Taller - Healthier - more equal? The biological standard of living in Switzerland in the second half of the 20th century

Body height among adult male and female Swiss Health Survey participants in 2017: Trends by birth years and associations with self-reported health status and life satisfaction

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Increase in average body height had slowed down from around the 1970s birth cohorts.

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Women and men with tertiary education levels were taller than participants holding other education levels.

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Taller participants were less overweighted and were more satisfied with their lives than shorter participants.

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Taller participants had better overall health than shorter participants.

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Taller men were more likely to have lower back pain than shorter men.

The increase in adult height for 150 years is linked to overall improvements in nutrition, hygiene, and living standards. Height is positively associated with general health and success on various levels (e.g. quality of life, earnings or happiness). The aim of this study was to investigate whether different subgroups show different trends across birth cohorts. We wanted to know whether taller individuals considered themselves as healthier and their quality of life as better than shorter individuals.

We included 19,435 participants from the Swiss population-based Health Survey 2017. GAM were used to assess nonlinear associations between height and birth year. Multinomial logistic regression was used to predict probabilities of self-rated health in relation to height.

The increase in average height slows down from the 1970s birth cohorts. Participants with parents from Central/Northern/Western Europe (men 177.9 cm, women: 165.1 cm) or Eastern Europe (men 178.7 cm, women: 165.7 cm) were taller than participants with parents from South America (men 174.3 cm, women: 161. cm) and Asia (men 173.2 cm, women: 160.1 cm). Participants with tertiary education were taller than participants from education levels (mean difference men: 4.5 cm, women: 5.0 cm). Height was positively associated with self-declared aspects of health and life satisfaction.

These results support the conclusion that body height as a co-factor of health aspects should be considered in public health research. Although adult body height can no longer be influenced, nutritional status and thus also healthy growth can be influenced in childhood by public health programs, by eliminating social inequalities, and by strengthen healthy living conditions.

Body height in adult women and men in a cross-sectional population-based survey in Geneva: temporal trends, association with general health status and height loss after age 50

OBJECTIVE

On the one hand, trends in average height in adulthood mirror changes in living standard and health status of a population and its subgroups; on the other hand, height in general, as well as the loss of height in older age in particular, are associated in different ways with outcomes for health. For these aspects, there is hardly any information for Switzerland based on representative and measured body height data.

DESIGN

Repeated cross-sectional survey study.

SETTING

Fully anonymised data from the representative population-based Geneva Bus Santé Study between 2005 and 2017 were analysed.

METHODS

Data from N=8686 study participants were used in the trend analysis. Height was measured and sociodemographic information and self-rated health was collected via questionnaires. Follow-up (mean: 7.1 years) measurements from N=2112 participants were available to assess height loss after age 50.

RESULTS

Women were, on average, 166.2 cm (SD 6.5) tall and men 179.2 cm (SD 6.5). Among men and women, higher socioeconomic status was associated with taller average height. The flattening of the increase in height from the 1970s birth years appears to begin earlier in the subgroup with the highest education level. The tallest average height was measured for men and women from Central and Northern Europe, the shortest for South America and Asia. The likelihood that participants rated their health as 'very good' increased with greater body height. The follow-up data show that men lost -0.11 cm per follow-up year (95% CI -0.12 to -0.10), women -0.17 cm (95% CI -0.18 to 0.15).

CONCLUSIONS

The association of height and health status is currently understudied. Monitoring changes in average body height may indicate disparities in different subgroups of populations. Based on our study and a growing literature, we think that the multifaceted role of body height should be better considered in clinical practice.

Growing taller unequally? Adult height and socioeconomic status in Spain (Cohorts 1940–1994)

Socioeconomic inequalities and their evolution in different historical contexts have been widely studied. However, some of their dimensions remain relatively unexplored, such as the role played by socioeconomic status in the trajectory of biological living standards, especially net nutritional status. The main objective of this article is to analyze whether the power of socioeconomic status (SES) to explain differences in the biological dimensions of human well-being (in this case, adult height, a reliable metric for health and nutritional status) has increased or diminished over time. Educational attainment and occupational category have been used as two different proxies for the SES of Spanish men and women born between 1940 and 1994, thus covering a historical period in Spain characterized by remarkable socioeconomic development and a marked increase in mean adult height. Our data is drawn from nine waves of the Spanish National Health Survey and the Spanish sample of two waves of the European Health Interview Survey (ENSE) for the period 1987 to 2017 (N = 73,699 citizens aged 23–47). A multivariate regression analysis has been conducted, showing that, as a whole, height differentials by educational attainment have diminished over time, whereas differences by occupational category of household heads have largely persisted. These results indicate the need for further qualification when describing the process of convergence in biological well-being indicators across social groups. For instance, the progressive enrollment of a greater proportion of the population into higher educational levels may lead us to underestimate the real differences between socioeconomic groups, while other proxies of SES still point to the persistence of such differences.

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Different SES impact on nutritional status according to SES operationalization.

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Significant reduction in height differentials by educational attainment over time.

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Height differentials largely persist by social class over time.

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Evidence is provided on recent halt of upward intergenerational growth in Spain.

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Mean cohort height stagnation not due to increases in social groups' differentials.

Have Swiss adult males and females stopped growing taller? Evidence from the population-based nutrition survey menuCH, 2014/2015

Data from the National Nutrition Survey for adults (menuCH) allow for the assessment of recent trends in measured height by year of birth for adult men and women from a population-based sample. The aim of the present study was to test if - similarly to conscripts and schoolchildren - the Swiss adult population stopped growing taller in recent birth cohorts, and if so, when the change occurred. We found that - when self-reported - height was overestimated on average by about 1 cm in both men and women, with an increasing tendency with older age and with shorter height. Average measured height increased by 4.5-5.0 cm for adult men and women between the birth years 1937-1949 and 1990-1995. However, this increase was not linear, and starting with the 1970s birth years, average height plateaued on a level of about 178 cm for men and 166 cm for women. Being born outside of Switzerland or adjustment for potential shrinkage with increasing age did not change this temporal pattern. We also found shorter average height among participants from the Italian part of Switzerland and those with lower educational level. It remains unclear if the phenomenon of stabilisation affects all subgroups of the Swiss population. Future studies should combine a larger number of population-based surveys to enhance the sample size, for example, for people with a migration background or with different educational levels. Continuing growth monitoring needs to be performed to assess if environmental and demographic changes with an impact on body growth (adverse trends in nutrition, increasing social inequality in health, ethnic composition of the population) positively or negatively influence future trends in average height.

Social reorganization and biological change: An examination of stature variation among Iron Age Samnites from Abruzzo, central Italy

Stature is a sensitive indicator of overall environmental quality experienced during growth and development, and can provide insights on a population's 'well-being'. This study investigated changes in estimated adult stature in a large (N=568) sample of Samnite Iron Age (800-27 BCE) people from central Italy, during a period of increasing sociopolitical complexity. Stature was analyzed diachronically, between sexes, and across social strata inferred using the 'Status Index' based on funerary treatment. It was expected: 1) a decrease in stature from the Orientalizing-Archaic period (O-A) to the fifth century BC (V SEC) and the following Hellenistic period (ELL), due to population increase and urbanization; 2) social status to positively influence the attainment of the full stature potential; 3) sexual dimorphism to be higher in more stratified groups. Results revealed no significant diachronic changes in stature (females: O-A: 154.2cm,V SEC: 154.2cm, and ELL: 153.6cm; males: O-A: 165.0cm,V SEC: 165.2cm, and ELL: 165.0cm) or sexual dimorphism. High-status males were taller than low-status (p=0.021), possibly due to a better diet, but only in the Orientalizing-Archaic period. Nonsignificant changes in females suggest either differential access to resources in women, or a better buffering from environmental optima or crises. The results of this study highlight the complex interrelation between social factors and human growth, and stress the importance of understanding the specific mechanisms leading to variation in adult stature.

A tall order: Small area mapping and modelling of adult height among Swiss male conscripts

Adult height reflects an individual's socio-economic background and offers insights into the well-being of populations. Height is linked to various health outcomes such as morbidity and mortality and has consequences on the societal level. The aim of this study was to describe small-area variation of height and associated factors among young men in Switzerland. Data from 175,916 conscripts (aged between 18.50 and 20.50 years) was collected between 2005 and 2011, which represented approximately 90% of the corresponding birth cohorts. These were analysed using Gaussian hierarchical models in a Bayesian framework to investigate the spatial pattern of mean height across postcodes. The models varied both in random effects and degree of adjustment (professional status, area-based socioeconomic position, and language region). We found a strong spatial structure for mean height across postcodes. The range of height differences between mean postcode level estimates was 3.40cm according to the best fitting model, with the shorter conscripts coming from the Italian and French speaking parts of Switzerland. There were positive socioeconomic gradients in height at both individual and area-based levels. Spatial patterns for height persisted after adjustment for individual factors, but not when language region was included. Socio-economic position and cultural/natural boundaries such as language borders and mountain passes are shaping patterns of height for Swiss conscripts. Small area mapping of height contributes to the understanding of its cofactors.

Biological aging and physical fitness in men aged 20-70 years from Kraków, Poland

OBJECTIVES

The increasing problem of population aging requires appropriate economic and health-related measures to mitigate its negative effects. The aim was to categorize the biological age of men between 20 and 70 years of age and assess its relationship to their physical activity and fitness.

METHODS

Data included morphological variables, total body water, the results of five Eurofit motor tests and the percentage of maximum heart rate (HR%), during a cardiovascular test of more than 1,400 20-70 year-old men living in Kraków. Biological age was estimated with regression equations.

RESULTS

There were significant and consistent differences in physical fitness profiles between the three established groups of relations between biological and chronological age (biologically younger, equal, and older). These three categories of biological age were generally consistent with the regression analysis of physical fitness results, although declared physical activity seemed to be an independent factor.

CONCLUSIONS

The selected morphological variables represent a set of characteristics useful for the determination of the biological age. The existing relationship between physical activity and biological age indicates that physical activity may contribute to the inhibition of involutional changes, even if it had only been performed regularly in the past. Am. J. Hum. Biol. 28:503-509, 2016. © 2015 Wiley Periodicals, Inc.

Evolução intergeracional da estatura no Estado de Pernambuco, Brasil, entre 1945 e 2006: 2 - aspectos analíticos

Utilizando-se modelos de regressão multinível, foram identificados fatores relacionados à evolução estatural de pessoas residentes em Pernambuco, Brasil, em 2006 e nascidas a partir de 1945. Os dados provêm de dois inquéritos estaduais de base populacional. No modelo final de cada grupo etário, ano de nascimento, sexo, escolaridade, renda e residência em área urbana ficaram positivamente associadas ao crescimento estatural dos adultos, bem como de crianças e adolescentes de 5 a 19 anos. Nos menores de cinco anos, além dessas variáveis, também ficaram positivamente associados o peso ao nascer e a realização de pré-natal, enquanto a ocorrência de diarreia nas últimas duas semanas anteriores à entrevista mostrou associação negativa. Os resultados do estudo mostram que o crescimento estatural foi mais favorecido em ambientes nos quais predominaram melhores condições socioeconômicas e ambientais.

Social inequality and the biological standard of living: an anthropometric analysis of Swiss conscription data, 1875-1950

We analyze the first representative series of individual measurements of the height of Swiss conscripts for the years 1875-1950. We find that average height followed a general upward time trend, but the economic downturn in the 1880s slowed down the increase in rural average-heights while the economic crisis subsequent to World War I had only a minor effect. Moreover, social-class affiliation was the most important determinant of differences in the biological standard of living, with class and regional disparities remaining constant, for the most part, during the observation period. Lower-class individuals' ability to overcome economic stress was limited, with the result that their biological standard of living, as reflected in the cyclicality of deviations from average height, was likely to be affected by cycles in economic activity.

Height of nations: a socioeconomic analysis of cohort differences and patterns among women in 54 low- to middle-income countries

Background

Adult height is a useful biological measure of long term population health and well being. We examined the cohort differences and socioeconomic patterning in adult height in low- to middle-income countries.

Methods/Findings

We analyzed cross-sectional, representative samples of 364538 women aged 25-49 years drawn from 54 Demographic and Health Surveys (DHS) conducted between 1994 and 2008. Linear multilevel regression models included year of birth, household wealth, education, and area of residence, and accounted for clustering by primary sampling units and countries. Attained height was measured using an adjustable measuring board. A yearly change in birth cohorts starting with those born in 1945 was associated with a 0.0138 cm (95% CI 0.0107, 0.0169) increase in height. Increases in heights in more recent birth year cohorts were largely concentrated in women from the richer wealth quintiles. 35 of the 54 countries experienced a decline (14) or stagnation (21) in height. The decline in heights was largely concentrated among the poorest wealth quintiles. There was a strong positive association between height and household wealth; those in two richest quintiles of household wealth were 1.988 cm (95% CI 1.886, 2.090) and 1.018 cm (95% CI 0.916, 1.120) taller, compared to those in the poorest wealth quintile. The strength of the association between wealth and height was positive (0.05 to 1.16) in 96% (52/54) countries.

Conclusions

Socioeconomic inequalities in height remain persistent. Height has stagnated or declined over the last decades in low- to middle-income countries, particularly in Africa, suggesting worsening nutritional and environmental circumstances during childhood.

Intra- and intergenerational social mobility in relation to height, weight and body mass index in a British national cohort

Using a sample of 2090 father and son pairs, the extent of intra- and inter-generational social mobility (migration between social classes) was examined over a 42-year period in a British cohort in relation to height, weight and body mass index (BMI). The mean height difference between the highest and lowest social class decreased from about 4 cm in the fathers' generation to about 3 cm in the sons' generation, indicating a decline in heterogeneity in height between classes. For fathers downward intra-generational social mobility ranged between 11% and 18% while between 16% and 26% were upwardly mobile; for sons 15% were downwardly mobile and 21% upwardly mobile. On average downwardly mobile fathers were shorter by between 0.1 cm and 0.7 cm while upwardly mobile fathers were taller by, on average, 0.6 cm to 1.7 cm. For sons, the downwardly mobile were on average 0.7 cm shorter and the upwardly mobile 0.8 cm taller. For weight and BMI there were no consistent relationships with intra-generational mobility in either the fathers' or sons' generations. Inter-generationally, between 18% and 19% of sons were downwardly mobile and between 39% and 40% were upwardly mobile; the downwardly mobile were shorter by about 0.9 cm and the upwardly taller by between 0.6 cm and 1.2 cm. Sons with higher BMI were more likely to be inter-generationally downwardly mobile.

Patterns and trends of adult height in India in 2005-2006

Differences in height by wealth, education, caste, geography, and birth years are examined for men and women born between 1961 and 1981 in India using data from the 2005-2006 Indian National Family Health Survey. There is a positive association between socioeconomic position (SEP) and height with lower SEP individuals being shorter. Height varies across the 29 Indian states even after accounting for individual differences in SEP, with substantial variation in height remaining at the neighborhood and state levels. Among men, height appears to have modestly increased for all birth cohorts as compared to the 1961-1965 cohort, with smaller increases for the most recent cohorts. For women, height across birth cohorts has shown little increase. These results suggest that inequalities in several health outcomes for low SEP adults may be reflected in inequalities in height, which can be used to represent long-term health at the population level. Shorter stature and slower growth among some groups may indicate that they did not experience the improvements that were assumed to have occurred across the population. This study presents a comprehensive, empirical description of mean height differences and the underlying variation among adults in India across diverse socioeconomic, demographic, and geographically oriented groups as well as birth cohorts.