The role of geographical isolation in children’s growth: Height of children and adolescents on the Kangean Island, Madura, Indonesia

Yuni Hisbiyah; Muhammad Faizi; Nabilah Azzah Putri Wairooy; Rayi Kurnia Perwitasari; Nur Rochmah

doi:10.52905/hbph2025.1.89

Authors

Yuni Hisbiyah Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya https://orcid.org/0000-0002-1362-108X
Muhammad Faizi Department of Child Health, Dr. Soetomo General Academic Hospital, Surabaya
Nabilah Azzah Putri Wairooy Faculty of Medicine, Universitas Airlangga, Surabaya https://orcid.org/0000-0003-2916-6859
Rayi Kurnia Perwitasari Department of Child Health, Dr. Soetomo General Academic Hospital, Surabaya https://orcid.org/0000-0002-8699-4063
Nur Rochmah Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya

DOI:

https://doi.org/10.52905/hbph2025.1.89

Keywords:

Height, Island, Isolated, Geographical, Growth

Abstract

Background Historical evidence highlights links between height and environmental factors, with geographic isolation playing a crucial role. The Kangean Island, one of Indonesia’s small, isolated islands, offers a unique context for research on growth.

Objectives The study aims to compare the height of 15-17-year-old girls in Malang, Java, with those of the same age on Kangean. It also compares the height of boys and girls aged 1 month–12 years old from Arjasa and Kangayan locations over two hours away from the port on the Kangean Island.

Sample and Methods We studied 2 groups with a total of 393 participants: girls aged 15–17 years from Malang (n=91); and Kangean (n=94), children aged 1 month–12 years from the Kangean Island (n=208); we measured the participants’ height, weight, and BMI, converted them based on the WHO-reference SDS values from 2007, and then analyzed the data using SPSS.

Results Compared with Malang, female adolescents on Kangean were shorter (-1.42±0.79 vs. -0.88±0.79, p<0.001), had lower weight (-1.84±1.40 vs. -0.50±1.18, p=0.00), and lower BMI (-0.84±1.29 vs. 0.069±1.02, p<0.001). Kangayan boys were shorter than those in Arjasa (-1.67±1.00 vs. -0.83±1.36; p<0.001), while Kangayan girls were similar to their counterparts in Arjasa. There were no significant differences in weight between all the Kangan and Arjasa groups, but Kangayan’s children had a higher mean BMI-SDS than Arjasa’s (boys: -0.55±1.45 vs. -1.32±1.52; p=0.009; girls: -0.54±0.94 vs. -1.12 ± 1.04; p=0.01).

Conclusion Living on a small island and the distance from its port differently affect the growth of children and adolescents.

References

Andayani, S./Rahmawati, E./Paramita, N. M. S./Arif, F./Satya, R. C./Wisanggeni, R. L. R. (2023). Social Cohesion of the Sulawesi Community in the Kangean Islands Society. In: Ramayda Akmal/Iping Liang/Vincenz Serrano et al. (Eds.). Proceedings of the Critical Island Studies 2023 Conference (CISC 2023). Paris, Atlantis Press SARL, 184–192. DOI: https://doi.org/10.2991/978-2-38476-186-9_19

Aßmann, C./Hermanussen, M. (2013). Modeling determinants of growth: evidence for a community-based target in height? Pediatric Research 74 (1), 88–95. https://doi.org/10.1038/pr.2013.50. DOI: https://doi.org/10.1038/pr.2013.50

Badan Pusat Statistik Kabupaten Sumenep (2021). Kecamatan Kangayan dalam angka 2021.

Bardosono, S./Sastroamidjojo, S./Lukito, W. (2007). Determinants of child malnutrition during the 1999 economic crisis in selected poor areas of Indonesia. Asia Pacific Journal of Clinical Nutrition 16 (3), 512–526.

Baten, J./Stegl, M./Eng, P. van der (2013). The biological standard of living and body height in colonial and post-colonial Indonesia, 1770–2000. Journal of Bioeconomics 15 (2), 103–122. https://doi.org/10.1007/s10818-012-9144-2. DOI: https://doi.org/10.1007/s10818-012-9144-2

Checkley, W./Gilman, R. H./Black, R. E./Epstein, L. D./Cabrera, L./Sterling, C. R./Moulton, L. H. (2004). Effect of water and sanitation on childhood health in a poor Peruvian peri-urban community. Lancet 363 (9403), 112–118. https://doi.org/10.1016/S0140-6736(03)15261-0. DOI: https://doi.org/10.1016/S0140-6736(03)15261-0

Fahmida, U./Santika, O./Kolopaking, R./Ferguson, E. (2014). Complementary feeding recommendations based on locally available foods in Indonesia. Food and Nutrition Bulletin 35 (4 Suppl), S174-9. https://doi.org/10.1177/15648265140354S302. DOI: https://doi.org/10.1177/15648265140354S302

Fatimah, E. R./Paramita, N. M. S./Andayani, S. (2024). Structural Assimilation of the Bugis Community with the Native on Kangean Island. Jurnal Antropologi: Isu-Isu Sosial Budaya 26 (1), 51. https://doi.org/10.25077/jantro.v26.n1.p51-58.2024. DOI: https://doi.org/10.25077/jantro.v26.n1.p51-58.2024

Grasgruber, P./Sebera, M./Hrazdíra, E./Cacek, J./Kalina, T. (2016). Major correlates of male height: A study of 105 countries. Economics and Human Biology 21, 172–195. https://doi.org/10.1016/j.ehb.2016.01.005. DOI: https://doi.org/10.1016/j.ehb.2016.01.005

Hasibuan, S. N./Djer, M. M./Andarie, A. A./Pulungan, A. B. (2023). International standard growth charts overestimate stunting prevalence in Nabire and Jakarta, Indonesia, compared to the Indonesian national growth chart. Clinical Pediatric Endocrinology 32 (2), 2022-0047. https://doi.org/10.1297/cpe.2022-0047. DOI: https://doi.org/10.1297/cpe.2022-0047

Hasibuan, S. N./Pulungan, A./Scheffler, C./Groth, D./Hermanussen, M. (2020). Environmental stimulation on height: The story from Indonesia. Journal of Clinical and Anthropological Medicine 77 (5), 423–429. https://doi.org/10.1127/anthranz/2020/1209. DOI: https://doi.org/10.1127/anthranz/2020/1209

Hermanussen, M./Bogin, B. (2014). Auxology – an editorial. Italian Journal of Pediatrics 40 (1), 8. https://doi.org/10.1186/1824-7288-40-8. DOI: https://doi.org/10.1186/1824-7288-40-8

Hudiyanto, R. (2007). Pahlawan yang Terlupakan: Pers Melayu, Etnik Thionghoa, dan Nasionalisme di Kota Malang 1920-1950. Humaniora 19, 215–223.

Kusumawardani, H. D./Laksono, A. D./Hidayat, T./Supadmi, S./Latifah, L./Sulasmi, S./Ashar, H./Musoddaq, M. A. (2023). Stunting Among Children Under Two Years in the Islands Areas: A Cross-sectional Study of the Maluku Region in Indonesia, 2021. Journal of Research in Health Sciences 23 (4), e00597. https://doi.org/10.34172/jrhs.2023.132. DOI: https://doi.org/10.34172/jrhs.2023.132

Losada-Rojas, L. L./Ke, Y./Pyrialakou, V. D./Gkritza, K. (2021). Access to healthy food in urban and rural areas: An empirical analysis. Journal of Transport and Health 23, 101245. https://doi.org/10.1016/j.jth.2021.101245. DOI: https://doi.org/10.1016/j.jth.2021.101245

Mavinkurve, M./Azriyanti, A. Z./Jalaludin, M. Y. (2021). The short child: Importance of early detection and timely referrai. Malaysian Family Physician 16 (3), 6–15. https://doi.org/10.51866/rv1157. DOI: https://doi.org/10.51866/rv1157

Premkumar, S./Ramanan, P. V./Lakshmi, J. D. (2019). Rural Childhood Obesity - An Emerging Health Concern. Indian Journal of Endocrinology and Metabolism 23 (3), 289–292. https://doi.org/10.4103/ijem.IJEM_649_18. DOI: https://doi.org/10.4103/ijem.IJEM_649_18

Prendergast, A. J./Humphrey, J. H. (2014). The stunting syndrome in developing countries. Paediatrics and International Child Health 34 (4), 250–265. https://doi.org/10.1179/2046905514Y.0000000158. DOI: https://doi.org/10.1179/2046905514Y.0000000158

Rachmi, C. N./Agho, K. E./Li, M./Baur, L. A. (2016). Stunting, Underweight and Overweight in Children Aged 2.0-4.9 Years in Indonesia: Prevalence Trends and Associated Risk Factors. PLOS one 11 (5), e0154756. https://doi.org/10.1371/journal.pone.0154756. DOI: https://doi.org/10.1371/journal.pone.0154756

Scheffler, C./Hermanussen, M./Bogin, B./Liana, D. S./Taolin, F./Cempaka, P. M. V. P./Irawan, M./Ibbibah, L. F./Mappapa, N. K./Payong, M. K. E./Homalessy, A. V./Takalapeta, A./Apriyanti, S./Manoeroe, M. G./Dupe, F. R./Ratri, R. R. K./Touw, S. Y./K, P. V./Murtani, B. J./Nunuhitu, R./Puspitasari, R./Riandra, I. K./Liwan, A. S./Amandari, P./Permatasari, A. A. I./Julia, M./Batubara, J./Pulungan, A. (2020). Stunting is not a synonym of malnutrition. European Journal of Clinical Nutrition 74 (3), 377–386. https://doi.org/10.1038/s41430-019-0439-4. DOI: https://doi.org/10.1038/s41430-019-0439-4

Semba, R. D./Moench-Pfanner, R./Sun, K./Pee, S. de/Akhter, N./Rah, J. H./Campbell, A. A./Badham, J./Bloem, M. W./Kraemer, K. (2011). Consumption of micronutrient-fortified milk and noodles is associated with lower risk of stunting in preschool-aged children in Indonesia. Food and Nutrition Bulletin 32 (4), 347–353. https://doi.org/10.1177/156482651103200406. DOI: https://doi.org/10.1177/156482651103200406

Semba, R. D./Pee, S. de/Sun, K./Sari, M./Akhter, N./Bloem, M. W. (2008). Effect of parental formal education on risk of child stunting in Indonesia and Bangladesh: a cross-sectional study. The Lancet 371 (9609), 322–328. https://doi.org/10.1016/S0140-6736(08)60169-5. DOI: https://doi.org/10.1016/S0140-6736(08)60169-5

Siswati, T./Susilo, J./Kusnanto, H./Waris, L. (2022). Risk Factors of Mild and Severe Stunting Children in Rural and Urban Areas in Indonesia. Iranian journal of public health 51 (1), 213–215. https://doi.org/10.18502/ijph.v51i1.8316. DOI: https://doi.org/10.18502/ijph.v51i1.8316

Stinson, S. (1985). Sex differences in environmental sensitivity during growth and development. American Journal of Physical Anthropology 28 (S6), 123–147. https://doi.org/10.1002/ajpa.1330280507. DOI: https://doi.org/10.1002/ajpa.1330280507

Stulp, G./Buunk, A. P./Verhulst, S./Pollet, T. V. (2015). Human Height Is Positively Related to Interpersonal Dominance in Dyadic Interactions. PLOS one 10 (2), e0117860. https://doi.org/10.1371/journal.pone.0117860. DOI: https://doi.org/10.1371/journal.pone.0117860

Tauney, B. (2013). in. In: Charles Illouz/Philippe Grangé/Ari Anggari Harapan (Eds.). Kepulauan Kangean : Penelitian Terapan untuk Pembangunan / disunting oleh Charles Illouz & Philippe Grangé ; penerjemah Ari Anggari Harapan [and 8 others]. Jakarta, KPG (Kepustakaan Populer Gramedia).

Torlesse, H./Cronin, A. A./Sebayang, S. K./Nandy, R. (2016). Determinants of stunting in Indonesian children: evidence from a cross-sectional survey indicate a prominent role for the water, sanitation and hygiene sector in stunting reduction. BMC Public Health 16, 669. https://doi.org/10.1186/s12889-016-3339-8. DOI: https://doi.org/10.1186/s12889-016-3339-8

Verma, R./Balhara, Y. P. S./Gupta, C. S. (2011). Gender differences in stress response: Role of developmental and biological determinants. Industrial Psychiatry Journal 20 (1), 4. https://doi.org/10.4103/0972-6748.98407. DOI: https://doi.org/10.4103/0972-6748.98407

Wamani, H./Astrøm, A. N./Peterson, S./Tumwine, J. K./Tylleskär, T. (2007). Boys are more stunted than girls in sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys. BMC Pediatrics 7, 17. https://doi.org/10.1186/1471-2431-7-17. DOI: https://doi.org/10.1186/1471-2431-7-17

WHO (2007). The WHO Child Growth Standards. Available online at https://www.who.int/tools/child-growth-standards/standards (accessed 1/17/2025).

Widyaningsih, V./Mulyaningsih, T./Rahmawati, F. N./Adhitya, D. (2022). Determinants of socioeconomic and rural-urban disparities in stunting: evidence from Indonesia. Rural and Remote Health 22 (1), 7082. https://doi.org/10.22605/RRH7082. DOI: https://doi.org/10.22605/RRH7082