Thursday, August 31, 2006

I just saw a CNN story called "High Price to Get Taller." It talked about the controversy of using human growth hormone in an attempt to make healthy short kids taller. Click here for the video clip: http://www.cnn.com/video/partners/clickability/index.html?url=/video/health/2006/08/31/cohen.paying.for.growth.hormone.affl

Bravo to bioethicist Lori Andrews who discussed the ethical problems of turning healthy short children into patients in need of a medical treatment. I agree with her belief that self-esteem doesn't come from buying inches. I understand, though, why parents would want to do what they can to help their short children grow taller. The fact that heightism is rampant in our culture influences many people to use growth hormone in an attempt to deal with the prejudice against short people. But in my opinion, the way to deal with heightism is to educate those who discriminate against short people, rather than trying to physically alter the victims of that prejudice.

Moreover, what the CNN story fails to mention, was that studies have shown that treatment with human growth hormone does not always translate into increased inches for the person undergoing the treatment, and that it looks like many recipients of growth hormone reach their adult height faster (so the rate of their growth is increased) but not taller. The young boy in the story who has gained 3 extra inches so far in treatment will not necessarily become 3 inches taller than his predicted adult height (and predicted height has a plus or minus 3 inch range). Also, the story reports that an extra inch costs about $50,000, which is true, and that if you want 4 extra inches, it will cost you $200,000. But studies show that for those children who do grow taller from the treatments, they add an average of one to one and a half extra inches...more money for treatment years does not translate into more inches. You can't just place an order for a particular height.

In addition, they CNN noted some potential side effects such as headaches and scoliosis but failed to mention the may potential adverse consequences of growth hormone therapy including: impaired glucose tolereance, diabetes, pseudotumor cerebri (a condition of the brain simulating the presence of an intracranial tumor), severe kidney damage, hypertension, and spontaneuos bone fractures. A small percentage of patients can be expected to form antibodies against growth hormone that can interfere with growth. Short-term acceleration of growth from human growth hormone therapy may hasten puberty and bone aging so that final adult height may actually be less than what it would have been without intervention. Similarly, stopping treatment before adult height is reached may render the child shorter than he/she would have been without treatment.
Finally, growth hormone causes the liver to manafacture chemicals that have effects on various parts of the body. One of the chemicals, insulin-like growth factor (IGF-1) is thought to play a role in breast cell growth and many doctors are concerned about a possible connection with the development of breast cancer. Human growth hormone (the synthetic version) has only been in use since 1985, and many children receiving this treatment do so for an average of 5-10 years. There has been insufficient time to determine potential long term consequences. Remember, the child is being subjected to these potentially serious effects when there is nothing physically wrong with him/her. They are healthy short children who live in a culture who is biased against short people.

Another point I want to make, is that the child they featured who had a predicted adult height of 5 feet 5 inches tall, and has grown 3 inches since he's been using human growth hormone. In 2003, the FDA approved the use of human growth hormone in healthy short children who had a predicted adult height of less that 5 feet 3 inches tall for men and 4 feet 11 inches for women. Therefore, the child did not meet the criteria set by the FDA, (a concern because more and more short people are being considered in need of treatment) and his treatment is even being covered by his insurance! (What about all the uninsured children in the U.S. who have no health care?)

CNN did a good job of showing some of the ehtical debate of using growth hormone with healthy short children, but with the above mentioned concerns about what they didn't highlight, I think people will come away with the idea that human growth hormone treatment is a safe and effective way of increasing height.

For me there is only one solution. We must confront heightism as a social issue, and not medicalize the victims of height prejudice.

New study claims taller people are smarter

Well folks, heightism is unfortunately alive and well. A new study by Princeton economists claim that taller people are smarter than shorter people and that the findings justify higher pay for more height. Here is an MSNBC article about the study and its findings:

Taller people are smarter, too, study says
Princeton economists say findings justify better pay for more height
Reuters
Updated: 6:40 p.m. ET Aug 25, 2006

NEW YORK - While researchers have long shown that tall people earn more than their shorter counterparts, it’s not only social discrimination that accounts for this inequality — tall people are just smarter than their height-challenged peers, a new study finds.
“As early as age 3 — before schooling has had a chance to play a role —and throughout childhood, taller children perform significantly better on cognitive tests,” wrote Anne Case and Christina Paxson of Princeton University in a paper published by the National Bureau of Economic Research.
The findings were based primarily on two British studies that followed children born in 1958 and 1970, respectively, through adulthood and a U.S. study on height and occupational choice.
Other studies have pointed to low self-esteem, better health that accompanies greater height, and social discrimination as culprits for lower pay for shorter people.
But researchers Case and Paxson believe the height advantage in the job world is more than just a question of image.
“As adults, taller individuals are more likely to select into higher paying occupations that require more advanced verbal and numerical skills and greater intelligence, for which they earn handsome returns,” they wrote.
For both men and women in the United States and the United Kingdom, a height advantage of four inches equated with a 10 percent increase in wages on average.
But the researchers said the differences in performance crop up long before the tall people enter the job force. Prenatal care and the time between birth and age 3 are critical periods for determining future cognitive ability and height.
“The speed of growth is more rapid during this period than at any other during the life course, and nutritional needs are greatest at this point,” the researchers wrote.
The research confirms previous studies that show that early nutrition is an important predictor of intelligence and height.
“Prenatal care and prenatal nutrition are just incredibly important, even more so than we already knew,” Case said in an interview.
Since the study’s data only included populations in the United Kingdom and the United States, the findings could not be applied to other regions, Case said.
And how tall are the researchers?
They are both about 5 feet 8 inches tall, well above the average height of 5 feet 4 inches for American women.
A copy of the paper can be found by clicking here.
Copyright 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content is
URL: http://www.msnbc.msn.com/id/14517687/


Okay, let's get this straight. The researchers explain that early nutrition is an important predictor of both intelligence and height. That makes sense, but then the problem to address would be adequate nutrition as it affects both intelligence and height, not the spurious conclusion that taller people are smarter. Moreover, children who have access to adequate nutrition will still be different heights as a result of genetic make-up. The bell-shaped curve for height attests to the fact that while children may grow at the same speed, they grow at different percentiles. To conclude that the child growing an average of 2 inches per year at the 75% is better off than the child growing an average of 2 inches per year at the 5% is based on heightist notions. The deeply ingrained heightism so pervasive in our culture and in the work force makes it easy for people to make assumptions that short people are inherently inferior rather than looking at the societal forces that lead to such discrimination. There was a study by David Kurtz, an Eastern Michigan University marketing professor. He asked 140 recruits to make a hypothetical hiring choice between two equally qualified applicants, one 6 feet 1 inch tall, and the other 5 feet 5 inches tall, for a sales job. Seventy-two percent "hired" the tall one, twenty-seven percent expressed no preference, and one percent chose the short one. This has nothing to do with actual intelligence and everything to do with heightism. This study by the Princeton economists is reminiscent of Arthur Jenson’s conclusions back in 1969 when he published an article in the Harvard Educational Review maintaining the whites are genetically superior in intelligence to blacks. We understand racism. It’s time we take a serious look at heightism.