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Scarring and selection effects on children surviving elevated rates of postneonatal mortality in sub-Saharan Africa

Karlsson, Omar LU (2022) In SSM - Population Health 19.
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Height-for-age, School attendance, Early life adversity, Scarring, Selective mortality, Postneonatal mortality rate
in
SSM - Population Health
volume
19
article number
101160
publisher
Elsevier
external identifiers
  • scopus:85133713613
  • pmid:35846870
ISSN
2352-8273
DOI
10.1016/j.ssmph.2022.101160
language
English
LU publication?
yes
id
3d93dd3d-2209-4ce1-bc89-3c2f952353ed
date added to LUP
2022-07-12 19:44:38
date last changed
2022-10-12 03:00:27
@article{3d93dd3d-2209-4ce1-bc89-3c2f952353ed,
  abstract     = {{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.}},
  author       = {{Karlsson, Omar}},
  issn         = {{2352-8273}},
  keywords     = {{Height-for-age; School attendance; Early life adversity; Scarring; Selective mortality; Postneonatal mortality rate}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{SSM - Population Health}},
  title        = {{Scarring and selection effects on children surviving elevated rates of postneonatal mortality in sub-Saharan Africa}},
  url          = {{http://dx.doi.org/10.1016/j.ssmph.2022.101160}},
  doi          = {{10.1016/j.ssmph.2022.101160}},
  volume       = {{19}},
  year         = {{2022}},
}