Kill the Economy

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154. Height, health, and development

http://www.pnas.org/content/104/33/13232.abstract

[font face=Serif][font size=5]Height, health, and development[/font]

Angus Deaton †

Edited by Richard A. Easterlin, University of Southern California, Los Angeles, CA, and approved May 2, 2007 (received for review December 22, 2006)

[font size=4]Abstract[/font]

[font size=3]Adult height is determined by genetic potential and by net nutrition, the balance between food intake and the demands on it, including the demands of disease, most importantly during early childhood. Historians have made effective use of recorded heights to indicate living standards, in both health and income, for periods where there are few other data. Understanding the determinants of height is also important for understanding health; taller people earn more on average, do better on cognitive tests, and live longer. This paper investigates the environmental determinants of height across 43 developing countries. Unlike in rich countries, where adult height is well predicted by mortality in infancy, there is no consistent relationship across and within countries between adult height on the one hand and childhood mortality or living conditions on the other. In particular, adult African women are taller than is warranted by their low incomes and high childhood mortality, not to mention their mothers' educational level and reported nutrition. High childhood mortality in Africa is associated with taller adults, which suggests that mortality selection dominates scarring, the opposite of what is found in the rest of the world. The relationship between population heights and income is inconsistent and unreliable, as is the relationship between income and health more generally.

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[font size=4]Discussion[/font]

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My results have implications for a number of strands of current research. The relationship between income and population height, which has been much relied on by economic historians, is of limited usefulness and will be downright hazardous for making comparisons across countries or continents. As in most other contexts, the link between income and health is not reliably mechanical (10). Attempts to infer African income levels or African disease burdens from African heights would fail spectacularly, much more spectacularly even than the well known but relatively minor failures in the height to income relationship in midnineteenth century Europe and America, particularly because at least some of the latter can be accounted for by an increased burden of disease. Even within countries over time, Table 1 does not suggest there is any reliable relationship between income and height. The African results also suggest the use of extreme caution in the use of skeletal remains to infer either material living standards or the disease environment of now-remote populations, although this is not to challenge the use of skeletal information to make inferences about health (21, 22). More generally, my results reinforce the view that “extreme caution should be used in making inferences from anthropometric data regarding living standards” (ref. 18, p. 141).

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