Anthropometrics

Likely that’s new jargon: the study of the physical metrics of human populations. You may have encountered that growing up in the form of “growth charts” for height versus age. You know by looking across campus that there’s variation in even a population as homogeneous as that of W&L. So what if we approach measures for populations and subgroups? Can we as economists learn anything from that? This question was first posed by the late Nobel laureate Robert Fogel of the University of Chicago, and then pursued in detail by two of his graduate students, Richard Steckel of Ohio State University and John Komlos, emiritus of the University of Munich and currently a visiting professor at Duke. (Both have double PhDs in history and in economics.) They began with (for example) the records of military schools, US slaves and Army recruits, and asked whether this could provide insights into the standard of living across regions and time. The short answer is yes.

So now we see reports that China is needing to redesign its tanks because its recruits are now too tall to fit (here in BusinessWeek but you can find similar stories in the FT and the WJS, all citing the PLA Daily, which publishes English-language chinamil.com). In short, er, in length it’s 2 cm and girth 5 cm. With longer arms to match, the average up-and-coming PLA officer doesn’t fit. Rifle stocks are too short, too. That of course is consistent with growth raising incomes and increasing the quantity, quality and variety of food in the average person’s diet.

Several years ago a student pursued this topic in one of the best papers I’ve seen at W&L. With the help of the science library she found lots of sources in the public health literature. A quick search of the databases I urge you to use yields the following, in no particular order, and selected from the top of much larger lists.

• James P. Smith, Yan Shen, John Strauss, Zhe Yang and Yaohui Zhao (2010). The Effects of Childhood Health on Adult Health and SES in China. RAND Corporation Working Papers No. 809.
  Abstract: In this paper, the authors model the consequences of childhood health on adult health and socioeconomic status outcomes in China using a new sample of middle aged and older Chinese respondents. Modeled after the American Health and Retirement Survey (HRS), the CHARLS Pilot survey respondents are forty-five years and older in two quite distinct provinces- Zhejiang, a high growth industrialized province on the East Coast and Gansu, a largely agricultural and poor province in the West. Childhood health in CHARLS relies on two measures that proxy for different dimensions of health during the childhood years. The first is a retrospective self-evaluation using a standard five-point scale (excellent, very good, good, fair, or poor) of general state of one’s health when one was less than 16 years old. The second is adult height often thought to be a good measure of levels of nutrition during early childhood and the prenatal period. They relate both these childhood health measures to adult health and SES outcomes during the adult years. They find strong effects of childhood health on adult health outcomes particularly among Chinese women and strong effects on adult BMI particularly for Chinese men.
• Hong Liu, Hai Fang and Zhong Zhao (2013). Urban-Rural Disparities of Child Health and Nutritional Status in China from 1989 to 2006. IZA Discussion Papers from Institute for the Study of Labor, Working Paper No 6528.
  Abstract: This paper analyzes urban–rural disparities of China’s child health and nutritional status using the China Health and Nutrition Survey data from 1989 to 2006. We investigate degrees of health and nutritional disparities between urban and rural children in China as well as how such disparities have changed during the period 1989–2006. The results show that on average urban children have 0.29 higher height-for-age z-scores and 0.19 greater weight-for-age z-scores than rural children. Urban children are approximately 40% less likely to be stunted (OR = 0.62; P < 0.01) or underweight (OR = 0.62; P < 0.05) during the period 1989-2006. We also find that the urban–rural health and nutritional disparities have been declining significantly from 1989 to 2006. Both urban and rural children have increased consumption of high protein and fat foods from 1989 to 2006, but the urban-rural difference decreased over time. Moreover, the urban-rural gap in child preventive health care access was also reduced during this period.
• Lars Spencer Osberg, Jiaping Shao and Kuan Xu (2009). “The growth of poor children in China 1991–2000: why food subsidies may matter.” Health Economics, 18:S1, S89-S108.
  Abstract: How did rapid growth in per capita income and rising income inequality during 1991–2000 in China affect the health status of Chinese children, given that the disappearance in the 1990s of subsidized food coupons simultaneously increased the importance of money income in enabling consumption of basic foods by poor families? Using the China Health and Nutrition Survey data for 1991, 1993, 1997, and 2000 on 4400 households in nine provinces, we examine the height-for‐age of Chinese children aged 2–13, with particular emphasis on the growth of children living in poor households. We use mean regression and quantile regression models to isolate the dynamic impact of poverty status and food coupon use on child height‐for‐age. Our principal findings are: (i) controlling for standard variables (e.g. parents’ weight, height, and education) poverty is correlated with slower growth in height‐for‐age between 1997 and 2000 but not earlier; (ii) in 2000, poverty is negatively correlated with strong growth in height‐for‐age; and (iii) food coupon use in earlier periods correlates positively with growth in height‐for‐age. The general moral is the crucial social protection role that subsidized food programmes can potentially play in maintaining the health of poor children.
• Joerg Baten, Debin Ma, Stephen L. Morgan and Qing Wang (2009). Evolution of living standards and human capital in China in 18-20th century: evidences from real wage and anthropometrics. Economic History Working Papers from London School of Economics and Political Science, Department of Economic History.
  Abstract: This article mobilizes and integrates both existing and new time series data on real wages, physical heights and age-heaping to examine the long-term trend of living standards and human capital for China during the eighteenth to twentieth centuries. Our findings confirm the existence of a substantial gap in living standards between China and North-western Europe in the eighteenth and nineteenth centuries. They also reveal a sustained decline in living standards and human capital at least in South China from the mid-nineteenth century followed by a recovery in the early twentieth century. However, comparative examination of age-heaping data shows that the level of Chinese human capital was relatively high by world standard during this period. We make a preliminary exploration of the historical implication of our findings.
• Caryn Bredenkamp (2009). “Policy-related determinants of child nutritional status in China: The effect of only-child status and access to healthcare.” Social Science & Medicine, 69:10, 1531-1538.
  Abstract: This paper examines the determinants of child nutritional status in China, focusing specifically on those determinants related to health system reform and only-child status. Data are drawn from four waves of the China Health and Nutrition Survey (1991-2000). The empirical relationship between nutritional status, on the one hand, and income, access to quality healthcare and being an only-child, on the other hand, is investigated using ordinary least squares (OLS), random effects (RE), fixed effects (FE) and instrumental variables (IV) models. In the preferred model – a fixed effects model where income is instrumented – we find that being an only-child increases height-for-age z-scores by 0.12 of a standard deviation. By contrast, measures of access to quality healthcare are not found to be significantly associated with improved nutritional status.
• Ouyang, Yusi and Pinstrup-Andersen, Per (2012). “Health Inequality between Ethnic Minority and Han Populations in China.” World Development 40:7, 1452-1468.
  Abstract: This paper examines the health status of Chinese ethnic minorities using the China Health and Nutrition Survey (CHNS) data collected during 1989-2006. We found negative and significant differences between minority and Han Chinese in a set of anthropometric measures for people of all age groups. OLS and province fixed-effects regressions suggest that the economic development level of the province of residence is a major factor contributing to the gap. Oaxaca decompositions further reveal that the observed health gap is mainly due to inequalities in endowments rather than inequalities in their effects.
• Marcoux, Alain (2002). “Sex Differentials in Undernutrition: A Look at Survey Evidence.” Population and Development Review 28:2, 275-284.
  Abstract: This note seeks indirect evidence regarding possible sex biases in food intake for adults and children, through large-scale survey findings for anthropometric indicators. Among adults, excess female undernutrition is a serious problem in view of the large populations concerned (rural China, India), but data are still needed to assess the situation in many countries. Regarding preschool children, the anti-female biases once noted for China, India, and other countries seem to have disappeared. Where differences exist, boys fare worse than girls (probably because girls, given a less than adequate food supply, tend to cope with it better than boys). Anti-female discriminatory practices either are limited in magnitude or apply in groups that are too few or too small to be detectable in large populations.
• Xin Meng and Nancy Qian (2006). The Long Run Health and Economic Consequences of Famine on Survivors: Evidence from China’s Great Famine. IZA Discussion Papers from Institute for the Study of Labor No 2471.
  Abstract: In the past century, more people have perished from famine than from the two World Wars combined. Many more were exposed to famine and survived. Yet we know almost nothing about the long run impact of famine on these survivors. This paper addresses this question by estimating the effect of childhood exposure to China’s Great Famine on adult health and labor market outcomes of survivors. It resolves two major empirical difficulties: 1) data limitation in measures of famine intensity; and 2) the potential joint determination of famine occurrences and survivors’ outcomes. As a measure of famine intensity, we use regional cohort size of the surviving population in a place and time when there is little migration. We then exploit a novel source of plausibly exogenous variation in famine intensity to estimate the causal effect of childhood exposure to famine on adult health, educational attainment and labor supply. The results show that exposure to famine had significant adverse effects on adult health and work capacity. The magnitude of the effect is negatively correlated with age at the onset of the famine. For example, for those who were one year old at the onset of the famine, exposure on average reduced height by 2.08% (3.34cm), weight by 6.03% (3.38kg), weight-for-height by 4% (0.01 kg/cm), upper arm circumference by 3.95% (0.99cm) and labor supply by 6.93% (3.28 hrs/week). The results also suggest that famine exposure decreased educational attainment by 3% (0.19 years); and that selection for survival decreased within-region inequality in famine stricken regions.
• Tue Gorgens, Xin Meng and Rhema Vaithianathan (2012). “Stunting and selection effects of famine: A case study of the Great Chinese Famine.” Journal of Development Economics, 97:1, 99-111.
  Abstract: Many developing countries experience famine. If survival is related to height, the increasingly common practice of using height as a measure of well-being may be misleading. We devise a novel method for disentangling the stunting from the selection effects of famine. Using data from the 1959–1961 Great Chinese Famine, we find that taller children were more likely to survive the famine. Controlling for selection, we estimate that children under the age of five who survived the famine grew up to be 1 to 2cm shorter. Our results suggest that if a country experiences a shock such as famine, average height is potentially a biased measure of economic conditions during childhood.