Measuring A Country's Health By Its Height

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Tiffani Mundaray has brought her son Wayne for a well-baby visit in the pediatric practice at Howard University Hospital in Washington, D.C. At age 2, he's 36 1/4 inches tall -- in the 90th percentile.

"His growth velocity is very nice. It's very appropriate for his age," says Sohail Rana, Wayne's pediatrician. "He's growing well."

toggle caption Nancy Shute/NPR

From the day we're born, height equals health. Babies are measured to make sure they're thriving.

But doctors aren't the only people who look to height as a sign of health.

Economists like John Komlos of the University of Munich in Germany use height to measure the health of entire countries. "Height is like holding a mirror to society's well-being," Komlos says.

And, it turns out, by that standard, the United States isn't measuring up.

Fallen From The Top

Through most of American history, we've been the tallest population on the planet. Americans were two inches taller than the Englishmen they fought in the Revolutionary War, thanks to abundant food and a healthy rural life, far from the disease-ridden cities of Europe.

But we're no longer at the top. Northern Europeans are now the world's tallest people, led by the Dutch. The average Dutch man is 6 feet tall, while the average American man maxes out at 5-foot-9.

Height is like holding a mirror to society's well-being.

Good health care and good nutrition during pregnancy and early childhood are two reasons why the Dutch have grown so tall, Komlos says. In addition, the Dutch guarantee equal access to critical resources like prenatal care. That's not the case in the United States, where 17 percent of the population has no health insurance.

The height of Americans reached a plateau in the 1960s. As a nation, we have not grown taller but we also have not lost stature. Komlos says groups of people usually don't lose height unless they're in the midst of a famine or a war. "It has practically never occurred in peacetime," he says.

Komlos would know; he was born in Budapest, Hungary, during World War II. And at 5-foot-7, he is shorter than his father, a fact he attributes to his family's lack of food, as well as the stresses of life during wartime.

Reaching Maximum Potential

Economists are interested in these biological questions about nations because while height is a reflection of health and nutrition, those factors usually result from economic well-being.

The Netherlands: The World's Tallest (And Healthiest) Country Their men tower at an average height of 6-foot-1, and their women average 5-foot-8; those impressive figures confirm the Dutch as the tallest people in the world. So serious are the Dutch about height that there's even a national association representing tall people. According to The New Yorker, the club has serious political clout. John Komlos' 2007 study in Social Science Quarterly offers several possible explanations for the good health and stature of the Dutch. One is the country's "high-quality" medical system and social services, including a public health monitoring program that allows moms to get child nutrition guidance from a pediatrician. Also, the study notes that lower labor-force participation rates among Dutch women means more moms stay at home, possibly allowing them to better care for their young children. This year, Commonwealth Fund ranked the Netherlands health system No. 1 among industrialized nations. While the Netherlands doesn't have a government-run health system, it does require everyone to have insurance coverage. In the same survey, the U.S. came in last and had the highest yearly spending per person. — Whitney Blair Wyckoff

Economic success and height even correlate to some degree on an individual level. Taller people tend to be smarter, and to earn more.

Andreas Schick, a graduate student at Ohio State University in Columbus, is trying to figure out why. He thinks it gets down to the fact that someone who is healthy and well-fed enough to grow tall -- or to the individual's maximum potential genetic height -- is also someone who is able to grow a strong, capable brain.

"If you've reached your maximum height, that probably means you've reached your physical and mental development," Schick says. "That helps you reach your maximum potential, be that intellectually or socially."

But the fact that Americans aren't getting taller means more and more children won't have the chance to reach their maximum potential, Komlos says.

And that has ramifications for the future. "A population that is not taking care of their children and youth is going to be in difficulties in a generation or two," he says.

At Howard University Hospital in Washington, D.C., two miles northwest of the White House, Rana says he sees children in difficulty every day. Many of his young patients suffer health problems from obesity -- too many empty calories and fat. Others are not getting enough to eat.

"You would be shocked by how many kids go without food in this town," he says. "What you have to do is go to clinics like ours and ask people: Did you have a meal today?"