Public Health Nutrition

Research Article

Does living in an urban environment confer advantages for childhood nutritional status? Analysis of disparities in nutritional status by wealth and residence in Angola, Central African Republic and Senegal

Gina Kennedya1 c1, Guy Nantela1, Inge D Brouwera2 and Frans J Koka2

a1 Nutrition Planning, Assessment and Evaluation Service, Food and Nutrition Division, Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, I-00 100, Rome, Italy

a2 Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands


Objective The purpose of this paper is to examine the relationship between childhood undernutrition and poverty in urban and rural areas.

Design Anthropometric and socio-economic data from Multiple Indicator Cluster Surveys in Angola-Secured Territory (Angola ST), Central African Republic and Senegal were used in this analysis. The population considered in this study is children 0–59 months, whose records include complete anthropometric data on height, weight, age, gender, socio-economic level and urban or rural area of residence. In addition to simple urban/rural comparisons, the population was stratified using a wealth index based on living conditions and asset ownership to compare the prevalence, mean Z-score and odds ratios for stunting and wasting.

Results In all cases, when using a simple urban/rural comparison, the prevalence of stunting was significantly higher in rural areas. However, when the urban and rural populations were stratified using a measure of wealth, the differences in prevalence of stunting and underweight in urban and rural areas of Angola ST, Central African Republic and Senegal disappeared. Poor children in these urban areas were just as likely to be stunted or underweight as poor children living in rural areas. The odds ratio of stunting in the poorest compared with the richest quintile was 3.4, 3.2 and 1.5 in Angola ST, Senegal and Central African Republic, respectively.

Conclusions This paper demonstrates that simple urban/rural comparisons mask wide disparities in subgroups according to wealth. There is a strong relationship between poverty and chronic undernutrition in both urban and rural areas; this relationship does not change simply by living in an urban environment. However, urban and rural living conditions and lifestyles differ, and it is important to consider these differences when designing programmes and policies to address undernutrition.

(Received January 05 2005)

(Accepted June 14 2005)


c1 *Corresponding author: Email