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Social inequalities and children's height in Trinidad and Tobago


Objective: The aim of the study was to report the association of socio-economic factors with child's height.

Design: Cross-sectional study based on a representative national sample of government schools.

Setting: Trinidad and Tobago in 1999.

Subjects: A total of 2608 boys and girls mean age 5.8 y, range 4.38–6.99 y and 3080 mean age 8.6 y, range 7.00–10.44 y olds.

Outcome: Measurement of height and a questionnaire completed by parents. In the analysis height was expressed as standard deviation scores (s.d.s.) based on the British height curves (1990) or height below −1.5 s.d.s.

Results: Ethnicity, parental heights, birthweight, maternal age at child's birth and number of children in the family were the main factors associated with children's height. Lack of piped water supply in the home was the only socio-economic factor consistently associated with height (mean difference in s.d.s. adjusted only for age group, gender and ethnicity −0.192, 95% CI −0.257 to −0.127 and in addition adjusted for the variables listed above −0.080, 95% CI −0.141 to −0.019). Parental education, household overcrowding and employment status were weakly associated with height in the partially adjusted model only. Analysis of severe growth failure gave similar results.

Conclusion: The impact of socio-economic factors on height is marginal in Trinidad and Tobago. As socio-economic factors may have an impact on a broad range of health indicators, height and rates of undernutrition should not be used as sole criteria for assessing progress in decreasing health differentials caused by social inequalities.

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The authors thank the Chief Medical Officer of Trinidad and Tobago for permission to report this work. They also thank the Principal Medical Officer (Community Services), the Ministry of Education, and the staff, pupils and parents of the participating schools for their support of the survey. Special thanks are due to the staff of the Nutrition Division for their skill and dedication in working on the survey.

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Correspondence to R J Rona.

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Rona, R., Mahabir, D., Rocke, B. et al. Social inequalities and children's height in Trinidad and Tobago. Eur J Clin Nutr 57, 143–150 (2003).

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