@article{17126,
  author = {Lear Scott and Teo K. and Subramanian S. and Rahman O. and Corsi D. and Chow Clara},
  title = {Shared environments: a multilevel analysis of community context and child nutritional status in Bangladesh},
  abstract = {<p>
ObjectiveThe goal of the present study was to examine the influence of community environment on the nutritional status (weight-for-age and height-for-age) of children (aged 049 years) and their children (n 5731), residing in 361 communities. Child nutritional outcomes are physical measurements of weight-for-age and height-for-age in sd units. We considered the following attributes of community environments potentially related to child nutrition: (i) community water and sanitation infrastructure; (ii) availability of community health and education services; (iii) community employment and social participation; and (iv) education level of the community.ResultsMultilevel regression analysis showed that the spatial distribution of maternal and child covariates did not entirely explain the between-community variation in child nutritional status. The education level of the community emerged as the strongest community-level predictor of child height-for-age (highest v. lowest tertile, 18 (se 0 = 006)). In the height-for-age model, community employment and social participation also emerged as being statistically significant (highest v. lowest tertile, 13 (se = 0·06)).ConclusionsThe community environment influences child nutrition in Bangladesh, and maternal- and child-level covariates may fail to capture the entire influence of communities. Interventions to reduce child undernutrition in developing countries should take into consideration the wider community context.
</p>
},
  year = {2011},
  journal = {Public Health Nutrition},
  volume = {14},
  number = {06},
  pages = {951-959},
  isbn = {1368-9800},
  language = {eng},
}