Community well-being and growth status of indigenous school children in rural Oaxaca, southern Mexico

Objective To evaluate the relationship between community well-being based on an index of marginalization and growth status of indigenous rural school children in Oaxaca.Methods Heights and weights of a cross-sectional sample of 11,454 children, 6-14 years, from schools for indigenous rural children (escuelas albergue) in 158 municipios in Oaxaca were measured in 2007. Tertiles of an index of marginalization were used to classify the 158 municipios into three categories of community well-being: lowest (highest marginalization), low, and moderate (lowest marginalization). Multivariate analysis of covariance, controlling for age, relative isolation and population size, was used to compare body size of children by category of community well-being. Contributions of marginalization, isolation and population size to variation in body size were estimated with sex-specific linear regression.Results Children from municipios lowest in well-being were shorter and lighter than children from municipios low and moderate in well-being. Marginalization and relative isolation accounted for 23% (boys) and 21% (girls) of the variance in height and for 21% of the variance in weight of girls. Marginalization was the predictor of weight in boys (23%).Conclusion Community well-being was reflected in the growth status of rural indigenous school children. Compromised growth status was consistent with poor health and nutritional conditions that were and are characteristic of rural areas in the state of Oaxaca.