Community‐based clustering of height in Ethiopia, India, Peru, and Vietnam

Abstract

Objectives: Human growth and final height are influenced by many factors such as genetics, nutrition, living conditions, socioeconomic background and, as recently proposed, by social peer groups and the community. In this paper, we aim to evaluate the extent to which spatial proximity, acting as a proxy for the social community, causes height clustering in low and middle income countries. Material and methods:We analyzed data from the study "Young Lives-Measuring Child Poverty and Health", a study performed in four low and middle income countries (Ethiopia, India, Peru and Vietnam) to describe the health situation of children. We used linear mixed effects models with different random effect structures to analyze the influence of the community on clustering of height in boys and girls.Results: In all analyzed low and middle income countries, linear mixed effects with hierarchical structures with communities nested within regions provide a better fit than the basic models neglecting community-based clustering (p < .001). Discussion: Although the underlying mechanisms require future research, spatial proximity arising from clustering needs to be integrated into explorative modelling of height variability in humans. K E Y W O R D S community effect, development, growth, height, influencing factor

Community Determinants of Physical Growth and Cognitive Development among Indian Children in Early Childhood: A Multivariate Multilevel Analysis

“…Although the community context has been highlighted as a critical level for interventions [12,13], much research on child growth and development has focused on individual-level factors especially within developing countries. Further, existing research assessing links between poor community conditions and adverse child development has dealt with either physical or cognitive outcomes, but not both [14][15][16][17][18][19]. Few studies have examined clustering of child physical growth and cognitive outcomes co-occurrence at the community level nor considered the shared environmental factors influencing both dimensions of child development.…”