Download - AGEC 640 – Agricultural Development and Policy Nutrition and Food Markets September 16 th , 2014
Slide 1
AGEC 640 – Agricultural Development and Policy
Nutrition and Food Markets
September 16th, 2014
Today:Nutrition, health and human capital
(Reading: Haddad et al., 2004) Next time:
“Demand and imperfect information”
Much of agricultural policy concerns food, nutrition and health…
You have all seen demand curves and elasticities…
Slide 2
Price of food
Quantity of food consumed
P1
P2
Q1 Q2 Consumers’ income
Quantity of food consumed
Q2
Q1
Y1 Y2
“demand curve” “Engel curve” (=income-consumption curve)
price elasticity of demand:%∆Q/ %∆P income
elasticity of demand:
%∆Q/ %∆Y
We will use these curves starting Thursday, but first…
How do peoples’ nutritional needs influence these curves -- and how closely is nutrition linked to basic survival?
Slide 3
Price of food
Quantity of food consumed
P1
P2
Q1 Q2 Consumers’ income
Quantity of food consumed
Q2
Q1
Y1 Y2
“demand curve” “Engel curve” (=income-consumption curve)
price elasticity of demand:%∆Q/ %∆P income
elasticity of demand:
%∆Q/ %∆Y
Slide 4
Source: Angus Deaton, “Health, Inequality, and Economic Development.” Journal of Economic Literature, XLI(1), March 2003: 113–158. Note: Circle size is proportional to population.
To start: how does health change with income?
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Life Expectancy at Birth, 1950-2000
35
40
45
50
55
60
65
70
75
1950-1955
1955-1960
1960-1965
1965-1970
1970-1975
1975-1980
1980-1985
1985-1990
1990-1995
1995-2000
Europe
Lat.Am.&Car.
World
India
Pakistan
Bangladesh
Africa
Source: Computed from UN Population Division, 2004 <http://esa.un.org/unpp>
How does health change over time?
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Health is closely related to weightThe “Waaler Curve”
Reprinted from: Fogel, R.W. “Economic Growth, Population Theory, and Physiology.” American Economic Review, Vol. 84, No. 3. (Jun., 1994), pp. 369-395.
Slide 7
Source: Fogel (1994), p. 376.
Europe’s gains in BMI and health began early
Slide 8
The closest nutrition-mortality link is for infants
Source: Fogel (1994), p. 382.
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A common metric: Z-scores
• Height-for-age (chronic stunting)• Weight-for-height (acute wasting)• Weight-for-age (body mass relative to age)
– Problematic because it depends on weight and height– Same score could signal tall + thin or short + normal
• Value compared to WHO international reference age-sex population for well-nourished children
• Typical cut-off is < - 2
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0.1
.2.3
.4.5
dens
ity
-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6height-for-age z-score (stunting)
Mountains Hills Terai
Source: DHS 2006
0.1
.2.3
.4.5
dens
ity
-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6weight-for-height z-score (wasting)
Mountains Hills Terai
Source: DHS 2006
Distribution of height-for-age (left panel) and weight-for-height (right panel) for children under 5 in Nepal in 2006, by agroecological zone (from left to right, means = -2.27, -2.02, -1.89, -1.11, -0.82, -0.73)
Source: Shively, Sununtnasuk and Brown (2012)
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Almost all shortfall in child growth occurs between 4 and 14 months of age
Source: Shrimpton, R. et al., 2001. “Worldwide Timing of Growth Faltering: Implications for Nutritional Interventions” Pediatrics 107:e75.
Mean weight-for-age z scores, relative to the NCHS reference
Latin America and the Caribbean
Asia
Africa
Slide 12
-4-3
-2-1
0ha
z in
200
6 D
HS
0 200 400 600 800ndvi for aug-sep-oct in year of birth
95% CI Mountains
Source: DHS and MODIS-NDVI
-4-3
-2-1
0ha
z in
200
6 D
HS
0 200 400 600 800ndvi for aug-sep-oct in year prior to birth
95% CI Mountains
Source: DHS and MODIS-NDVI
Plots of height-for-age for children under 5 in Nepal in 2006 against cluster average NDVI for district in Aug-Oct of birth year (left panel) and year prior to birth (right panel), Mountain zone only
Source: Shively, Sununtnasuk and Brown (2012)
Does Agriculture Matter? Yes, but…
Nepal: comparison of district-level nutrition and agriculture outcomes
HAZ < average HAZ > average
yield < average 22 21
yield > average 13 19
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Table entries show # of districts
HAZ from 2006 DHSyields from 2004 NLSS
Negative deviants
Positive deviants
Slide 14
Lack of food is still the world’s greatest health threat!
0 20 40 60 80 100 120 140
Underweight Unsafe sex
Blood pressure Water & sanitation
TobaccoIndoor smoke from fuels
Cholesterol Alcohol
Zinc deficiency Vitamin A deficiency
Iron deficiency Low fruit and vegetable intake
Overweight
Annual loss of disability-adjusted life-years
(millions of DALYs)
Worldwide disease burden from m ajor risk factors, 2000
Source: WHO (2002), World Health Report 2002, available online at www.who.int.
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Nutrient deficiencies are major health risksWorldwide disease burden attributable to major health risk factors, 2000
DALYs (M) % total
Disease burden attributable to undernutrition
Underweight 138 9.5%
Iron deficiency 35 2.4%
Zinc deficiency 28 1.9%
Inadequate fruit and vegetable intake 27 1.8%
Vitamin A deficiency 27 1.8%
254 17.5%
Disease burden attributable to risk-factor exposure
Unsafe sex 92 6.3%
Smoking and oral tobacco 59 4.1%
Alcohol 58 4.0%
209 14.4%
Disease burden attributable to cardiovascular condition
Blood pressure 64 4.4%
Cholesterol 40 2.8%
Body mass index 33 2.3%
Physical inactivity 19 1.3%
157 10.8%
Disease burden attributable to environmental conditions
Unsafe water, sanitation, and hygiene 54 3.7%
Indoor smoke from solid fuels 39 2.6% 93 6.4%
Source: WHO (2002), World Health Report 2002. Online at www.who.int/whr. Data shown are from web annexes at www.who.int/whr/2002/material/en.
Some
interaction
Slide 16
Risk factors vary with income
Contribution to global burden of disease by risk factor and region
Why?
Slide 17
The role of nutrition in disease is rarely clear
Attribution of disease burden to major risk factors in high-mortality developing countries
Risk factor % DALYs Disease or injury % DALYsUnderweight 14.9 HIV/AIDS 9.0Unsafe sex 10.2 Lower respiratory infections 8.2Unsafe water, sanitation and hygiene 5.5 Diarrhoeal diseases 6.3Indoor smoke from solid fuels 3.7 Childhood cluster diseases 5.5Zinc deficiency 3.2 Low birth weight 5.0Iron deficiency 3.1 Malaria 4.9Vitamin A deficiency 3.0 Unipolar depressive disorders 3.1Blood pressure 2.5 Ischaemic heart disease 3.0Tobacco 2.0 Tuberculosis 2.9Cholesterol 1.9 Road traffic injury 2.0Subtotal for under-nutrition 24.3
Notes: Arrows are roughly proportional to attribution rates. Risk factors and diseases associated with under-nutrition are in italics. The selected risk factors cause diseases in addition to those relationships illustrated, and additional risk factors are also important in the aetiology of the diseases illustrated.
Data shown are totals for 69 countries defined by the WHO as having both high child mortality and high adult mortality. Source: WHO (2002), World Health Report 2002, Annex Table 14 (p. 232). Available online at www.who.int/whr.
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Undernutrition is falling, except in Africa
Data and projections on childhood underweight, 1995-2015
30
25
20
15
10
5
0
1995 2000 2005 2010 2015 MDG
Africa Asia Lat. Am. &Caribbean
DevelopingCountries
World
Trends, projections and MDGs for prevalence of underweight children under 5, 1995-2015
Perc
en
t o
f c
hild
ren
Source: UN Standing Committee on Nutrition (2004), Fifth Report on the World Nutrition Situation. New York: UN SCN.
Note: Data show estimated percentage of children aged 0-5 who areunderweight, defined as <2 s.d. below median NCHS weight for age.
…but between Africa and South Asia, there is a very important puzzle:
(Based on surveys of child bodyweights) (Based on estimated food availability)
Source: UN Millennium Development Goals Report, July 2009. Online at http://mdgs.un.org.
Why does South Asia have more
underweight children
than Africa,
despite higher
estimated food
availability?not disease,
but low birth weight due to
maternal malnutrition
Some conclusions
• Nutrition is clearly a major driver of health and human capital…
• But the link between food availability and nutritional status is complicated, and depends on– inequality in access and entitlements– disease pressure and public health– market failures and policy failures
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