Child health and nutrition is important not only for its own sake, but because the negative consequences of poor health in childhood are felt throughout the life course. There is significant evidence that malnourishment in childhood has negative effects on future health, educational and labor market outcomes. This together with the strong relationship between parental socioeconomic status and child health, suggests that poor health in childhood could be an important mechanism in the intergenerational transmission of socioeconomic status. Under-nutrition among children remains a pervasive public health problem in developing countries. In South Africa, a nationally representative survey conducted in 1993 found one in four pre-school children to be stunted, and one in 10 to be underweight for their age with pronounced socioeconomic and racial inequities in the distribution of malnutrition. Research into malnutrition in South Africa has been hampered by a dearth of nationally representative data. This project will take advantage of the new longitudinal National Income Dynamics Study together with other South African datasets to investigate a range of issues around the links between malnutrition and socioeconomic status. The project has the following specific aims. 1. Estimating the current national prevalence of child malnutrition and investigating socio-economic determinants of and inequities in child malnutrition. 2. Monitoring progress in reducing rates of malnutrition and racial and socioeconomic inequities in child malnutrition over the last 15 years. 3. Using longitudinal data to investigate how parental death affects children's health outcomes, particularly their nutritional status. Within this aim, the following four questions will also be addressed: Do mothers'and fathers'deaths produce different effects on outcomes? Are orphans'outcomes buffered by higher socioeconomic status? Are orphans'outcomes better protected when they live with more closely-related caregivers? Does the impact of orphanhood change with time since parents'deaths? 4. Investigating the extent to which the lower educational attainment observed among orphans can be attributed to poorer nutritional status. 5. Using the state old age pension and longitudinal data to examine whether children's nutritional status is affected by the arrival of a large stable source of income. Within this aim, special attention will be given to the following questions: Do pension gain and pension loss have symmetric effects? Does the gender of the recipient affect the impact of pension? Are there are differential effects for male and female children? Does pension income have a greater impact on children living in poorer households?

Public Health Relevance

Reducing rates of malnutrition and narrowing racial disparities in child health remain key public health challenges in South Africa over the next decade. This project will monitor progress in addressing these challenges and make a substantial contribution to our understanding of the some of the causes of child malnutrition.

National Institute of Health (NIH)
Fogarty International Center (FIC)
Research Project (R01)
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Special Emphasis Panel (ZRG1-ICP3-B (50))
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Liu, Xingzhu
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University of Cape Town
South Africa
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Branson, Nicola; Ardington, Cally; Leibbrandt, Murray (2015) Health outcomes for children born to teen mothers in Cape Town, South Africa. Econ Dev Cult Change 63:589-616
Ardington, Cally; Menendez, Alicia; Mutevedzi, Tinofa (2015) Early childbearing, human capital attainment and mortality risk: Evidence from a longitudinal demographic surveillance area in rural-KwaZulu-Natal, South Africa. Econ Dev Cult Change 63:281-317
Ardington, Cally; Gasealahwe, Boingotlo (2014) Mortality in South Africa - socioeconomic profile and association with self-reported health. Dev South Afr 31:127-145
McLaren, Zoë M; Ardington, Cally; Leibbrandt, Murray (2014) Distance decay and persistent health care disparities in South Africa. BMC Health Serv Res 14:541
Ardington, Cally; Bärnighausen, Till; Case, Anne et al. (2014) The Economic Consequences of AIDS mortality in South Africa. J Dev Econ 111:48-60