Stunting, Socioeconomic Status and Early Child Development in the East Asia Pacific

Abstract

Stunting (being >2 SDs below the median height-for-age of the reference population) impairs cognitive ability and psychosocial competencies throughout childhood and adolescence, and continues to have long-term detrimental impacts on adult cognitive ability and achievement. This paper examines the relationships among stunting, socioeconomic status (SES) and early child development. The sample included 6,352 children (3,168 girls) ranging in age from 36 to 71 months from Cambodia (n=1,178), China (n=1,557), Mongolia (n=1,226), Papua New Guinea (PNG) (n=1,697), and Vanuatu (n=674). Children’s height was measured and WHO growth standards were used to determine the presence of stunting. SES was determined based on family wealth. The Cognitive Development, Language & Emergent Literacy and Socio- Emotional Development domain scores of the East Asia-Pacific Early Child Development Scales (EAP-ECDS) (Rao et al., 2014) were used to determine early child development. Stunting prevalence was highest in PNG (50.3%), followed by Vanuatu (44.4%), Cambodia (29.9%), Mongolia (11.1%), and China (1.1%), respectively. The wealth gap was highest in PNG, Cambodia, Mongolia, Vanuatu, and China, respectively. Stunted children had significantly poorer development relative to non-stunted children in all five countries and the prevalence of stunting was higher for children in the bottom SES quartile compared to children in the top quartile. In general, the lower the level of economic development in a country, the higher the rates of stunting. Further, smaller wealth gaps and lower stunting prevalence go hand in hand, supporting recent evidence highlighting that the poorest children in the poorest countries have the highest rates of stunting. Results highlight the importance of addressing chronic malnutrition for the poorest children who face the greatest disadvantage.