Scarring and selection effects on children surviving elevated rates of postneonatal mortality in sub-Saharan Africa
Infants in sub-Saharan Africa face adversity: Infections and undernutrition are major causes of infant deaths and can cause physiological damage with long-lasting adverse scarring effects on the human development of the survivors, for example, in terms of health and education. However, selective mor...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | SSM: Population Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352827322001392 |
| _version_ | 1798030941049847808 |
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| author | Omar Karlsson |
| author_facet | Omar Karlsson |
| author_sort | Omar Karlsson |
| collection | DOAJ |
| description | Infants in sub-Saharan Africa face adversity: Infections and undernutrition are major causes of infant deaths and can cause physiological damage with long-lasting adverse scarring effects on the human development of the survivors, for example, in terms of health and education. However, selective mortality of more vulnerable children at very high levels of adversity in early life can leave the surviving population to appear on average healthier. This paper estimated the nonlinear effects of postneonatal mortality rate—a proxy for adversity, particularly infections and undernutrition—in a 50 km radius, occurring over the period of infancy, on the subsequent height-for-age and school attendance of the surviving children. The results indicated that an adverse environment in infancy negatively affected height-for-age at age 1–4 years: At relatively low levels of adversity (at the 10th percentile of postneonatal mortality rate), an additional postneonatal death per 100 person-years decreased height-for-age of the survivors by almost 2% of the mean deficit in height (relative to a common growth standard) when comparing siblings born into different levels of adversity. At high levels of adversity, no effect was found for height-for-age while a small positive association was observed for school attendance at age 7–16 years. The results indicated that selective mortality may have canceled out (or even dominated in the case of school attendance) observable scarring effects following high levels of postneonatal mortality rate in sub-Saharan Africa. |
| first_indexed | 2024-04-11T19:49:24Z |
| format | Article |
| id | doaj.art-836f5bdb4c114fe4b092eb38edd28cba |
| institution | Directory Open Access Journal |
| issn | 2352-8273 |
| language | English |
| last_indexed | 2024-04-11T19:49:24Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Population Health |
| spelling | doaj.art-836f5bdb4c114fe4b092eb38edd28cba2022-12-22T04:06:22ZengElsevierSSM: Population Health2352-82732022-09-0119101160Scarring and selection effects on children surviving elevated rates of postneonatal mortality in sub-Saharan AfricaOmar Karlsson0Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA, 02115, United States; Department of Economic History, School of Economics and Management, Lund University, P.O. Box 7083, 220 07 Lund, Sweden; Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA, 02115, United States.Infants in sub-Saharan Africa face adversity: Infections and undernutrition are major causes of infant deaths and can cause physiological damage with long-lasting adverse scarring effects on the human development of the survivors, for example, in terms of health and education. However, selective mortality of more vulnerable children at very high levels of adversity in early life can leave the surviving population to appear on average healthier. This paper estimated the nonlinear effects of postneonatal mortality rate—a proxy for adversity, particularly infections and undernutrition—in a 50 km radius, occurring over the period of infancy, on the subsequent height-for-age and school attendance of the surviving children. The results indicated that an adverse environment in infancy negatively affected height-for-age at age 1–4 years: At relatively low levels of adversity (at the 10th percentile of postneonatal mortality rate), an additional postneonatal death per 100 person-years decreased height-for-age of the survivors by almost 2% of the mean deficit in height (relative to a common growth standard) when comparing siblings born into different levels of adversity. At high levels of adversity, no effect was found for height-for-age while a small positive association was observed for school attendance at age 7–16 years. The results indicated that selective mortality may have canceled out (or even dominated in the case of school attendance) observable scarring effects following high levels of postneonatal mortality rate in sub-Saharan Africa.http://www.sciencedirect.com/science/article/pii/S2352827322001392Height-for-ageSchool attendanceEarly life adversityScarringSelective mortalityPostneonatal mortality rate |
| spellingShingle | Omar Karlsson Scarring and selection effects on children surviving elevated rates of postneonatal mortality in sub-Saharan Africa SSM: Population Health Height-for-age School attendance Early life adversity Scarring Selective mortality Postneonatal mortality rate |
| title | Scarring and selection effects on children surviving elevated rates of postneonatal mortality in sub-Saharan Africa |
| title_full | Scarring and selection effects on children surviving elevated rates of postneonatal mortality in sub-Saharan Africa |
| title_fullStr | Scarring and selection effects on children surviving elevated rates of postneonatal mortality in sub-Saharan Africa |
| title_full_unstemmed | Scarring and selection effects on children surviving elevated rates of postneonatal mortality in sub-Saharan Africa |
| title_short | Scarring and selection effects on children surviving elevated rates of postneonatal mortality in sub-Saharan Africa |
| title_sort | scarring and selection effects on children surviving elevated rates of postneonatal mortality in sub saharan africa |
| topic | Height-for-age School attendance Early life adversity Scarring Selective mortality Postneonatal mortality rate |
| url | http://www.sciencedirect.com/science/article/pii/S2352827322001392 |
| work_keys_str_mv | AT omarkarlsson scarringandselectioneffectsonchildrensurvivingelevatedratesofpostneonatalmortalityinsubsaharanafrica |