How costly is a bout of malnourishment in infancy? That question has been answered in a new way by a study (.pdf) that reports on the economic status of 40-year-olds who were hospitalized for treatment of severe malnutrition in infancy. Its finding, in a nutshell, is that malnourishment in infancy lowers an individual's income in middle age, at least in part because of cognitive deficits that persist throughout life.
The research, published online this week in Pediatrics, is part of an extremely comprehensive effort to follow a group of malnourished infants across their lives: the Barbados Nutrition Study, which tracks a group of Barbadians born between 1967 and 1972 who were treated for marasmus or kwashiorkor in infancy. After their initial hospitalization for malnourishment, these individuals were enrolled in a nutrition program that followed them through age 12. For the study, subjects were matched with Barbadian peers who did not experience malnutrition.
The research shows that children who experienced malnourishment came from poorer households than those who did not (no surprise there), but also that the income gap between these individuals' households widened over time. More than 80% of the children who were malnourished dropped out of high school, whereas almost half of those in the healthy comparison group got some college education. In middle age, the previously-malnourished individuals' jobs were nearly always in manual labor.
The researchers conclude:
Our data thus suggest that neurologic consequences of infantile malnutrition, manifest in cognitive compromise, limiteducational and occupational opportunities in adulthood. Although it is theoretically possible that early malnutritionaffects economic outcomes indirectly by impairing health and resulting in reduced school attendance and hence achievement,31 this scenario would not explain outcomes observed in Barbados, where significant resources were devoted to restoring and maintaining child health.
Fortunately, Barbados has changed a lot since the early 1970s, and severe malnourishment of Barbadian children is now rare. But about a third of the world's children still experience some degree of malnourishment. I hope the findings will prompt more investment in meeting children's nutritional needs, not just because it's the right thing to do but because it is economically sensible as well.