ABSTRACT
OBJECTIVE: This study uses longitudinal data from school children in Dunedin, New Zealand, to evaluate impacts of COVID-19 lockdown measures on changes in body mass (BMI, kg/m2 ). Impacts are assessed using two non-mutually exclusive hypotheses. The "structured days" hypothesis holds that children tend to alter sleep patterns, reduce activity and increase snacking when not in structured environments. The bidirectional hypothesis proposes that over-weight or obese children are predisposed to further gains in unstructured settings. METHODS: Juveniles and adolescents (n = 95, 60% female) were recruited from Dunedin schools. Repeated measures analyses assessed variation in intra-individual change in BMI during four periods: P1 (before summer break), P2 (during summer break), P3 (during the COVID-19 lockdown), and P4 (after the lockdown ended). The model also examined if these changes were influenced by participants' sex or body size early in the first period assessed using log-transformed BMI, log-transformed weight, height, or lower leg length. RESULTS: Repeated measures analyses of per month gains in BMI (kg/m2 ) during the four periods revealed consistent period (p ≤ .001), period by sex (p ≤ .010), and period by body size (p ≤ .001) interactions across all four body size proxies. Both sexes experienced the greatest gains during the lockdown (P3), but differed in response to their summer break (P2). CONCLUSION: Results are mostly consistent with the "structured days" hypothesis, but challenge the bidirectional hypothesis as defined. Further research better characterizing risks of gains in adiposity are needed.
Subject(s)
COVID-19 , Pediatric Obesity , Male , Humans , Child , Female , Adolescent , Body Mass Index , Pediatric Obesity/epidemiology , New Zealand/epidemiology , COVID-19/epidemiology , Communicable Disease ControlSubject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Humans , Indigenous Peoples , Socioeconomic FactorsABSTRACT
OBJECTIVES: To explore whether synergistic epidemics of measles and scarlet fever in 1860s-1870s Victoria, Australia could be characterized as syndemics, we apply the methods of Sawchuk, Tripp, and Samakaroon (Social Science & Medicine 2022, 295, 112956) to quantify the impact of each of the two major co-occurring epidemic events (1867, 1875) in terms of life expectancy (LE) changes. Sawchuk et al. posit the presence of a harvesting effect, indicated by a statistically significant increase in LE in the immediate post-epidemic "fallow period", as a criterion for identification of a historical syndemic. We test an alternate hypothesis that the same methods can identify a short-term scarring effect. MATERIALS AND METHODS: Using annual age- and cause-specific death statistics and census population data, we constructed abridged period life tables for baseline period, potential syndemic year, and "fallow" year for each of the two periods (1860s and 1870s). We compared LE at birth using Z-tests. We decomposed age-cause-specific mortality according to Arriaga's method to identify age-and cause-specific contributions to LE change. RESULTS: LE was significantly lower than baseline (1864-1865) in 1867 but not in the "fallow" year (1869). LE in 1875 and the 1878 "fallow" year were both significantly below baseline (1871-1873). Age-cause-specific decomposition showed similar patterns for 1867 and 1875 for measles and scarlet fever combined effects. DISCUSSION: Evidence of a scarring effect following the 1875 measles/scarlet fever combined peak supports the interpretation of this event as a syndemic. We suggest the short-term scarring effect can be a useful additional criterion for identifying historical syndemics.
ABSTRACT
Questions regarding access to and the use of medical and surgical treatment for people with disabilities revisit themes central to medical anthropology. The "Ashley Treatment" is named after a nine-year-old girl, Ashley, who has extreme physical and cognitive disabilities. The Treatment refers to extensive medical and surgical procedures that are claimed to improve quality of life and prevent future medical problems. The Treatment has stimulated lively public debate on disability, medicalization, and caregiving. We illustrate how the Ashley Treatment emphasizes the importance of medical anthropological research on the construction of personhood and childhood disability, agency and autonomy, and the rights of representation and control, as well as the ethics of invasive procedures, hormone therapy, and body modification surgery.