Socioeconomic factors associated with severe acute malnutrition in Jamaica

• Published in: PloS one 2017-03, Vol.12 (3), p.e0173101-e0173101
• Main Authors: Thompson, Debbie S, Younger-Coleman, Novie, Lyew-Ayee, Parris, Greene, Lisa-Gaye, Boyne, Michael S, Forrester, Terrence E
• Format: Article
• Language: English
• Subjects: Acute Disease; Age; Arsenic; Biology and Life Sciences; Birth weight; Breastfeeding & lactation; Cadmium; Child poverty; Child, Preschool; Children; Correlation; Crime; Criminality; Domestic violence; Drinking water; Economic factors; Edema; Education; Educational attainment; Geochemistry; Geographic information systems; Health aspects; Heavy metals; Humans; Indexes; Infant; Infant, Newborn; Infants; Jamaica; Lead; Lead content; Low income groups; Malnutrition; Malnutrition - etiology; Medicine and Health Sciences; Metals, Heavy - analysis; Murders & murder attempts; Nutrition; People and places; Physical Sciences; Poverty; Pregnancy; Remote sensing; Risk Factors; Rural areas; Rural communities; Satellite navigation systems; Social aspects; Social class; Social factors; Social Sciences; Socioeconomic Factors; Socioeconomics; Soil Pollutants - analysis; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0173101

Severe acute malnutrition (SAM) is an important risk factor for illness and death globally, contributing to more than half of deaths in children worldwide. We hypothesized that SAM is positively correlated to poverty, low educational attainment, major crime and higher mean soil concentrations of lead, cadmium and arsenic. We reviewed admission records of infants admitted with a diagnosis of SAM over 14 years (2000-2013) in Jamaica. Poverty index, educational attainment, major crime and environmental heavy metal exposure were represented in a Geographic Information System (GIS). Cases of SAM were grouped by community and the number of cases per community/year correlated to socioeconomic variables and geochemistry data for the relevant year. 375 cases of SAM were mapped across 204 urban and rural communities in Jamaica. The mean age at admission was 9 months (range 1-45 months) and 57% were male. SAM had a positive correlation with major crime (r = 0.53; P < 0.001), but not with educational attainment or the poverty index. For every one unit increase in the number of crimes reported, the rate of occurrence of SAM cases increased by 1.01% [Incidence rate ratio (IRR) = 1.01 (95% CI = 1.006-1.014); P P