Abstract
Environmental conditions in early life are known to have impacts on later health outcomes, but causal mechanisms and potential remedies have been difficult to discern. This paper uses the Nepal Demographic and Health Surveys of 2006 and 2011, combined with earlier NASA satellite observations of variation in the Normalized Difference Vegetation Index (NDVI) at each child’s location and time of birth to identify the trimesters of gestation and periods of infancy when climate variation is linked to attained height later in life. We find significant differences by sex: males are most affected by conditions in their second trimester of gestation, and females in the first three months after birth. Each 100-point difference in NDVI at those times is associated with a difference in height-for-age z-score (HAZ) measured at age 12–59 months of 0.088 for boys and 0.054 for girls, an effect size similar to that of moving within the distribution of household wealth by close to one quintile for boys and one decile for girls. The entire seasonal change in NDVI from peak to trough is approximately 200–300 points during the 2000–2011 study period, implying a seasonal effect on HAZ similar to one to three quintiles of household wealth. This effect is observed only in households without toilets; in households with toilets, there is no seasonal fluctuation, implying protection against climatic conditions that facilitate disease transmission. We also use data from the Nepal Living Standards Surveys on district-level agricultural production and marketing, and find a climate effect on child growth only in districts where households’ food consumption derives primarily from their own production. Robustness tests find no evidence of selection effects, and placebo regression results reveal no significant artefactual correlations. The timing and sex-specificity of climatic effects are consistent with previous studies, while the protective effects of household sanitation and food markets are novel indications of mechanisms by which households can gain resilience against adverse climatic conditions.
Highlights
AND MOTIVATIONAttained height is among the most important indicators of childhood deprivation
The Nepal Demographic Health Survey (NDHS) enumerators measured the length or height of all children under five years of age, here we focus on heights attained between the child’s first and fifth birthdays, as a function of agroclimatic conditions experienced in utero and the child’s first year after birth
All data are from the NDHS 2006 and 2011 except for district-level data on food market participation and distance to market centers, which are obtained from the two waves of the Nepal Living Standard Survey (NLSS)
Summary
AND MOTIVATIONAttained height is among the most important indicators of childhood deprivation. Stunting rates have been especially high in Nepal where extreme poverty and political instability led to rates as high as 57 percent in 2001, before declining to 41 percent in 2011 (UNICEF, 2013) Despite this improvement Nepal remains one of the 10 countries in the world with the highest stunting prevalence (UNICEF, 2014), making it a high-priority location for research into increasingly effective ways of protecting children from harmful early-life circumstances. Socioeconomic factors associated with stunting in Nepal are described by Headey and Hoddinott (2015), who show how changes in household and community-level characteristics help explain local variation and the overall improvement from 2001 to 2011 Key changes involve both greater sanitation and access to improved diets, which are pillars of the Nepal government’s multi-sector nutrition plan (Government of Nepal, 2012). Consistent with global trends of increasing temperature and erratic rainfall patterns (NASA, 2015), temperatures in Nepal increased by 1.5°C over the period from 1978 to 2005 (Krishnamurthy et al, 2013), while rainfall has declined in frequency and increased in intensity (Malla, 2008)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
