SHAPING THE FUTURE HOW CHANGING DEMOGRAPHICS CAN POWER HUMAN DEVELOPMENT

BOX 3.7:
Malnutrition and disability: making connections
Both malnutrition and disability are major global
public health problems and key human rights
concerns. Children with disabilities are among the
most marginalized and excluded groups in society.
Facing daily discrimination, and lack of adequate
policies and legislation, they are effectively barred
from realizing their rights to health care, education
and even survival.
An estimated 93 million to 150 million children
worldwide live with disabilities. They are often
among the poorest members of the population.
They are less likely to access medical services or
have their voices heard. They are more likely to drop
out of school than any other vulnerable group, even
in countries with high primary school enrolment
rates. Their disabilities place them at a higher risk
of physical abuse, and often exclude them from receiving
proper nutrition or humanitarian assistance
in emergencies. Too few data are collected about
children with disabilities, hindering appropriate
interventions.
Many countries have begun including children
with disabilities in mainstream education, although
some still favour segregation. In practice, most
countries have hybrid policies and are incrementally
improving inclusive practices.
Strengthening links between nutrition and disability
could lead to important benefits. At numerous
points throughout the life cycle, malnutrition can
cause or contribute to an individual’s physical,
sensory, intellectual or mental health disability. By
bringing work on these two issues together, some
problems can be transformed into opportunities.
Nutrition programmes for children can act as
entry points to address and, in some cases, avoid
or mitigate disability, for instance. This requires
political commitment and resources, and improved
collection and use of better data on disability.
Source: UNESCO 2015b, UNICEF 2015a.
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Obesity is
a concern especially
among city-dwellers
in East Asia
A GROWING ISSUE OF OBESITY
At the opposite end of the spectrum, rates of
obesity have grown among children and adolescents.
Obesity is a significant risk factor
for many non-communicable diseases, which
now account for a growing share, and in some
countries, the largest share of overall mortality.
The World Health Organization has declared
childhood obesity as one of the most serious
public health challenges of the 21st century,
given links in later life to diabetes, hypertension,
heart disease and other illnesses.
Globally the number of overweight infants
and young children under age five increased from
32 million in 1990 to 42 million in 2013, 52 with
much of the rise occurring in low- and middle-income
countries. The numbers of children
in Asia-Pacific edged up from 13.4 million in
1990 to 14.7 million in 2013. 53 Although childhood
obesity has been common in some Pacific
countries, it is now increasingly being reported
from countries that have recently become affluent,
such as China, Indonesia, Malaysia and
Thailand. The rate is alarmingly high, more than
10 percent, in Indonesia, Mongolia and Thailand.
In 2013, the proportion of obese girls, aged 2
to 19, reached 30 percent or more in Kiribati,
Micronesia and Samoa—the highest levels in
the world. Similar trends were found in boys.
At the same time, the rate is less than 2 percent
in Bangladesh, Cambodia, Democratic People’s
Republic of Korea, Lao People’s Democratic
Republic and Nepal. South Asian countries with
low rates still have to contend with significant
numbers of children who are overweight, given
their large populations. (Figure 3.6)
Rapid urbanization, modernization and
life styles with reduced physical activity and
increasing intake of high calorie food foster the
rise of obesity—levels are significantly higher in
richer, more educated urban households. China,
which once had the leanest of populations, is now
rapidly catching up with the West in prevalence.
Diabetes cases have almost quadrupled in the
last 15 years. 54
Both obesity and undernutrition coexist in
a number of countries. In Indonesia, 36 percent
of preschool and school children were stunted in
2013, while 12 percent were overweight. Some