Rare prism

Who of the kids will die? Who will get a more-than-even chance to achieve full lives? “Seventy is the sum of our years, eighty if we are strong,” the Psalmist  writes. More important, how do we ensure that in the future, youngsters  need no longer slump into premature graves?

Today’s headlines and evening news bulletins swirl around ousted president Joseph “Erap” Estrada getting fed up with Sen. Aquilino “Koko” Pimentel III’s reluctance to play ball with the opposition, Manila Mayor Alfredo Lim’s word brawl with Vice Mayor Francisco Damagoso to Abu Sayyaf kidnapping of a Jordanian journalist.

In contrast, a barely-noticed conference in Cebu City mid-June analyzed “Early Life Determinants of Health and Well Being.” Organized by the Consortium of Health Orientated Research in Transitioning Societies, the meeting examined child-health issues with a rare international  prism: studies that tracked children across generations.

“Longitudinal analysis” is rare. Countries  assembled, under the Consortium’s umbrella , are from the Philippines, Brazil, India, South Africa and Guatemala. These five have  on-going birth cohort studies that cover close to 11,000 individuals. All had “at least 15 years or more of follow up.”

Brazil failed to track 17 percent of infants, studied by Universidad Federal de Pelotas, into adulthood. In contrast, the Cebu Longitudinal Health and Nutrition Survey (CLHNS) at the University of San Carlos (USC) lost contact with only one percent of 3080 mothers and infants, from 243 barangays that it first examined in 1983.

“Cebu study findings shaped the first World Bank health financing strategy,” University of North Carolina’s Barry Popkin wrote. The Cebu research was “instrumental” in United Nation’s Children’s Fund policy on breast-milk substitutes and Asian Development programs on early child development. A Harvard University team used CLHNS for analysis of two long-term vaccination programs.

Over the last 28 years, USC’s Office of Population Studies (OPS) conducted seven  follow-up surveys. CLHNS data anchor 125 international and national research projects. They range from pre-birth malnutrition’s effect on blood pressure and early onset of menstruation to parental and peer pressure on young adult sexual behavior.

Yesterday’s Cebu infants are today’s adults. Some are parents and hold down jobs. There are school dropouts. A number have died and 136 moved out. One is an Overseas Filipino worker in Iceland.

These life-changes are mirrored in the analysis. In CLHNS’ early years, focus was on infant feeding, birth spacing to nutritional status. In the 1990s, attention shifted to childhood stunting and entry-into-school development. As kids emerged into young adults, the spotlight turned to “early life factors that predict schooling and academic achievement.”

CLHNS mothers were followed to learn about their long term patterns of health, birth spacing to diet and work patterns, noted the “International Journal of  Epidemology.” CLHNS is “one of the few sources for long analysis of intimate partner violence… and consequences for women and young adults”

In 2011, USC completed its  examination of new pregnancies and birth outcomes among those who were once 1983  infants. This “makes CLHNS a three generation study.”

Linda Adair of North Carolina University  and Judith Borja of USC OPS presented findings on breastfeeding in 17 urban barangays and 16 rural villages. Breastfeeding had declined. As an alternative, mothers fed their babies milk formulas. Others used diluted condensed milk. Diarrhea was related to babies who were fed substitute milk, they found. Four in 10 of babies who were not breastfed,  and lived in poor conditions, proved  vulnerable to diseases.

Cesar Victoria of Brazil cobbled the Consortium into its present structure. “The bottom line” for decisive intervention in form is in the first 24 months of the child’s life. “Act here,” he urged. Dividends in the child’s health dwindle in the later months. “Maternal and child under nutrition have adverse consequences for adult and health capital.”

Some of the fallout emerge from comparison of data. Malnourished pregnant mothers result in “stunting, lower attained schooling, reduced adult income” and wizened “underweight offspring.”

“Children who are undernourished in early life, and then gain weight rapidly after infancy, are at high risk of chronic disease,” Linda Richter from South Africa’s University of Witwatersand reported. “Prevention of maternal and child under nutrition is a long term investment. (It) benefits both the current generation and their children….”

Members differed in patterns of child growth, in both length and height. “Guatemala and Cebu showed marked growth failure in early childhood. Brazil growth hewed to international standards. South Africa and India showed intermediate patterns.

Data from the five participating countries  underscore that children from low and middle income countries, who are assisted in the “first and possibly in the second year of life show improved human capital indicators as adults.” They are also less prone to the “increased risk of chronic diseases in later life.”

Present Consortium findings “in a format that policymakers can understand,” urged Florentino Solon of Nutrition Center of the Philippines who conceptualized CLHNS with the late Society of the Divine Word father Wilhelm Fleiger. “Policy-making is in the hands of politicians. How do you convince these politicians (to implement these them?”

For a start, slam them with  the American psychiatrist Karl Menninger’s warning in his book, “The Human Mind”: “What’s done to children, they will do to society.”