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

Abstract

Inadequate child physical growth and cognitive development share common individual-level risk factors. Less understood is how outcomes co-cluster at the community level and to what extent certain community-level characteristics influence the clustering. This study aims to quantify the extent to which child growth and development co-occur across communities, and to identify community-level characteristics associated with the clustering of the two development dimensions. We used longitudinal data from 1824 children (aged 5 years) across 98 communities in Andhra Pradesh, India in round 2 (2006) of the Young Lives study, who were followed up 3 years later in round 3 (2009). A multivariate, multilevel statistical model was estimated wherein the responses were nested within individuals, and communities. We used z-scores of height-for-age, weight-for-age, Peabody Picture Vocabulary Test, and a mathematics test in 2009 as outcome variables. At the community level, we included compositional variables representing community characteristics while controlling for child socio-demographic characteristics at the individual level. At the community level, children's physical growth and cognitive development were strongly correlated (coefficient: 0.55-0.76) and, even after controlling for individual-level covariables, a more pronounced correlation was shown at the community level than individual level correlation. Greater local healthcare resources were associated with better physical growth. More local programs run by government and NGOs/charities were associated with higher child language skills. Local social problems were inversely associated with math scores. Our study showed that physical growth and cognitive development tended to be clustered and co-occurred within communities as well as individual children.

Relationship between Animal Sourced Food Consumption and Early Childhood Development Outcomes

“…The exact relationship between growth and ECD has not been well established as both are affected by common factors such as diet, childcare, community, and infectious diseases, indicating that their association may be a co-occurrence, causal, or a combination, i.e., both causal and co-occurrence [ 6 , 7 ]. Despite this ambiguity, several studies have shown that ECD and child’s physical growth are interconnected [ 8 , 9 , 10 , 11 , 12 ].…”

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“…Physical growth, in terms of weight, height and body mass index (BMI), is considered a parameter that reflects the pattern of growth and development in a community. 1,2 Weight-for-age, height-for-age and BMI-for-age percentiles provide essential information to infer the nutritional and health status of children and adolescents. [3][4][5] The real value of growth curves for weight, height and BMI is that they help determine the degree to which the physiological needs of children and adolescents are being met during their growth and motor development process, 6 that is, anthropometric measurement is an early method and a suitable data source for assessing growth in this population.…”

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“…In the last decade, human growth has been widely studied due to its association with the socio economic status [1]. Especially, the study of physical growth in children or infants is an interesting and challenging and which depends on many factors such as genetic, malnutrition, physiological and socio-economic factors [2][3][4]. Normal growth is the greatest indicator of children's well-being and provides an accurate marker of inequalities in human development.…”