Examining the relationships between early childhood experiences and adolescent and young adult health status in a resource-limited population: A cohort study

Autor: Wasiat H Shah, Khalil Ahmed, Ejaz Hussain, Nicole Zhong, Benjamin J.J. McCormick, Chelsea L Hansen, Alexandra F Jamison, Zeba A Rasmussen, Syed Iqbal Azam, Barbara A. Schaefer, Hygiene Interventions
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Pulmonology
Economics
Health Status
Social Sciences
Blood Pressure
Adolescents
Pediatrics
Vascular Medicine
Cohort Studies
Families
Child Development
Cognition
Medicine and Health Sciences
Public and Occupational Health
Pakistan
Early childhood
Longitudinal Studies
Young adult
Child
Children
education.field_of_study
Human Capital
Child Health
General Medicine
Socioeconomic Aspects of Health
Medicine
Educational Status
Health Resources
Female
Psychology
Cohort study
Research Article
Diarrhea
Adolescent
Population
Gastroenterology and Hepatology
Life Change Events
Young Adult
Signs and Symptoms
Humans
education
Socioeconomic status
Poverty
Bayes Theorem
Pneumonia
Anthropometry
Adolescent Development
Educational attainment
Health Care
Social Class
Age Groups
People and Places
Population Groupings
Clinical Medicine
Demography
Zdroj: PLoS Medicine
PLoS Medicine, Vol 18, Iss 9, p e1003745 (2021)
ISSN: 1549-1676
1549-1277
Popis: Background Adolescence is a critical point in the realization of human capital, as health and educational decisions with long-term impacts are made. We examined the role of early childhood experiences on health, cognitive abilities, and educational outcomes of adolescents followed up from a longitudinal cohort study in Pakistan, hypothesizing that early childhood experiences reflecting poverty would manifest in reduced health and development in adolescence. Methods and findings Adolescents/young adults previously followed as children aged under 5 years were interviewed. Childhood data were available on diarrhea, pneumonia, and parental/household characteristics. New data were collected on health, anthropometry, education, employment, and languages spoken; nonverbal reasoning was assessed. A multivariable Bayesian network was constructed to explore structural relationships between variables. Of 1,868 children originally enrolled, 1,463 (78.3%) were interviewed as adolescents (range 16.0–29.3 years, mean age 22.6 years); 945 (65%) lived in Oshikhandass. While 1,031 (70.5%) of their mothers and 440 (30.1%) of their fathers had received no formal education, adolescents reported a mean of 11.1 years of education. Childhood diarrhea (calculated as episodes/child-year) had no association with nonverbal reasoning score (an arc was supported in just 4.6% of bootstrap samples), health measures (with BMI, 1% of bootstrap samples; systolic and diastolic blood pressure, 0.1% and 1.6% of bootstrap samples, respectively), education (0.7% of bootstrap samples), or employment (0% of bootstrap samples). Relationships were found between nonverbal reasoning and adolescent height (arc supported in 63% of bootstrap samples), age (84%), educational attainment (100%), and speaking English (100%); speaking English was linked to the childhood home environment, mediated through maternal education and primary language. Speaking English (n = 390, 26.7% of adolescents) was associated with education (100% of bootstrap samples), self-reported child health (82%), current location (85%) and variables describing childhood socioeconomic status. The main limitations of this study were the lack of parental data to characterize the home setting (including parental mental and physical health, and female empowerment) and reliance on self-reporting of health status. Conclusions In this population, investments in education, especially for females, are associated with an increase in human capital. Against the backdrop of substantial societal change, with the exception of a small and indirect association between childhood malnutrition and cognitive scores, educational opportunities and cultural language groups have stronger associations with aspects of human capital than childhood morbidity.
In a cohort study, Zeba A Rasmussen and colleagues examine the relationship between early childhood experiences on health, cognitive abilities and education, and health outcomes in adolescents and young adults in Pakistan.
Author summary Why was this study done? Childhood diarrhea and pneumonia remain leading causes of morbidity and mortality, and their effects are hypothesized to have long-lasting impacts that could potentially negatively affect adolescent/young adult nutrition, reasoning skills, and educational status. Studies across different geographical settings have focused on outcomes during early childhood and on nutritional status or interventions, though very few have extended into adolescence/young adulthood. Other studies have noted negative associations between poverty, morbidity, and malnutrition and childhood attainment and physical and cognitive development. What did the researchers do and find? We conducted a prospective longitudinal study on a cohort of children (n = 1,868, 1989–1996) from a poor, remote rural Pakistani village who were followed up 20 years later (n = 1,463, 2011–2014), when they were adolescents and young adults (mean age 22.6 years old). Most of their mothers (70.5%) and fathers (30.1%) had received no formal education, but the adolescents had, on average, 11.1 years of education. Childhood illness was not related to nonverbal reasoning score, health measures, education, or employment. Education (including speaking English) was strongly related to nonverbal reasoning score. Speaking English was related to improved childhood socioeconomic status, better child health, more years of education by adolescence, and greater likelihood of having left the village. What do these findings mean? Investment in education, especially for females, is important in the development of human capital. Childhood undernutrition was related to adolescent height, and thereby weakly to cognitive score, whereas educational opportunities and cultural language group were more strongly associated with human capital than childhood illness was. This population underwent substantial secular changes, including economic growth and expanded educational opportunities, that may have overcome deficits from childhood undernutrition.
Databáze: OpenAIRE
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