South Korean women are neither especially diminutive nor remarkably lofty. With a mean height of 162.3cm, they are 12.5cm taller than their Filipina peers, and 7.5cm shorter than Latvian women. But they stand out from the crowd for one reason: they are a full 20cm taller than their ancestors a century ago. That collective growth spurt tells us something important: that height differences often ascribed to genetics owe a huge amount to nutrition, hygiene and healthcare. South Korea’s rapid development meant women’s growth was no longer hindered as it had been. In contrast, under-nourished Filipinas are still associated with “shortness”. Even within a community, cultural factors – such as an eldest son preference in South Asia – can lead to marked differences in height outcomes.
This is not a question of mere vanity. What really matters is not how tall one can grow, but whether one fails to grow as expected. More than 160 million of the world’s under-fives are stunted. In India 39% of children are stunted and in the Democratic Republic of the Congo 70%. Though stunting is a physical measure, and is associated with the increased risk of some chronic diseases such as diabetes in future, it is also an important indicator that mental development may have been affected. Their brains are unable to make the neural connections that they should; their cognitive ability does not blossom. Malnourished children also have little energy, further diminishing their ability to learn and escape poverty. Research suggests they are less likely to be enrolled in school, and learn less when they are there.
It is obvious why this bothers the World Health Organisation. But now the World Bank’s president is threatening to name and shame countries which fail to address the problem. Jim Yong Kim, a former doctor, says that stunting is not only the outcome of the unfair distribution of resources: it drives such imbalances, too, since inequality is “baked into the brains” of a quarter of children before they reach the age of five. The problem is not only humanitarian, but economic. And it is in the interest of governments to act – even if they are looking at the narrowest possible measures of national success – because they cannot compete if large portions of their workforces are stunted. Dr Kim’s ambitious goal is to halve stunting in seven years and end it in 14. A World Bank-sponsored programme in Peru, targeting families from pregnancy onwards, slashed stunting rates by giving conditional cash transfers to mothers, allowing them – and educating them – to give their children nutritious food and stimulate them through play. Health clinics were given incentives to support them. Swift action can bring immense benefits to a generation. Bodies and brains develop fastest in the womb and in the first two years after birth; it is hard for those who fall behind to catch up later. When we talk of children growing to their full potential, we speak more literally than we realise.