Disease and Discrimination by Hutchinson Dale L.;

Author:Hutchinson, Dale L.;
Language: eng
Format: epub
Publisher: University Press of Florida
Published: 2019-03-08T16:00:00+00:00

Source: Wood, Black Majority, Table 1, 144. I have used the ancestry terms in Wood’s original table. Undoubtedly, he was confronted with the same issue that I was—how to know what criteria were used for classification and through what lens those classifications were made.

The most prevalent form of childhood malnutrition is protein-energy malnutrition, or PEM. It is called kwashiorkor when the diet includes a sufficient amount of food but is lacking in protein. There are a number of ways of measuring nutritional status. Height and weight measures can be compared to world standards. Low weight for height reflects acute, short-term food shortages, such as during famines, and is called wasting. Children who received inadequate nutrition in their younger years but who later have an adequate diet may be shorter than they would have been if they had consistently had a nutritionally sound diet, a condition called stunting. All of these nutritional impacts have seriously implications for later adult health.

A healthy child grows up and becomes, all things working right, a healthy adult. An unhealthy child, on the other hand, can generally look forward to an unhealthy life and a shorter life span. The health of the mother carrying an unborn child also impacts the later health of the child. And so the cycle of malnutrition goes from a mother who is malnourished to a low-birth-weight baby, who will become a child with stunting. The World Health Organization (WHO) emphasizes that the critical window for adequate nutrition is the 1,000 days between conception and 24 months of age.19 Stunting leads to a number of later developmental problems that include impaired mental (neurocognitive) development, compromised immune systems, and reduced productivity in later life.

The point of view that early health and nutrition influences later health is part of a larger theoretical framework called life history theory (LHT). LHT emphasizes that resources are limited and that energy is given to three primary life functions: growth, reproduction, and somatic (body) maintenance. Because resources are limited, there are always trade-offs—there is no free lunch. To partition a resource to one function means that it cannot be used for another. Thus, an increased investment in growth means that there may be less energy devoted to maintenance. These trade-offs, known as allocations, can involve the immune system, growth, gestation, and fertility, to name a few.

Let’s take the trade-off between investment in growth and immune function—a child who invests more energy in fighting infection will have less energy to devote to growth. Further, a correlative relationship has been observed between growth and the immune system—those with stunted growth tend to suffer more immune system problems. Children who have less access to nutritional resources will have less energy to put into any investment, be it growth or the immune system. Children with adequate access to food will grow better and have healthier immune systems than those who do not.

We have long known that there is a synergistic relationship between malnutrition and infectious disease. Poor nutrition, especially protein deficiency, will lower an individual’s resistance to infection and depress the cell-mediated immune response.

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