Building a New Biocultural Synthesis: Political-Economic Perspectives on Human Biology

14. Poverty and Nutrition in Eastern Kentucky: The Political Economy of Childhood Growth

Chapter 14 Poverty and Nutrition in Eastern Kentucky: The Political Economy of Childhood Growth Deborah L. Crooks This chapter discusses child poverty in the United States and the role of biological anthropologists in poverty research. Biological anthropologists have made important contributions to research on poverty in the developing world via a focus on child growth and development. Child growth is an accepted marker of the quality of a child's environmental circumstances because of its well-documented sensitivity to those circumstances (HussAshmore and Johnston 1985; Schell 1986). In developing countries, child growth has been an effective monitor of economic and social conditions that limit resources and erode adaptive strategies of those living on the margins. Where political and economic agendas and policies combine to prevent access to adequate nutrition, housing, sanitation, and healthrelated resources, child growth often suffers. With few exceptions biological anthropologists have paid less attention to this issue in the developed world. But given that childhood growth reflects the quality of a child's environment, research in this area could raise critical flags, calling attention to geographical areas and populations within the United States where more resources could improve children's lives. Thus by bringing their expertise to bear on these issues in the United States, biological anthropologists could bring much to the understanding of the relationship between poverty and childhood well-being. Already, limited research in the United States has documented a relationship between poverty or socioeconomic status (SES) and child growth, indicating deficits in stature and weight, and, conversely, excesses in weight among some poor children in the United States, although some research indicates little/no effect on growth (reviewed by Crooks 1995). 339 340 Building a New Biocultural Synthesis Clearly there is variation in the research outcomes. However, it is not clear whether this variation results from methodology, for example, how poverty is defined and how it is used in the research, or whether it represents true variation based on the circumstances and experience of poverty for different groups in the United States. What is clear is the need for more research to sort out the complex relationship between poverty and malnutrition in the United States, because the consequences ofmalnutrition may be devastating and lifelong. In the developing world, undernutrition, measured by low stature, weight, and body composition may have long-term consequences for adult productivity and success via cognitive deficits, compromised school performance , and even reduced work capacity (e.g., Grantham-McGregor 1984; Spurr 1983; Johnston and Low 1995). Similar consequences may hold for U.S. children, as well, especially as they relate to school achievement (Wilson et a11986; Karp et al. 1992; Sewell, Price, and Karp 1993). Another form of malnutrition, overnutrition, which is measured by high weight, body mass index, and/or skinfold thickness, may also have consequences for adult productivity. Although this remains to be documented , we can hypothesize a connection from childhood behaviors to adulthood behaviors that produce obesity, which is associated with chronic diseases, e.g., cancer, heart disease, and high blood pressure (Bandini and Dietz 1992; Dietz 1994; Greenwood et al. 1993; Webber et al. 1995). Where these diseases result in disability and where there is discrimination against overweight individuals, social and economic success may be compromised (Gortmaker et al. 1993). Finally, a third form of malnutrition found among children in the United States is micronutrient deficiency. Not as easily recognizable as under- or overnutrition, micronutrient deficiencies result from inadequate diets in terms ofquantity, quality, or both. Various micronutrient deficiencies are reported to be associated with negative child function (Buzina et al. 1989; Allen 1990; Kanarek and Marks-Kaufman 1991). Where these affect school achievement or health, adult productivity may be compromised. These three forms of malnutrition occur in the context of poverty in the United States and may result from lack of resources for appropriate and adequate nutrition. However, the path from poverty to malnutrition in the United States is complex, with linkages that are mUltiple and often indirect (Crooks 1995). Hypothesized linkages include the ability of parents to secure a job that enables them to adequately provide for their chil- Poverty and Nutrition in Eastern Kentucky 341 dren (education, job availability, transportation, and child care are all indirect links here), the ability offamilies to secure and/or produce quality food for their children (education, employment, land productivity/availability , and food prices/availability are all indirect links here), and parents' understanding ofwhat constitutes quality nutrition...