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The socioeconomic status of a child’s family, their race as a marker of genetic traits, and family cultural practices all influence the physical growth of children. Understanding the importance of these three factors can help clinicians recognize the wide range of growth variations found in a diverse pediatric population. This review examines these factors in relationship to the adiposity epidemic in developed countries; changes in growth patterns of refugee and immigrant children whose families relocate to developed countries; and racial differences in physical manifestations of puberty, skeletal growth, and bone density.

As each of these areas is reviewed, it will be apparent that some unhealthy growth variations affect minority and low-income children disproportionately. Further, many pediatric growth norms have been based on data from European populations that are not representative of the world’s diverse population and must be modified when applied...

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