[Social inequalities and other determinants of height in children: a multi-level analysis]

A cross-sectional household survey of height among children under five years of age (n = 2,632) was conducted in the city of Porto Alegre, Rio Grande do Sul State, Brazil. Multi-level linear regression was applied to investigate the effect of socioeconomic and demographic factors, physical and social environment, and health conditions on children s height, measured by the height-for-age z-scores of the National Center for Health Statistics standards. Area of residence (census tract) was classified as good versus poor in terms of housing and sanitation standards. On average, children s height was -0.18 z-score. Average height increased with maternal and paternal schooling, parents work skills, per capita family income, improved housing, maternal age, birth intervals, and birth weight. Height decreased with hospitalization in the first two years of life, number of under-five children in the household, and preterm birth. In the poor residential areas, the effect of maternal schooling was twice as great as in the better-off areas. The effect of parental work skills was only evident in the more deprived areas. Area of residence modified the effects of socioeconomic conditions on children s growth. Housing and sanitation programs are potentially beneficial to offset the negative effect of social disadvantage on children's growth.