||Clinical undernutrition in the Kingston/St Andrew metropolitan area: 1967-1976|
||Soc Sci Med: Med Geography;15D(4):471-7, Nov. 1981.
||The spatial and temporal characteristics of undernutrition in the Kingston/St. Andrew Metropolitan Area, Jamaica are described, and the relationship between the incidence and certain social and economic indices are examined. For the latter purpose, a sample was drawn from urban constituencies solely, since some of the variables used have different implications in a rural setting. A total of 1521 cases of undernutrition were admitted to 2 hospitals from the Kingston/St. Andrew Metropolitan region. There was a slight majority of male (55 percent) over females. Over 91 percent of all patients diagnosed as undernourished fell within the age group 0-23 months. The average of admission was 12 months . No clear temporal pattern emerges from the current study of a 10-year pattern in Kingston/St. Andrew. The cumulated monthly total ranged from 111 in August to 138 in March, and the quarterly figures from 374 in the 2nd and 3rd quarters to 398 in the last quarter of the year. These totals, however, mask wide variations from year to year. The last quater of the year accounted for the highest percentage of admissions due to undernutrition, while the 2nd and 3rd provided the lowest. The variations are so slight as to be of little importance. There was a heavy concentration af cases in the west and southwest of the Kingston/St. Andrew Metropolitan area, where the 3 constituencies of St. Andrew west-central, St. Andrew south-west and St. Andrew south accounted for 47 percent of all admissions due to undernutrition. The numbers declined towards the north and especially the southeast. Overall, the incidence of undernutrition was fairly high in the late 1960s and rose to a peak in 1970. There was a marked decline in 1971, a rise to the highest level achieved in 1974, and thereafter a decline until 1976. Within the sample, the social and economic variables identified as important factors in the occurrence of undernutrition are 1st presented in the form of simple associations and then stepwide multiple regression analysis is undertaken to attempt an explanation for the spatial distribution of malnutrition. The following social and economic variables are identified as important factors: infant feeding practices; family stability; unemployment; family size; and mothers 20 years of age and younger. Correlation values revealed that the unemployment of mothers was the most important of the variables utilized. 57 percent of the mothers in the sample were unemployed. The level of undernutrition over the 10-year period bore a statistically significant relationship to the level of unemployment among mothers. Even when these mothers were employed their incomes were far too low to meet without additional support the high costs of artificial baby foods, which in 1970 were estimated to cost about 50 percent more than the food needed to lactation. It is suggested that a national scheme of child allowance payable directly to mothers would provide needed help to parents without being at odds with a government policy aimed at limiting family size (AU)|
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