The monitoring of growth and nutritional status in South Africa.

Analyses of the economic, political, demographic, and health indicators of South Africa place it within the context of the developing nations of the world. In particular current urbanization and population growth rates will lead to an increase of the Black urban population from 6.5 million in 1985 to over 20 million by the year 2000. Such dramatic social change will place major stress on the health of urban children. Few studies are available, however, that may be used to monitor the growth, and by implication the health, of rural children and thereby act as a baseline for the investigation of the effects of the urban environment. Research since 1985 on the growth and nutritional status of children has concentrated on longitudinal studies of rural children to form a basis for comparison to their urban counterparts. The results of these rural studies demonstrate growth patterns characteristic of children living in developing countries with some degree of variation, particularly with regard to weight and subcutaneous fat, between different rural groups. Rural children have a superior growth status in comparison to "average" urban children but are inferior to "well-off" urban children. The urban environment thus favors those children with adequate socioeconomic support but may be disadvantageous to children from "average" backgrounds. Interpretation of the effects of the rural environment will be greatly enhanced with information relating to nutritional intake and morbidity.