Abstract:

     This paper describes the use of child growth assessment as a measure of community health, and, under certain circumstances, as a means of judging the effects of toxic materials on community health. While the application of child growth to judge effects from exposure to toxic materials is fairly new (Schell, 1986), the general approach originates with Edwin Chadwick, the English sanitation reformer (Tanner, 1979). In 1833, Chadwick advocated measuring child stature to see whether it was affected by factory work. From his call came the discovery that poverty, and the exploitation of children for industrial labor that it commonly included, was closely associated with poor physical child growth. In fact, Chadwick believed that size, rather than age documentation was the best criterion to judge a young person's ability to work, since age documentation was frequently forged by unscrupulous guardians and parents (Tanner, 1979). Though growth assessment was appropriate to that task, the use of growth data to search out suboptimal health was superseded in epidemiology, first by mortality rates, and then by morbidity rates.