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American Journal of Epidemiology Vol. 130, No. 6: 1219-1226
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health

research-article

THE IMPORTANCE OF AGE IN EVALUATING ANTHROPOMETRIC INDICES FOR PREDICTING MORTALITY

JOANNE KATZ1,, KEITH P. WEST, Jr.1, IGNATIUS TARWOTJO2 and ALFRED SOMMER1

1International Center for Epidemiologic and Preventive Ophthalmology (ICEPO), Dana Center for Preventive Ophthalmology of the Wilmer Institute, The Johns Hopkins University Schools of Medicine and of Hygiene and Public Health Baltimore, MD
2Indonesian Nutritional Blindness Prevention Project Bandung, Indonesia

Reprint requests to Dr. Joanne Katz, Dana Center for Preventive Ophthalmology, Wilmer 120, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21205

Weights and heights were obtained on approximately 4,000 preschool-aged children in six rural villages of West Java between 1977 and 1978. Deaths occurring in the ensuing 18 months were ascertained at three-month intervals. The abilities of relative weight for height and height for age to discriminate children at greatest risk of dying were compared. Younger children (≤two years) with low height for age (<95% of the reference median) were at greater risk of dying than children of the same age who were not stunted. This risk declined with increasing age, and among children aged 3–5 years, those who were stunted were at no greater risk than those of normal height for age. The mortality risk associated with mild wasting (80–90% of the reference median) also declined with increasing age. However, the risk of dying among moderately to severely wasted (<80% of the reference median) children increased with increasing age. These results suggest that stunting, rather than wasting, puts younger children at greater risk of death, but among older children, wasting carries a greater relative mortality risk over an 18-month period.

anthropometry; body height; body weight; growth; malnutrition; mortality


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