Homeless Urban Children in Developing Countries Found to Be Healthier Than Expected

BUFFALO, N.Y. -- The rapid increase in the number of homeless children in cities in the developing world is a matter of grave concern, particularly with regard to their physical well-being.

A study by a University at Buffalo researcher, however, supports earlier findings that although fraught with danger and poverty, the conditions under which these children live are more optimal for survival than originally thought.

The study of the health of urban Guatemalan street children by Timothy Sullivan, a UB doctoral candidate in anthropology, was presented here today (April 10, 2002) in an abstract at the annual meeting of the American Association of Physical Anthropologists.

Sullivan's findings support the contention by other researchers that in developing countries, these children are in better health and have a better chance of survival than do their peers who reside in intact homes in agricultural villages.

He found that his subjects' average body mass index (BMI), a measure related to a variety of health risks throughout life, was very similar to that of American children whose BMI values, as reported by the National Center for Health Statistics, are the standards by which general child health is judged worldwide.

BMI, or relative weight to height ratio, correlates with mortality and morbidity from a variety of causes. The BMI is used worldwide as an index of Chronic Energy Deficiency (CED), a serious health problem in developing countries. In addition, it predicts impaired maternal health and lactation, impaired fetal growth, decreased work capacity and economic productivity, high rates of chronic disease and mortality.

Sullivan's study involved 51 street children ages 5-15 who were associated with a street school in a highland city in Guatemala.

The children were found to be shorter and weigh less than American children in their age cohort. However, their BMI was found to be similar to mean NCHS values. Sullivan said this indicates that although the children's growth is stunted, the amount of weight carried on that height is about the same as that of U.S. children of that height whose scores provide the NCHS values.

The z-scores used by Sullivan are based on the NCHS standard deviations. The boys' z-scores for weight averaged 0.90 and for height, 2.6. The girls' z-score for weight was 0.9 and that for height was 2.0. This means, for example, that the boy's heights were 1 to 2.6 standard deviations from the NCHS mean scores.

Although the z-scores indicate that the children are shorter than the average American child of the same age, the boys' BMI z-scores were 0.5 above NCHS values and the girls' z-scores measured 0.0.

A 1996 research study by behavioral biologist Catherine Panter-Brick cited by Sullivan looked at growth and biochemical markers for physical and psychosocial well-being among street children of Kathmandu. It contrasted these with those of urban middle-class and rural-village children living in intact families.

Sullivan's findings, like Panter-Brick's, confirm that the lives of homeless urban children are complex yet less desperate in some ways than previously thought. He said the research suggests, as Panter-Brick wrote, that "homelessness may be an appropriate response to circumstances of poverty."

A.G. Steegman, Ph.D., UB professor of anthropology at UB, concurred.

"The business of being a street urchin, of making a living on the street, seems to work better for these children than we might anticipate," Steegman said. "Their health as measured by their BMIs doesn't prove that they live a fine life -- it is fraught with great danger, including murder and sexual exploitation, especially for the girls -- but it does confound our expectations," he says.

Whatever the long-term psychosocial costs of urban homelessness, Steegman said street boys like those in Sullivan's study, appear to trade them off against short-term survival benefits.

"These kids are resilient and self-reliant and adapt physically to the difficult conditions of homelessness," Steegman says. "Although middle-class urban kids certainly fare better, homeless urban children seem to be doing better health-wise than they would if they lived in intact families in poor agricultural communities."

Looking for experts to quote in a story? Search the experts database on the UB News Services Web site at http://www.buffalo.edu/news and click on "UB Experts."