title: Current socio-economic measures, and not those measured during infancy, affect bone mass in poor urban South african children.
abstract: Understanding the impact of socio-economic status (SES) on physical development in children is important, especially in developing countries where considerable inequalities persist. This is the first study to examine the association between SES on bone development at the whole body, femoral neck, and lumbar spine in black children living in Soweto and Johannesburg, South Africa. Linear regression models were used to study associations between SES during infancy and current SES, anthropometric, and DXA-derived bone mass in 9/10-yr-old children (n = 309). Findings suggest that current SES measures, rather than SES during infancy, are stronger predictors of current whole body bone area (BA) and whole body BMC after adjusting for body size, pubertal development, physical activity, habitual dietary calcium intake, and body composition. SES had no significant effect on either hip or spine bone mass. Caregiver's marital/cohabiting status (indicator of social support) and whether there was a television in the home (indicator of greater income) at age 9/10 yr were the most important socio-economic determinants of whole body BA and BMC. SES has a significant independent effect on whole body BMC through its impact on BA. This suggests that poverty alleviation policies in South Africa could have a positive effect on bone health.
authors.affiliation: Department of Paediatrics, MRC Mineral Metabolism Research Unit, University of the Witwatersrand, Johannesburg, South Africa. san@global.co.za
authors.forename: Shane A
authors.initials: SA
authors.lastname: Norris
authors.forename: Zoë A
authors.initials: ZA
authors.lastname: Sheppard
authors.forename: Paula L
authors.initials: PL
authors.lastname: Griffiths
authors.forename: Noël
authors.initials: N
authors.lastname: Cameron
authors.forename: John M
authors.initials: JM
authors.lastname: Pettifor
mesh_terms: D001842:Bone and Bones / Q000033:anatomy & histology*; D002648:Child; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009929:Organ Size; D011203:Poverty; D012044:Regression Analysis; D012959:Socioeconomic Factors; D013019:South Africa; D013997:Time Factors; D014505:Urban Population