Childhood Mortality & Nutritional Status as Indicators of Standard of Living: Evidence from World War I Recruits in the United States

This paper examines variations in stature and the Body Mass Index (BMI) across space for the United States in 1917/18, using published data on the measurement of approximately 890,000 recruits for the American Army for World War I. It also connects those anthropometric measurements with an index of childhood mortality estimated from the censuses of 1900 and 1910. This index is taken to be an indicator of early childhood environment for these recruits. Aggregated data were published for states and groups of counties by the Surgeon General after the war. These data are related to regional data taken primarily from the censuses of 1900 and 1910. The results indicate that early childhood mortality was a good (negative) predictor of height and the body mass index, while it is also possible to predict early childhood experience from terminal adult height. Urbanization was important, although the importance declined over time. Income apparently had little effect on health in this period.

Getting research findings into practice : when to act on the evidence.

There is increasing interest in providing evidence based health care—that is, care in which healthcare professionals, provider managers, those who commission health care, the public, and policymakers consistently consider research evidence when making decisions. Purchasers, for example, should be able to influence the organisation and delivery of care (such as for cancer and stroke services) and the type and content of services (such as using chiropractic for back pain or dilatation and curettage and drug treatment for menorrhagia). Policymakers should ensure that policies on treatment reflect and are consistent with research evidence, and that the incentive structure within the health system promotes cost effective practice. They must also ensure that there is an adequate infrastructure for monitoring changes in practice and for producing, gathering, summarising, and disseminating evidence. Clinicians determine the day to day care patients receive in healthcare systems, and user groups (for example, patients, their families, and their representatives) are also beginning to play an important role in influencing healthcare decisions