Development, and Maturation: Findings From the Ten-State Nutrition Survey of 1968-1970

The Ten-State Nutrition Survey of 1968-1970, originally designated as the National Nutrition Survey, was the first and by all means the most comprehensive attempt to survey the nutritional status of Americans at all age levels. By way of illustrative numbers, 86,352 individuals were contacted; 40,847 participants were studied from an anthropometric, dietary, or biochemical point of view; and data on nearly 16,000 participants in the pediatric age group were collected and analyzed. More than 53 million bits of coded health information were acquired on infants, children, and adolescents alone. By act of Congress, primary attention was given to “the incidence and location of serious hunger and malnutrition and health problems incident thereto in the United States.”l This means that the study was to pay particular attenlion to the poor, to people in poverty areas, and to the racial and ethnic groups most likely to be exposed to the culture of poverty, undernutrition, and malnutrition. The sample used for study was primarily to be drawn from the lower half of the income spectrum and with the lowest incomes disproportionately represented. The history of the Ten-State Nutrition Survey is a complicated one. It began with the amendments approved by Congress on December 5, 1967, but without appropriations. The survey was then initiated in several states during 1968, and responsibility for coordination of data analysis was transferred to the Nutrition Program, Center for Disease Control. The Nutrition Program was abolished in 1972, long before all of the data could be fully analyzed or even partially reported. The findings of the Ten-State Nutrition Survey, we find, go far beyond the original expectations. We worked with original data tapes and reexamined the data state by state and variable by variable, and we had opportunities for careful comparisons. We now have three major statements to make. First, the Ten-State data (from ten states and New York City) do not show evidence of acute Biafra-type malnutrition, even in the lowest (below-poverty) income groupings. Second, the data show remarkably consistent socioeconomic effects on size, growth, and development that have major bearing on the nation’s health and the national welfare. Third, the findings have broad implications for our knowledge of growth and development. The applicability of many presently used “norms” are questioned, and new needs both for information and application are evident.