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Lecture 9

HLTC05H3 Lecture Notes - Lecture 9: Hypoplasia, Atole, Coronary Artery Disease

Health Studies
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R Song

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Lecture 9 06/12/2012 22:50:00
Inequality and Childhood
Inequalities also exist among and between children
These inequalities broadly reflect the class, race, and gender
divisions inherent in their societies (structural violence)
In some nations, these inequalities can be lessened among children
(e.g., social services provided by gov`t protect children and ensure
more universal access to health care, education, etc.)
In others, these inequalities can be intensified (widespread poverty,
lack of social services, etc.)
UN 2012
Global Under 5 Mortality in 2008 (WHO 2011)
Survival and development of all children, male or female, is strongly related
to the position of women
1)Growth and Development
2)Psychosocial development and living environment
3)Long-term consequences: adult morbidity/mortality
Childhood Requirements
Prenatal health: maternal health, nutrition, SES
Successful, low stress, childbirth

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Post-natal nutrition, health care
Infant/child/juvenile/adolescent nutrition
Access to health resources: immunizations, medicine, etc.
Family/kin social resources: care, support, education and
Safe, healthy home environments: adequate shelter, hygiene,
sanitation, water, protection from elements, adequate space, free
from pests and pollutants/toxic materials (air, water, solids), basic
amenities, play/educational resources
Community resources: schools/formal education, recreation, park
land, health clinics, religious institutions, etc.
Child Growth and Development
•Period of great morbidity & mortality (to age 5), malnutrition-
•Hard tissue evidence: Enamel Hypoplasia (generalized stress)
horizontal band across teeth occurs when children are
undernourished, chronic stress affects their dental development
Developmental “Milestones”
1)Social and emotional development
2)Language and communication
3)Cognitive (learning, thinking, problem-solving)
4)Physical development and movement (motor skills)
Human Brain Growth and Function
•Newborn uses 87% of its resting metabolic rate (RMR) (body
energy expenditure during rest) for brain growth and function
(under 5yrs: 44-85% RMR)
•By 5 years: 44% of RMR for brain growth/function

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•Adult human: 16-25% of RMR for brain function
Nutrition, Poverty and Intellectual Performance
Pollitt and Brown 1996
Guatemalan study, changed the perpective of how we think of
interventions, what we need to do with supplementation
SES of the parents, and social living environemtns of these kids
plays a significant role of the IQ
SES and Intellectual Development
Strong and persistent connection between SES (e.g., education,
occupation, income) and childhood cognitive ability and achievement, as
measured by IQ, achievement test scores, and functional literacy
Malnutrition and Intellectual Development
Brown and Pollitt 1996
Earlier assumptions:
1.Poor nutrition is primarily an issue up to 2 yrs of age (when brain =
80% adult size)
2.Poor nutrition up to age 2 yrs hinders normal brain development,
resulting in severe, lasting damage
Malnutrition and Intellectual Development
Current Understanding:
1.With improvement in diet and health after 2 yrs, brain may exhibit
“catch-up” growth (damage is not irreversible)
2.Brain growth can continue to be compromised by undernutrition
after 2 yrs
3.Intellectual impairment can result from more moderate malnutrition
(micronutrients) THUS: importance of nutrition throughout childhood
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