Socioeconomic impacts on Andean adolescents' growth

Mecca E. Burris, Esperanza Caceres, Emily M. Chester, Kathryn A. Hicks, Thomas W. McDade, Lynn Sikkink, Hilde Spielvogel, Jonathan Thornburg, Virginia J. Vitzthum*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background/Objectives: We evaluated potential socioeconomic contributors to variation in Andean adolescents' growth between households within a peri-urban community undergoing rapid demographic and economic change, between different community types (rural, peri-urban, urban) and over time. Because growth monitoring is widely used for assessing community needs and progress, we compared the prevalences of stunting, underweight, and overweight estimated by three different growth references. Methods: Anthropometrics of 101 El Alto, Bolivia, adolescents (Alteños), 11.0-14.9 years old in 2003, were compared between households (economic status assessed by parental occupations); to one urban and two rural samples collected in 1983/1998/1977, respectively; and to the WHO growth reference, a representative sample of Bolivian children (MESA), and a region-wide sample of high-Altitude Peruvian children (Puno). Results: Female Alteños' growth was positively associated with household and maternal income indices. Alteños' height averaged ∼0.8SD/∼0.6SD/∼2SDs greater than adolescents' height in urban and rural communities measured in 1983/1998/1977, respectively. Overweight prevalence was comparable to the WHO, and lower than MESA and Puno, references. Stunting was 8.5/2.5/0.5 times WHO/MESA/Puno samples, respectively. Conclusions/Implications: Both peri-urban conditions and temporal trends contributed to gains in Alteños' growth. Rural out-migration can alleviate migrants' poverty, partly because of more diverse economic options in urbanized communities, especially for women. Nonetheless, Alteños averaged below WHO and MESA height and weight medians. Evolved biological adaptations to environmental challenges, and the consequent variability in growth trajectories, favor using multiple growth references. Growth monitoring should be informed by community-and household-level studies to detect and understand local factors causing or alleviating health disparities.

Original languageEnglish (US)
Pages (from-to)409-428
Number of pages20
JournalEvolution, Medicine and Public Health
Issue number1
StatePublished - 2022


  • adolescent growth
  • children's growth references
  • double burden of malnutrition
  • health disparities
  • high-Altitude adaptation
  • secular trend

ASJC Scopus subject areas

  • Ecology, Evolution, Behavior and Systematics
  • Health, Toxicology and Mutagenesis
  • Medicine (miscellaneous)


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