CHILD MALNUTRITION AND POVERTY

CHILD MALNUTRITION

Child Malnutrition a global problem that exists in developing as well as industrialized countries. In developing countries, poor nutrition contributes to more than half of all childhood deaths. One in three children in Africa is underweight, while half of all children in south Asia are malnourished. Approximately five million children in these developing countries die each year from malnutrition.
Child malnutrition impacts countries well beyond the individual effect it has on the children. Inadequate consumption of food and necessary vitamins and minerals during the developing years can have irreversible effects on a child’s physical and mental capacities that consequently contribute to decreased productivity of future generations and of the society as a whole. Infectious disease is highly associated with malnutrition and can be the cause of this condition, or the result.
Families in poverty very often do not have adequate healthcare and live in impoverished areas that lack proper sanitation and clean drinking water. These conditions contribute to malnutrition by creating environments that are conducive to infectious diseases. A lack of essential nutrients breaks down the body’s ability to fight off disease. Children, with their immature immune systems, are highly susceptible to these diseases, especially if their bodies are already fragile from lack of nutrition.
While malnutrition often invokes images of underweight children, those who suffer from malnutrition may suffer from obesity. Obesity as a result of malnutrition is often seen in more developed countries such as the United States. The United States is one of the richest countries in the world; however, areas such as the Rio Grande Valley, Central Appalachia, and the Mississippi experience poverty rivaling countries in the developing world. Reliance on cheap food that is high in calories and low in nutrients precipitates malnutrition in poor families in the United States, which can lead to obesity and diabetes in children.
Micronutrient deficiency and protein-energy malnutrition are the two basic types of malnutrition. Micronutrients are trace vitamins and minerals that are essential for health. Deficiencies in the micronutrients vitamin A, iron, and iodine are of great concern for poor people in developing countries. A deficiency of the micronutrient vitamin A can cause night blindness, a reduction in the body’s resistance to disease, and growth retardation.

Iron deficiency is a principal cause of anemia and results in a decrease in the amount of red cells in the blood. For children, health consequences of iron deficiency anemia include infections, physical and cognitive development impairment, and elevated risk of premature death.
Iodine deficiency can have devastating effects on a child’s health, even before he/she is born. Iodine deficiencies in the mother can result in permanent damage to her child by increasing the risk of congenital abnormalities such as cretinism, a grave, irreversible form of mental retardation.
The second type of malnutrition, protein-energy malnutrition, is the most lethal form of malnutrition and results from inadequate consumption of calories and protein necessary to meet the physical requirements for an active and healthy life. This type of malnutrition affects every fourth child worldwide and is the type normally thought of when one discusses malnutrition. Infants and young children are the most susceptible to protein-energy malnutrition because of their high energy and protein needs.
The degree of malnutrition in children is normally determined by height, weight, and age of the child. Three indicators often used to assess malnutrition in children include stunting, wasting, and underweight. For a child to meet the international criteria for malnutrition, he or she must be two or more standard deviations below the international average for height (stunting) or weight (wasting and underweight).
Children who do not have adequate height for their age may meet the criteria for stunting. Stunting is the result of chronic malnutrition at a young age. Adequate nutrition is essential to support growth; consequently, children who are lacking in nutrition do not have the ability to sustain growth and their height may be retarded as a result.
Wasting and underweight both refer to inadequate weight. Wasting is a condition in which the child’s height is within the normal range for his age; however, the weight is below the expected weight for his height. Therefore, wasting compares the child’s weight to her height. Conversely, the underweight indicator compares the child’s weight to the average for her age. Children who are two or more standard deviations below the average weight for their age are said to be underweight.
Malnutrition is a devastating problem that ultimately impacts everyone. While children in developing countries are at great risk of suffering malnutrition, it is also a concern in more prosperous countries. The future of societies is rooted in their children. Strong, healthy children create strong, healthy future generations.

CHILDREN AND POVERTY

In acknowledging that every individual under the age of 18, if recognized by a country’s law, has certain rights that must be protected, the United Nations Convention on the Rights of the Child sought to ensure the well-being of all children and treat them as individuals with their own privileges and freedom of expression. The convention, which was ratified by most United Nations member states (the exceptions being Somalia and the United States) and adopted into law in September 1990, asserts that children must be protected and provided with the necessary supports in order to mature into healthy adults.
Adoption of the convention has spurred a growing awareness on the part of world leaders that more concerted efforts were needed to provide children with a healthy start and protection against abuse, exploitation, and inadequate diet. To this end, the September 2005 United Nations World Summit witnessed one of the most auspicious gatherings of world dignitaries to reaffirm the Millennium Development Goals (MDG) that the United Nations declared in 2000. Among the nine stated goals that the MDG seeks to realize by 2015 is an improvement in the life chances of children by eradicating extreme poverty and hunger and reducing child mortality.
Poverty is highly contextual, which means that child poverty can take on different forms and can be accounted for by varying micro and macro conditions, depending on what region of the world they reside in. For some of the most impoverished nations in the southern hemisphere, poverty is often described in absolute terms and reflects an individual or family’s ability to consume a specific caloric intake of food that is considered to be minimal to guard against starvation, dehydration, or life-threatening disease.
For richer nations, where basic human needs such as food and water are provided, poverty measures often focus on income disparities or individuals’ ability to purchase a range of goods and services deemed acceptable based on a country’s standard of living. Poverty measures used around the world reflect these technical and conceptual distinctions about what constitutes poverty and also underscore differences in the standard of living enjoyed by nations of the northern hemisphere compared to those in the south.
A commonly cited measure of poverty in developing countries is the World Bank’s Purchasing Power Parity (PPP) estimate, which sets the international poverty level for extreme poverty around $1.08 per day or $32.74 a month. By the end of the 1990s, the per capita income for nearly 44 percent of the population of least developed countries was at or below this extreme poverty threshold and close to 75 percent of the population were trying to survive on nearly $2 per day.
In contrast, most western European countries have favored measuring poverty in “relative” terms, whereby thresholds are set in terms of the proportion of households with incomes less than 50 percent of the median adjusted household income for the country of residence. The United States’ Federal Poverty Line (FPL), a more “absolute” approach, which was established in the mid-1960s to define a minimum level of subsistence, takes into consideration the size and composition of a household to determine its poverty status at a fixed point in time. Families are considered as being in poverty if their annual earnings fall below a designated threshold, depending on the size of the family. For a family of four in 2004, the U.S. poverty threshold was $19,307.
Critics of an absolute measure of poverty contend that a more accurate appraisal of poverty would involve comparing some combination of a person’s economic, social, and cultural resources to those of the society. Using such estimates, child poverty rates would be adjusted upward in countries like the United States where income disparities are far greater than in other developed nations in Europe and elsewhere.
Even by existing and possibly restrictive measures of poverty, rates of severe deprivation among children in the developing and industrialized world remain woefully high at the dawn of the 21st century. By 2000, babies in least developed countries were twice as likely to die at birth than infants born in richer nations. In addition, children in these countries experienced lower immunization coverage, worse healthcare services, higher rates of malnutrition, and greater gender disparities, in comparison to their better-off counterparts in the richer nations.
Wealthy nations are not above reproach. Official U.S. Census Bureau figures, using an absolute measure of poverty, report that the rate for children under 18 years of age was 17.8 percent in 2004, one of the highest among leading developed countries. Given how strongly individuals’ social class during childhood predicts their economic opportunities later in life, such statistics suggest that even the richest nation is a long way from eradicating poverty at home.

CAUSES OF CHILD POVERTY

In addition to the ravages of war and a pandemic rise in the incidences of life-threatening diseases such as AIDS/HIV, which kills millions of adults and leaves countless children orphaned and impoverished, childhood poverty in underdeveloped countries is due in part to global economic restructuring, the outmigration of low-income families from rural or agricultural-based dwellings to urban areas, demographic shifts, cultural norms, as well as an institutional framework that fails to meet the changing needs of indigenous peoples.
Though children constitute nearly 50 percent of the size of the population of least developed countries, investments in children are woefully inadequate. And, given the realities of enormous external debt, bureaucratic mismanagement, social norms, and cultural values that subjugate the rights of the child, plus a lack ofa basic infrastructure upon which to build a compendium of services to support children, these countries face incredible obstacles to raising the quality of life of their youngest citizens, as noted by H. Penn.
Since children depend so much on parents’ income, child poverty in both the north and south goes hand in hand with the economic prosperity of an adult caretaker. In some of the richer nations, global economic restructuring also has played a prominent role in the marginalization and social isolation of low-income families and their children. The shift from manufacturing to a service-based economy and the increased emphasis on technology have excluded large portions of the population from the labor force in developed countries. A comparison of unemployment and child poverty rates among richer nations reveals some apparent inconsistencies.
Whereas countries like the United States, United Kingdom, and Italy have low levels of unemployment but high rates of child poverty, others, like Finland and Spain, have higher rates of unemployment yet report lower levels of child poverty. What accounts for these dissimilarities is the concentration of unemployment and underemployment among adults with families, as is the case in countries like the United States, unlike Finland and other nations where young, childless adults are overrepresented on the unemployment rolls.
Other social demographic indicators have also been linked to poverty rates among children. In the United States, as divorce and nonmarital birth rates increase, so does the proportion of children who reside in singleparent, often female-headed families. Apart from the absence of an additional adult breadwinner, low-income female-headed households are often characterized by other socioeconomic and demographic characteristics, such as mothers’ low educational attainment and early childbearing, which increase the likelihood that the children will spend some part of their formative years in poverty.
Minority status also matters since minority populations often find it harder to access employment opportunities that would afford a family a reasonable standard of living. In the United States, for example, where the legacy of slavery and racial intolerance continues to impact the life chances of black children, overt discrimination as well as the cumulative effect of prejudicial policies that prevented blacks from reaching their true potential in past decades today help to account for why black adults are more likely to be unemployed and earn less on average when they find a job.
Literacy among mothers is also linked to child poverty rates in developing countries. More educated girls are seen to delay marriage and make more informed decisions about childbearing and -rearing practices. In addition to basic literacy rates, low-income women’s reproductive patterns, notably short birth spacing as well as mother’s age at first birth, are strong indicators of poverty among children.

CONSEQUENCES OF POVERTY

Exposure to prolonged poverty can be especially detrimental to the health and safety of children. In instances where caregivers are either incapacitated, jobless, or have died or abandoned their offspring, children are often required to work for their own survival. Domestic and international laws have succeeded in outlawing child labor in wealthy nations around the globe. In developing countries the situation is much more complex, since poor families must often depend on the earnings of all household members, including the youngest.
Human rights groups have discovered some egregious examples of inhuman child labor conditions, and while the practice continues, such actions have increased the pressure that is brought to bear on developing countries and the companies that promote it, to abandon the practice altogether. What is not so easy to regulate and indeed continues to flourish below the radar screens of many international observers is the use of children as domestic laborers or indentured servants. Often these children endure long hours and the everpresent danger of physical or sexual abuse. Such labor is often associated with minimal or no compensation for the child and little regard for his or her personal development.
In addition to such flagrant examples of child neglect, poverty among children is also causally linked to illiteracy, short life spans, lack of access to appropriate healthcare, as well as social and economic disenfranchisement.
For instance, enrollment rates in school for children were around 58 percent in least developed countries by 2000 compared to 85 percent in richer nations, according to UNICEF. These numbers only begin to elucidate the extent of the problem, since the rates are even starker if we look at disparities by gender (girls usually do worse on most measures in comparison to boys), region, birth order, caste, or ethnic origin of children in certain parts of the world.
Even then, our understanding of the consequences of poverty on children in poorer countries is quite superficial apart from such fundamental measures that have been cited. This is because the south has not benefited from the wealth of investments, in terms of time and money, that have been devoted to understanding poverty’s varied effects on children in the north.
North American and European studies, and growing evidence from the south, reinforce the argument that regardless of where they are born, the short- and long-term consequences of poverty on children are profound. While prolonged poverty is thought to have the most severe effects, even short exposure to extreme poverty, especially during prenatal or postnatal periods, can cause irreparable psychological, physical, or emotional harm to a child. A preponderance of evidence indicates that growing up poor increases the likelihood of cognitive deficiencies, health problems, poor academic achievement, as well as impaired behavioral and psychosocial abilities among children and earnings inequalities among adults, according to J. Brooks-Gunn and G.J. Duncan.
Mounting evidence also bolsters the argument that even among richer nations, the physical and social isolation of poor families in high-poverty neighborhoods has detrimental effects on children and youth. Communities that are characterized as being low in social organization and social control among neighbors are most often characterized as risky for children, as shown by R. Sampson et al.

GENDER DIFFERENCES

Faced with the need to support themselves or other family members who are unable to find work, boys and girls are often expected to assume the responsibility of primary provider for themselves and their families. When conventional methods of employment are unavailable, youth often resort to illegal activities. Boys are more likely to engage in property crimes, including theft or larceny, and in some instances, prostitution.
Girls are also likely to engage in pilfering when no other viable legitimate means are open to them, but all too often they are forced to sell themselves in order to earn a living. Ethnic and civil strife in some of the world’s poorer nations has had an enormous impact on the number of boys who populate towns and villages. Boys are either conscripted into the armed forces or are some of the first victims of warring factions. Girls are more often the victims of sexual violence and are more likely to be exposed to sexual disease and impregnation.
Gender also confers different statuses on children, which, when coupled with the retarding effects of poverty and cultural norms, can further compound their precarious situation. In households where resources are greatly limited, girls may be the first to be denied opportunities for advancement. However, boys’ preferred status does not provide them with a free ride since they are often the ones who are expected to work outside of the home to supplement meager household earnings or serve as the family’s sole breadwinner.
Policies that work to ameliorate poverty are as diverse as are the conditions under which child poverty is realized and accentuated. In an effort to tackle the fundamental social inequalities that exist in many underdeveloped countries, there is currently enormous support for loan forgiveness programs, which would help to remove some of their debt burden. Such actions, as well as increased and consistent support from donor countries, proponents of such policies argue, would allow these nations to redirect the saved monies toward much needed investments such as primary education, access to clean drinking water, and better health and nutrition services for pregnant mothers and children, according to J. Sachs.
Job training, affirmative action programs, setting minimum wage limits, and providing tax credits as well as public cash transfers and noncash benefits are just some of the approaches used by countries in the north to try to reduce poverty. Cash transfer programs seek to raise the standard of living of poor families and their children. Noncash benefits include such things as housing allowances and food stamp programs that are geared toward basic commodities that help to improve family security. Support for childcare in formal settings is also favored as an important service for low-income single mothers who must work outside the home.

However, prevailing notions of what constitutes basic entitlements are being challenged in some countries. In 1996, breaking from existing policies that supported low-income single mothers’ desire to remain at home to raise a family, the U.S. federal government passed the Personal Responsibility and Work Reconciliation Act (PRWORA), which placed a limit on the amount of time low-income families can receive cash assistance and imposed strict work requirements on all able-bodied caregivers. Such approaches aim to increase the marketable skills and work readiness of low-income parents.
Other approaches in vogue currently include policies that promote marriage among unwed couples, which at their core also aim to reduce the numbers of poor children in the country. Though child poverty rates did fall in the United States during the 1990s, it remains to be seen if these gains were due to changes in national policy or a robust economy that has since fizzled.

By JIM QUANE (HARVARD UNIVERSITY) in the book 'Encyclopedia of World Poverty' v. 1, M. Oderon- Skidmore College (General Editor) Sage Publications, Thousand Oaks (U.S.A) $ London, 2006, p.146,147 & 150-154. Adapted and illustrated to be posted by Leopoldo Costa.

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