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The	
  Effects	
  of	
  Poli/cal	
  Marginaliza/on	
  on	
  Childhood	
  Health	
  
Minna	
  Sabbahi¹,2,	
  Daniel	
  Hoffman,	
  PhD²	
  	
  
¹Department	
  Poli/cal	
  Science,	
  ²Department	
  of	
  Nutri/onal	
  Science,	
  	
  
Rutgers	
  University,	
  New	
  Brunswick,	
  NJ	
  	
  
Abstract	
   Discussion	
  
	
  
Objec1ves	
  &	
  Methodology	
  	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
•  To	
  conduct	
  content	
  analysis	
  and	
  historical	
  
studies	
  of	
  poli/cal	
  and	
  health	
  policies	
  of	
  
Pales/ne	
  and	
  Brazil	
  
•  To	
  demonstrate	
  the	
  correla/on	
  between	
  
poli/cal	
  marginaliza/on	
  and	
  deteriora/ng	
  
childhood	
  health	
  
•  To	
  closely	
  examine	
  sta/s/cal	
  data	
  on	
  weight	
  
regula/ons	
  and	
  func/ons	
  
	
  	
  
Future	
  Direc1ons	
  
	
  	
  	
  	
  Future	
  work	
  must	
  be	
  done	
  to	
  study	
  the	
  efficacy	
  and	
  
response	
  of	
  interna/onal	
  policies	
  to	
  the	
  health	
  
statuses	
  of	
  marginalized	
  people.	
  In	
  doing	
  so,	
  this	
  
research	
  will	
  further	
  develop	
  our	
  understanding	
  of	
  
the	
  rela/onship	
  between	
  nutri/on	
  and	
  food	
  policy.	
  	
  
Introduc1on	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
	
  
Acknowledgements	
  	
  
	
  	
  	
  	
  This	
  research	
  is	
  funded	
  in	
  part	
  by	
  the	
  Ronald	
  E.	
  
McNair	
  Post	
  Baccalaureate	
  Achievement	
  Program	
  at	
  
Rutgers	
  University.	
  A	
  special	
  thanks	
  is	
  given	
  to	
  Dr.	
  
Daniel	
  Hoffman	
  and	
  to	
  the	
  McNair	
  advisors	
  and	
  staff.	
  	
  
	
  	
  	
  	
  Pales/nians	
  face	
  numerous	
  health	
  
complica/ons,	
  due	
  to	
  the	
  policies	
  and	
  
blockades	
  established	
  by	
  the	
  Israeli	
  
government.	
  Such	
  policies	
  prevent	
  basic	
  
needs	
  from	
  being	
  within	
  civilians’	
  reach.	
  	
  
	
  
	
  	
  	
  	
  Similarly,	
  in	
  Brazil,	
  the	
  favela,	
  more	
  
commonly	
  known	
  as	
  slums	
  or	
  shantytowns,	
  
are	
  constantly	
  barred	
  from	
  the	
  poli/cal	
  realm	
  
because	
  of	
  racial	
  and	
  socioeconomic	
  
bigotries,	
  in	
  turn	
  worsening	
  the	
  quality	
  of	
  
childhood	
  health.	
  	
  
	
  
Poli/cal	
  Marginaliza/on-­‐	
  a	
  process	
  in	
  which	
  
individuals	
  are	
  deliberately	
  blocked	
  from	
  
enjoying	
  the	
  rights	
  of	
  full	
  ci/zenship	
  and	
  
social	
  privileges	
  that	
  include	
  the	
  rights	
  to	
  
basic	
  economic	
  and	
  social	
  welfare	
  as	
  well	
  as	
  
par/cipa/on	
  in	
  society,	
  including	
  work	
  
opportuni/es,	
  educa/on,	
  and	
  fulfillment	
  of	
  
basic	
  needs	
  in	
  terms	
  of	
  access	
  to	
  medical	
  aid	
  
and	
  food	
  supplies¹	
  
	
  
References	
  
¹Giacaman,	
  R.	
  (2001).	
  A	
  community	
  of	
  ci/zens:	
  disability	
  rehabilita/on	
  in	
  
the	
  Pales/nian	
  transi/on	
  to	
  statehood.	
  Disability	
  &	
  Rehabilita.on,	
  23(14),	
  
639-­‐644.	
  doi:10.1080/09638280110036544	
  
²Sawaya,	
  A.	
  L.,	
  Mar/ns,	
  P.	
  A.,	
  Grillo,	
  L.	
  P.,	
  &	
  Florêncio,	
  T.	
  T.	
  (2004).	
  Long-­‐
term	
  effects	
  of	
  early	
  malnutri/on	
  on	
  body	
  weight	
  regula/on.	
  Nutri.on	
  
Reviews,	
  62(7),	
  127-­‐133.	
  doi:10.1301/nr.2004.jul.S127-­‐S133	
  
³Rahim,	
  H.	
  F.	
  A.,	
  Wick,	
  L.,	
  Halileh,	
  S.,	
  Hassan-­‐Bitar,	
  S.,	
  Chekir,	
  H.,	
  Waj,	
  G.,	
  
&	
  Khawaja,	
  M.	
  (2009).	
  Maternal	
  and	
  child	
  health	
  in	
  the	
  occupied	
  
Pales/nian	
  territory.	
  The	
  Lancet,	
  373(9667),	
  967-­‐977.	
  doi:10.1016/
S0140-­‐6736(09)60108-­‐2	
  
⁴Devi,	
  S.	
  (2004).	
  Health	
  under	
  fire.	
  Lancet,	
  364(9439),	
  1027-­‐1028.	
  
5Perlman,	
  J.	
  E.	
  (2010).	
  Favela	
  :	
  Four	
  decades	
  of	
  living	
  on	
  the	
  edge	
  in	
  Rio	
  de	
  
Janeiro.	
  Oxford;	
  New	
  York:	
  Oxford	
  University	
  Press.	
  
	
  
	
  
	
  
Table	
  1:	
  Nutri1onal	
  Deficiencies	
  in	
  Favela²	
  	
  	
  
Physical	
  and	
  Psychosocial	
  Barriers	
  
Poli1cal	
  
Marginaliza1on	
  	
  
Denial	
  of	
  
Access	
  to	
  Basic	
  
Needs	
  	
  
Nutri1onal	
  
Status	
  
Mental	
  and	
  
Physical	
  health	
  	
  
Social	
  
Instability	
  
Further	
  
Exclusion	
  	
  
Poli1cal	
  
Marginaliza1on	
  	
  
Poor	
  Childhood	
  
Health	
  	
  
	
  	
  	
  	
  Poli/cal	
  marginaliza/on	
  indirectly	
  affects	
  the	
  
totality	
  of	
  health	
  condi/ons	
  of	
  those	
  ostracized.	
  
The	
  exclusion	
  of	
  groups	
  from	
  the	
  poli/cal	
  
process	
  leads	
  to	
  the	
  denial	
  of	
  access	
  for	
  basic	
  
needs,	
  such	
  as	
  medical	
  aid	
  and	
  food	
  supplies.	
  
Consequently,	
  this	
  may	
  create	
  nutri/onal	
  
deficiencies	
  in	
  children.	
  Demographic	
  
characteris/cs	
  indicate	
  which	
  group	
  are	
  
excluded	
  and	
  for	
  what	
  purposes.	
  	
  
This	
  study	
  aims	
  to	
  offer	
  familiarity	
  in	
  the	
  
coexistence	
  between	
  poli/cal	
  marginaliza/on	
  
and	
  childhood	
  health	
  by	
  assessing	
  Pales/ne	
  and	
  
Brazil	
  as	
  two	
  separate	
  case	
  studies.	
  Through	
  
these	
  findings,	
  this	
  study	
  will	
  show	
  the	
  
universality	
  of	
  marginaliza/on	
  and	
  the	
  causal	
  
pathway	
  to	
  poor	
  childhood	
  health,	
  a	
  factor	
  that	
  
limits	
  overall	
  health	
  and	
  long	
  term	
  social	
  and	
  
mental	
  development.	
  
Figure	
  1:	
  Stun1ng	
  in	
  children	
  younger	
  than	
  5	
  years	
  in	
  the	
  
occupied	
  Pales1nian	
  territory	
  by	
  year	
  and	
  region³	
  
Data	
  from	
  Pales/nian	
  Central	
  bureau	
  of	
  Sta/s/cs.	
  Stun/ng	
  
(height-­‐for-­‐age	
  index)	
  was	
  determined	
  by	
  use	
  of	
  the	
  
interna/onal	
  reference	
  popula/on	
  defined	
  by	
  the	
  US	
  
Na/onal	
  Center	
  for	
  Disease	
  Control	
  and	
  Preven/on.	
  
Children	
  who	
  were	
  below	
  –2	
  SD	
  from	
  the	
  reference	
  median	
  
were	
  classified	
  as	
  stunted,	
  and	
  those	
  who	
  were	
  below	
  –3	
  
SD	
  from	
  the	
  reference	
  median	
  were	
  classified	
  as	
  severely	
  
stunted	
  	
  
	
  	
  	
  	
  The	
  analy/cal	
  concept	
  of	
  marginaliza/on,	
  
although	
  applied	
  differently	
  around	
  the	
  
world,	
  has	
  a	
  global	
  relevance.	
  Any	
  group	
  of	
  
individuals,	
  regardless	
  of	
  where	
  they	
  are	
  
situated,	
  once	
  marginalized,	
  face	
  various	
  
repercussions.	
  The	
  most	
  prominent	
  is	
  
childhood	
  health,	
  as	
  demonstrated	
  by	
  the	
  
two	
  separate	
  case	
  studies	
  of	
  Pales/ne	
  and	
  
Brazil.	
  Both	
  Brazilians	
  and	
  Pales/nians	
  deal	
  
with	
  the	
  widespread	
  problem	
  of	
  
malnourishment,	
  par/cularly	
  stun/ng,	
  which	
  
predisposes	
  those	
  children	
  to	
  long	
  term	
  
health	
  effects	
  leading	
  into	
  adulthood.	
  The	
  
grave	
  effects	
  on	
  childhood	
  health	
  then	
  trickle	
  
down	
  into	
  social	
  instability,	
  violence,	
  poor	
  
mental	
  and	
  physical	
  health,	
  which	
  diminishes	
  
the	
  quality	
  of	
  life	
  for	
  those	
  ci/zens.	
  	
  
Figure	
  2:	
  	
  
Marginaliza1on	
  Cycle	
  	
  
Nutri/onal	
  Status	
  of	
  Children	
  Under	
  10	
  Living	
  in	
  a	
  Slum	
  in	
  
Maceio,	
  Alagoas,	
  Brazil,	
  According	
  to	
  Standard	
  Devia/ons	
  of	
  
Weight-­‐for-­‐age	
  and	
  Height-­‐for-­‐age	
  as	
  Compared	
  to	
  the	
  NCHS	
  
Distribu/on	
  	
  	
  
Results	
  
Pales1ne	
  
Checkpoints	
  
Blockades	
  	
  
Sejlements	
  	
  
Lack	
  of	
  funding	
  
Ongoing	
  conflict	
  	
  	
  	
  
Brazil	
  
Inequality	
  
Discrimina/on	
  	
  
Violence	
  
Misuse	
  of	
  power	
  	
  
Disenchantment	
  à	
  
voluntary	
  isola/on5	
  
“A	
  Refugee	
  Diary”	
  	
  
By:	
  Najwa	
  Sheikh,	
  6/3/12	
  
“Majority	
  of	
  Gazans	
  are	
  now	
  dependant	
  
on	
  welfare	
  and	
  humanitarian	
  
organisations	
  for	
  food	
  supplies.	
  If	
  any	
  
of	
  these	
  organisations	
  were	
  to	
  
experience	
  a	
  sudden	
  funding	
  crisis,	
  
many	
  Gazan	
  families	
  would	
  find	
  
themselves	
  begging	
  on	
  the	
  
streets.”	
  (UNRWA)	
  	
  

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McNair Poster Session

  • 1. The  Effects  of  Poli/cal  Marginaliza/on  on  Childhood  Health   Minna  Sabbahi¹,2,  Daniel  Hoffman,  PhD²     ¹Department  Poli/cal  Science,  ²Department  of  Nutri/onal  Science,     Rutgers  University,  New  Brunswick,  NJ     Abstract   Discussion     Objec1ves  &  Methodology                       •  To  conduct  content  analysis  and  historical   studies  of  poli/cal  and  health  policies  of   Pales/ne  and  Brazil   •  To  demonstrate  the  correla/on  between   poli/cal  marginaliza/on  and  deteriora/ng   childhood  health   •  To  closely  examine  sta/s/cal  data  on  weight   regula/ons  and  func/ons       Future  Direc1ons          Future  work  must  be  done  to  study  the  efficacy  and   response  of  interna/onal  policies  to  the  health   statuses  of  marginalized  people.  In  doing  so,  this   research  will  further  develop  our  understanding  of   the  rela/onship  between  nutri/on  and  food  policy.     Introduc1on                   Acknowledgements            This  research  is  funded  in  part  by  the  Ronald  E.   McNair  Post  Baccalaureate  Achievement  Program  at   Rutgers  University.  A  special  thanks  is  given  to  Dr.   Daniel  Hoffman  and  to  the  McNair  advisors  and  staff.            Pales/nians  face  numerous  health   complica/ons,  due  to  the  policies  and   blockades  established  by  the  Israeli   government.  Such  policies  prevent  basic   needs  from  being  within  civilians’  reach.              Similarly,  in  Brazil,  the  favela,  more   commonly  known  as  slums  or  shantytowns,   are  constantly  barred  from  the  poli/cal  realm   because  of  racial  and  socioeconomic   bigotries,  in  turn  worsening  the  quality  of   childhood  health.       Poli/cal  Marginaliza/on-­‐  a  process  in  which   individuals  are  deliberately  blocked  from   enjoying  the  rights  of  full  ci/zenship  and   social  privileges  that  include  the  rights  to   basic  economic  and  social  welfare  as  well  as   par/cipa/on  in  society,  including  work   opportuni/es,  educa/on,  and  fulfillment  of   basic  needs  in  terms  of  access  to  medical  aid   and  food  supplies¹     References   ¹Giacaman,  R.  (2001).  A  community  of  ci/zens:  disability  rehabilita/on  in   the  Pales/nian  transi/on  to  statehood.  Disability  &  Rehabilita.on,  23(14),   639-­‐644.  doi:10.1080/09638280110036544   ²Sawaya,  A.  L.,  Mar/ns,  P.  A.,  Grillo,  L.  P.,  &  Florêncio,  T.  T.  (2004).  Long-­‐ term  effects  of  early  malnutri/on  on  body  weight  regula/on.  Nutri.on   Reviews,  62(7),  127-­‐133.  doi:10.1301/nr.2004.jul.S127-­‐S133   ³Rahim,  H.  F.  A.,  Wick,  L.,  Halileh,  S.,  Hassan-­‐Bitar,  S.,  Chekir,  H.,  Waj,  G.,   &  Khawaja,  M.  (2009).  Maternal  and  child  health  in  the  occupied   Pales/nian  territory.  The  Lancet,  373(9667),  967-­‐977.  doi:10.1016/ S0140-­‐6736(09)60108-­‐2   ⁴Devi,  S.  (2004).  Health  under  fire.  Lancet,  364(9439),  1027-­‐1028.   5Perlman,  J.  E.  (2010).  Favela  :  Four  decades  of  living  on  the  edge  in  Rio  de   Janeiro.  Oxford;  New  York:  Oxford  University  Press.         Table  1:  Nutri1onal  Deficiencies  in  Favela²       Physical  and  Psychosocial  Barriers   Poli1cal   Marginaliza1on     Denial  of   Access  to  Basic   Needs     Nutri1onal   Status   Mental  and   Physical  health     Social   Instability   Further   Exclusion     Poli1cal   Marginaliza1on     Poor  Childhood   Health            Poli/cal  marginaliza/on  indirectly  affects  the   totality  of  health  condi/ons  of  those  ostracized.   The  exclusion  of  groups  from  the  poli/cal   process  leads  to  the  denial  of  access  for  basic   needs,  such  as  medical  aid  and  food  supplies.   Consequently,  this  may  create  nutri/onal   deficiencies  in  children.  Demographic   characteris/cs  indicate  which  group  are   excluded  and  for  what  purposes.     This  study  aims  to  offer  familiarity  in  the   coexistence  between  poli/cal  marginaliza/on   and  childhood  health  by  assessing  Pales/ne  and   Brazil  as  two  separate  case  studies.  Through   these  findings,  this  study  will  show  the   universality  of  marginaliza/on  and  the  causal   pathway  to  poor  childhood  health,  a  factor  that   limits  overall  health  and  long  term  social  and   mental  development.   Figure  1:  Stun1ng  in  children  younger  than  5  years  in  the   occupied  Pales1nian  territory  by  year  and  region³   Data  from  Pales/nian  Central  bureau  of  Sta/s/cs.  Stun/ng   (height-­‐for-­‐age  index)  was  determined  by  use  of  the   interna/onal  reference  popula/on  defined  by  the  US   Na/onal  Center  for  Disease  Control  and  Preven/on.   Children  who  were  below  –2  SD  from  the  reference  median   were  classified  as  stunted,  and  those  who  were  below  –3   SD  from  the  reference  median  were  classified  as  severely   stunted            The  analy/cal  concept  of  marginaliza/on,   although  applied  differently  around  the   world,  has  a  global  relevance.  Any  group  of   individuals,  regardless  of  where  they  are   situated,  once  marginalized,  face  various   repercussions.  The  most  prominent  is   childhood  health,  as  demonstrated  by  the   two  separate  case  studies  of  Pales/ne  and   Brazil.  Both  Brazilians  and  Pales/nians  deal   with  the  widespread  problem  of   malnourishment,  par/cularly  stun/ng,  which   predisposes  those  children  to  long  term   health  effects  leading  into  adulthood.  The   grave  effects  on  childhood  health  then  trickle   down  into  social  instability,  violence,  poor   mental  and  physical  health,  which  diminishes   the  quality  of  life  for  those  ci/zens.     Figure  2:     Marginaliza1on  Cycle     Nutri/onal  Status  of  Children  Under  10  Living  in  a  Slum  in   Maceio,  Alagoas,  Brazil,  According  to  Standard  Devia/ons  of   Weight-­‐for-­‐age  and  Height-­‐for-­‐age  as  Compared  to  the  NCHS   Distribu/on       Results   Pales1ne   Checkpoints   Blockades     Sejlements     Lack  of  funding   Ongoing  conflict         Brazil   Inequality   Discrimina/on     Violence   Misuse  of  power     Disenchantment  à   voluntary  isola/on5   “A  Refugee  Diary”     By:  Najwa  Sheikh,  6/3/12   “Majority  of  Gazans  are  now  dependant   on  welfare  and  humanitarian   organisations  for  food  supplies.  If  any   of  these  organisations  were  to   experience  a  sudden  funding  crisis,   many  Gazan  families  would  find   themselves  begging  on  the   streets.”  (UNRWA)