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Stature and Stature Distribution in Portuguese Male Adults 1904-1998

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Stature and Stature Distribution in Portuguese Male Adults 1904-1998 AMERICAN JOURNAL OFHUMAN BIOLOGY 14:39±49 (2002) Stature and Stature Distribution in Portuguese Male Adults 1904À1998: The Role of Environmental Factors CRISTINA PADEZ* Departamento de Antropologia, Universidade de Coimbra, 3000-056 Coimbra, Portugal ABSTRACT The records of height of 841,457 18-year-old Portuguese males were analyzed by area of residence (districts). The sample included all Portuguese 18-year-old males born between 1966 and 1979 and examined between 1985 and 1998, in the north, center, and south of Portugal. They represent all social strata. There were statistically significant differences (P £ 0.001) among districts: males from Lisbon (172.8 cm) and Setu bal (172.7 cm), the most developed districts, were tallest, and those from Madeira (169.7 cm) and Coimbra (171.6 cm) were shortest. Compared with published data for 1904, there was a positive secular trend in height. The average increase was 8.93 cm and the estimated rate was 0.99 cm per decade. The changes that occurred were mainly the result of the reduction of the shortest classes of stature, those <150 cm to 170 cm, and an increase in the frequency of the highest classes, ³170 cm. This positive trend and the changes in stature distribution must be related to the general improvement in standard living conditions that occurred in Portugal primarily after the 1960s and 1970s, especially in terms of nutrition and the health system. Taking into account the socioeco- nomic differences that still exist between districts, the results suggest that the secular trend in height should continue for the Portuguese population in future decades. Am. J. Hum. Biol. 14:39À49, 2002. Ó 2002 Wiley-Liss, Inc. Since the end of the 19th century, a pos- influences during childhood underlie adult itive secular trend towards a taller adult differences between population subgroups stature has been observed in almost every (Nystrom Peck and Lundber, 1995). country in Europe, North America, and Ja- Adult height reached a plateau during the pan. Human adult height represents the mid-1980s in some developed European end product of a continuous and often non- countries, which suggests that they are additive interaction between genetic and perhaps near their genetic potentialor that environmentalforces (Tanner, 1992). The socialconditions have ceased to improve. In most important environmentalfactors to the European countries the secular trend is influence secular trends are nutrition and more marked among the lower social classes health (Malina, 1979). Indirect factors af- (Susanne and Heyne, 1972; Low et al., 1981, fecting nutrition (both qualitatively and 1982; Laska-Mierzejewska, et al., 1982; quantitatively) and health are alterations Chinn et al., 1989; Vercauteren and Slach- in socioeconomic living conditions, social muylder, 1993). In some lesser-developed and health care (preventive and curative), European nations, an increase is still oc- minimum income, quality of food prepara- curring (Bielicki et al., 1992; Hauspie et al., tion, better sanitary conditions, mass vac- 1996; Schmidt et al., 1995). cination, and level of education (Tanner, Despite the large amount of work con- 1992; BodzsaÂr and Susanne, 1998; Hauspie cerning the secular trend, investigation of et al., 1996; van Wieringen, 1986). Growth stature has largely been limited to the study of a population can, therefore, be used as a of changes in means through time, whereas "mirror of conditions in society" (Tanner, changes in stature distributions have been 1986). In recent years, economic historians, regarded as less impressive. Few works on led by Fogel et al. (1982), have used data on secular trend can analyze stature distribu- the heights of various populations over the tion like those published by Hermanussen last 150 years to trace their economic for- tunes and even to predict trends in mor- tality and morbidity. Adult height is a predictor of mortality from coronary heart *Correspondence to: C. Padez, Departamento de Antropologia, disease and, to a lesser extent, other dis- Universidade de Coimbra, 3000À056 Coimbra, Portugal. E-mail: [email protected] eases (Barker et al., 1990; Waaler, 1984). Received 14 March; Revision received 24 July 2001; Accepted Some research suggest that environmental 25 July 2001 ã 2002 Wiley-Liss, Inc. DOI 10.1002/ajhb.10017 40 C. PADEZ et al. (1995) on West German, Italian, and the economic sector and not the industrial Dutch conscripts, two studies on the Span- sector. An indirect consequence of these ish population (Carrion, 1986; HernaÂndez major changes in socialand economic and GarcÂõa-Moro, 1986), two on the French structures was a global improvement of population (Chamla, 1983; Pineau, 1993), living conditions during the past 40 years. and the work of van Wieringen (1986) in The Netherlands. The aim of the present study is to exam- MATERIALS AND METHODS ine how socialand economic changes in Sample Portugalduring the 20th century relateto changes in adult height and height distri- Data were obtained from the records of bution between 1904 and 1998 in a sample medicalexamination at District Recruiting of 18-year-old male Portuguese. Regional Centers of Portugal(North, Center, and differences from 1904 to 1998 are also ana- South). Military service is compulsory in lyzed. Portugal. The entire cohort of males born in a given year is examined by military phy- sicians during a registration visit lasting 3 days. Height was measured to the nearest SOCIAL CHANGES IN PORTUGAL centimeter during the medicalexamination. Contrary to many other European coun- The sample thus represents all regions of tries, which experienced important social the country and all social strata (Fig. 1). and economic changes after World War II, The sample included all Portuguese 18- the generalimprovement in the livingcon- year-old males born between 1966 and 1979 ditions of the Portuguese population oc- and examined between 1985 and 1998 curred later during the 1960s. At this time, (841,457 subjects). Data published by Lac- from the demographic point of view, Portu- erda (1904) for all districts of Portugal and galwas a very different country in Europe. data published by Sobral (1990) for the years 1930 to 1980 just for the South of It had the highest proportion of young peo-  ple (<15 years), the lowest proportion of old Portugal(Districts of Lisboa, Set u bal, Evora, people (>65 years), the lowest life expec- and Beja) were also considered. tancy at birth, the highest rate of natality, and the highest rate of infant mortality. Social data After 40 years, these values are very dif- Locality of each subject's residence by ferent. Portugalis now the country with the district (i.e., administrative region) was lowest population growth rate, and the also obtained. In Portugal there are 20 dis- proportions of young and old people are now tricts. Two of them (AcËores and Madeira) similar to other European countries. Life are islands located in the Atlantic Ocean expectancy at birth is still one of the lowest (Fig. 1). but close to the average European values, the birth rate is similar to the European mean, and infant mortality is also similar to Vital statistics other European countries (Barreto, 1996, Data concerning demography, health, 2000). economy, nutrition, and house conditions However, there are some specific factors between 1920 and 1990 were collected from in the socialand economic evolutionof the statisticalyearbooks publishedof the Na- Portuguese population. The first is the rate tionalInstitute of Statistics (INE). For same of external emigration to Europe, especially variables, e.g., house conditions, data are to France, and the rate of internalmigra- available only after 1960. The following tion from the countryside to cities, espe- demographic and health indicators were cially to Lisbon and Porto. In 1990, almost recorded: birth rate; age distribution; infant 40% of the Portuguese population live in the and post-neonatal mortality rates; life ex- Lisbon and Porto areas (Barreto, 1996, pectancy; adult literacy; number of physi- 2000). cians per 1,000 population; maternal The industrialsector alsoshowed an ac- mortality; and born at the maternity hos- celeration in the decade of the 1960s. But, pital( %). The following economic and contrary to all the other European coun- housing conditions were recorded: distribu- tries, the services were more important in tion of the population in the three economic STATURE/STATURE DISTRIBUTION IN MALE ADULT 41 mality of distributions of heights for each year. RESULTS Sociodemographic and health characteristics Table 1 summarizes the evolution of sev- eralsocio-demographic and healthindica- tors in Portugalduring the 20th century. Birth rates decreased sharply from 1920 (33.6) to 1990 (11.6). The age distribution showed a decrease in the percentage of young people (<15 years), from 32.6% in 1920 to 20% in 1990. At the same time, the percentage of old people increased from 5.9% in 1920 to 13.6% in 1990. Infant mor- tality and post-neonatal mortality rates both decreased, and life expectancy increase from 35.8 years in men and 40 years in women in 1920 to 70.3 and 77.5 years in 1990 for men and women, respectively. Adult literacy increased from 34.6% in 1920 to 89% in 1990. The health system of Portugal also showed major changes. The number of physicians per 1,000 population increased from 352 to 1256 between 1960 and 1990. Maternalmortalitydecreased, from 115.5 in 1960 to 10.3 in 1990, and the percentage of newborns that was delivered at a hospital Fig. 1. Districts of Portugal: 1, V. Castelo; 2, Braga; increased from 18.4% in 1960 to 95.5% in 3, V. Real; 4, BragancËa; 5, Porto; 6, Aveiro; 7, Viseu; 8, 1990. Guarda; 9, Coimbra; 10, C. Branco; 11, Leiria; 12, Lis- boa; 13, SantareÂm; 14, Portalegre; 15, E vora; 16, SetuÂ- In the economic sector, the agricultural bal; 17, Beja; 18, Faro; 19, AcËores; 20, Madeira.
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