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Is taller better?

Even as kids are treated for extreme shortness, new research challenges what we know, or think we know, about stature and its advantages.

January 15, 2007|Susan Brink | Times Staff Writer

CONVENTIONAL wisdom has it that taller men make more money, get more dates and are more likely to win a presidential election. Shorter women aren't taken seriously, and boys and girls both suffer psychologically well into adulthood if they've grown up the shortest in their class. Right?

Well, maybe ... or maybe not. What people thought they knew about the height advantage doesn't always hold up to the cold eye of psychological and sociological research. Experts are digging deeper into data on the consequences of shortness, and though recent studies validate some of society's long-held assumptions about height, others are getting chipped away -- even dismissed.

"There is little or no evidence that making short people taller changes their lives in any meaningful way," says Dr. Norman Fost, professor of pediatrics and bioethics at the University of Wisconsin Medical School.

The reality of the relative advantages of being tall is increasingly important because in 2003 the Food and Drug Administration approved the use of synthetic growth hormone for kids with idiopathic short stature, or shortness for no apparent medical reason.

The treatment, an injection every day for many years, is expensive and not consistently covered by insurers. The average benefits -- an increase of about 2 inches in height -- are modest. Although no one expects ill health consequences down the road, no one really knows for sure what might happen. And critics say all this risk and expense is aimed at altering healthy children who are objects of social prejudice, rather than attacking the prejudice itself.

There's little doubt that short kids get teased, even occasionally ridiculed. But most grow up to do just as well as their taller taunters. Take the common perception that employers discriminate against short men in hiring and income. That isn't exactly what happens. It turns out the much-touted income advantage of height is more closely linked to high school experiences than to hiring practices in the adult workplace. And when brothers are studied, one tall and one short, the two have exactly the same employment opportunities and income, regardless of height.

"There's still a widespread perception that male success is measured in stature," says Dalton C. Conley, chairman of the sociology department at New York University. "But in terms of total income, earnings and occupational outcomes, the male height issue is really a red herring."

Other widely held notions about short people do hold up. Based on history, there can be no doubt that Americans like their presidents tall. And on the dating scene, women go for taller men. When it comes to romance, height is often a deal-breaker.

Children who can be treated for idiopathic short stature are the shortest 1.2%, measuring 2.25 or more standard deviations below the mean, according to FDA guidelines. That translates, for 10-year-old boys and girls, to 4 feet, 1 inch and to a projected adult height of less than 4 feet, 11 inches for females and less than 5 feet, 3 inches for males.

Some of these children are short simply because both parents are short. But, the FDA panel reasoned, maybe the parents, grandparents and on down the family line were short for some as-yet-unidentified medical reason. If children of short stature with a known medical diagnosis, such as growth hormone deficiency, can be treated to help them grow taller, children whose very short stature has no presently known cause should be allowed treatment too, it said.

Treatment with growth hormone helps some, but not all, children grow taller. Medical tests cannot predict in advance which children will respond. In general, growth hormone works best when started younger, given in higher doses and administered for longer periods of time. On average, treatment helps children grow a little taller -- but not much. An analysis of studies published in 2002 in the Archives of Pediatric & Adolescent Medicine found that children with idiopathic short stature who were given growth hormone for an average of 5.3 years had an average gain of 1.6 to 2.4 inches in height over what had been predicted when they began the drug.

The added height comes at a cost of $52,634 per gained inch, according to a study in the March 2006 issue of the same journal. About 410,000 U.S. children qualify under the FDA guidelines. If they were all treated with growth hormone, the total healthcare cost would be more than $8 billion a year, wrote Dr. Leona Cuttler, pediatric endocrinologist at Rainbow Babies and Childrens Hospital in Cleveland, in a February 2004 editorial in the journal.

Beating the odds

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