ArticlePloS one2024
Stunting and its association with education and cognitive outcomes in adulthood: A longitudinal study in Indonesia.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Determinants and district-level variation in childhood undernutrition in Sindh, Pakistan: evidence from MICS 2018.BMC nutrition · 2026Article
- Nutraceutical Interventions in Stunting: Advances, Challenges, and Prospects.Food science & nutrition · 2026Review
- Train-the-trainer model in public health practice: Feasibility of senior nursing students as catalysts for hand hygiene education in school-aged children.Journal of family medicine and primary care · 2026Article
- TRENDS AND RESEARCH FRONTIERS ON GUT MICROBIOTA AND STUNTING: A BIBLIOMETRIC INSIGHT FROM 2009 TO 2025.Arquivos de gastroenterologia · 2026Article
- Differences in growth trajectories in breastfed HIV-exposed uninfected and HIV-unexposed infants in Kenya: An observational cohort study.PLoS medicine · 2025Observational
- Understanding Stunting: Impact, Causes, and Strategy to Accelerate Stunting Reduction-A Narrative Review.Nutrients · 2025Review
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4 authors.
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Abstract
backgroundStunting is associated with adverse outcomes in adulthood. This article specifically aims to analyse the relationship between childhood stunting and education as well as cognitive outcomes for adults in Indonesia.
methodsPooled data from wave one (1) and two (2) of the Indonesia Family Life Survey (IFLS) in 1993 and 1997 identified a sub-sample of 4,379 children aged 0-5 by their height-for-age (HAZ) to be compared for their differences in educational outcomes and cognitive abilities in 2014. HAZ was used to proxy relative height to determine stunting status based on 2006 WHO child's growth standards. Education and cognitive abilities outcomes include years of schooling, age of school entry, grade repetition, and scores for cognitive and math tests. The study employs estimation models of pooled regressions and instrumental variable (IV) to address problems of endogeneity and bias from omitted variables.
resultsStunting and relatively small stature had significant associations with cognitive development, and they worked as intermediaries to cognitive developmental barriers as manifested in reduced educational outcomes. A lack of one SD in HAZ was associated with 0.6 years shortened length of the school, 3% higher chances of dropouts from secondary school, and 0.10-0.23 SD lowered cognitive and numerical scores. Similarly, stunting is associated with decrease cognitive test scores by 0.56-0.8 SD compared to non-stunting, two years less schooling, and 0.4 years of delayed entry to school. As for cognitive abilities, stunting is associated with lower cognitive and numerical abilities by 0.38-0.82 z-scores.
conclusionGrowth retardation during childhood in Indonesia was associated with lower cognitive abilities, particularly during school age, and this correlation faded as individuals grew up. Subsequently, growth retardation is significantly linked to lower educational outcomes. Impaired growth has implications for reduced lifetime earnings potential mediated by diminished cognitive capacity and lower educational attainment. The finding suggests that development in Indonesia during recent decades has not provided an adequate environment to enable children to achieve their potential educational outcomes.
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