

“Our study suggests that the potential for paternal education as a determinant of child health may have been understated in the past,” Vollmer said. “Our hope is that our findings will spark a new debate on the way in which both maternal and paternal education can affect children’s nutritional status as well as their health in general.”

The researchers noted that there is much more data available about female schooling than male schooling, since the former is linked to a number of other important outcomes for women such as their fertility and risk of suffering domestic violence. The researchers recommended that future household surveys include in-depth questions on fathers’ health knowledge as well as their attitudes about child health care.

Previous research by the study’s senior author S V Subramanian, professor of population health and geography at Harvard Chan, and colleagues has also identified poor sanitation, maternal height and weight, and poor dietary diversity as factors that contribute to stunting.

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