Height inequalities and change trends among Chinese children and adolescents aged 718 years from 1985 to 2019.

BackgroundGreat health inequalities have been reported in China over the past few years. Height has been used as an important parameter of health and it may also be distributed unequally in different regions. By studying height data of Chinese children and adolescents aged 7 to 18 years, we analyze height inequalities and their change trends during 1985–2010.MethodsOn the base of data from 6 successive cross-sectional surveys of the Chinese National Survey on Student’s Constitution and Health(CNSSCH) conducted in 1985,1991,1995,2000,2005 and 2010, we calculated difference of height for children and adolescents aged 7–18 years in different regions. Coefficients of Variation (CVs) of height were computed in urban and rural areas during 1985–2010.ResultsGreat height difference existed between urban and rural, eastern and western, Shanghai and Guizhou children and adolescents aged 7–18 years. The urban-rural difference averagely decreased from 4.24 cm to 2.85 cm for boys and 3.72 cm to 1.31 cm for girls since 1985. Urban-rural difference tend to be more obvious in the poorer provinces, which has short mean statures. From 1985 to 2010, height difference became larger in eastern-western and Shanghai-Guizhou which represented the comparison between the richest and poorest regions. We also found there was a larger height inequality in rural areas compared with that in urban areas, and difference in rural subjects increased greater than their urban peers in eastern-western and Shanghai-Guizhou.ConclusionsThere were obvious height inequalities in China and the urban-rural difference narrowed, while increasing differences happened between regions with different socioeconomic levels especially in their rural residents. More attention should be paid to these differences and policies and strategies should be developed to reduce inequalities in height.

Height development trends among 7-18-year-old school-age children in central plains of China between 2000 and 2019: A serial cross-sectional surveillance study in China.

To analyze the intakes of main food among the children of 6-17 years in different regions of China from 2019 to 2021, and to provide a scientific basis for evaluation and guiding Chinese children to make reasonable diet. Multistage stratified random sampling method was used to collect data in east China, north China, central China, south China, southwest, northwest and northeast seven areas of each random two provinces, randomly selected from each province one urban survey site and one rural survey site, 28 sites of the 13th Five Year National Science and Technology Basic Resources Survey Project-Chinese children aged 0-18 investigation and application of nutrition and health system in 14 provinces of China. The study included 6413 children aged 6 to 17. Three consecutive 24-hour recalls method combined with weighing were used to collect the information of food intake. According to the food classification in the standard version of the food composition list, the food was divided into cereals, tubers, fresh vegetables, fresh fruits, meat and poultry, fish and shrimp, eggs, milk, etc. , and the intake of various foods was calculated for boys and girls aged 6-8, 9-11, 12-14 and 15-17 in different regions. Compared with the average daily food intake of children of the same sex and age in the urban and rural, The average daily intake of cereals and tubers for boys aged 9-17, cereals for girls aged 9-17, tubers for girls aged 12-17, and fish and shrimp for boys of edible population aged 15-17 were higher in rural areas than in urban areas. There were differences in the average daily food intake and consumption rate of fresh vegetables, fresh fruits, meat and poultry, eggs and milk of the same sex and age, which were higher in urban than in rural areas(P<0.05). Compared with the average daily food intake of children of the same sex and age in the south and the north, the average daily intake of cereals and eggs for boys aged 9-14, cereals for girls aged 6-8, and fresh fruits for boys and girls of edible population aged 6-17 were higher in the north than in the south. There were differences in average daily intake and consumption rates of tubers, fresh vegetables, meat and poultry, milk and fish and shrimp of the same sex and age, which were higher in the south than in the north(P<0.05). Compared with the average daily food intake of children of the same sex and age in the eastern, central and western regions, the average daily intake of cereals for boys aged 6-14, cereals for girls aged 6-17, fresh fruits for boys and girls of edible population aged 6-17, and fish and shrimp for boys and girls of edible population aged 15-17 were lower in the eastern region than in the central and western regions. The average daily intake of tubers for boys aged 9-11 and 15-17, for girls aged 9-17 were higher in the western regions than the eastern and central regions. The average daily intake of eggs for boys and girls aged 12-17 was lower in western regions than the eastern and central regions. There were differences in average daily intake and consumption rates of fresh vegetables, meat and poultry and milk of the same sex and age, which were higher in the eastern region than in the central and western regions. (P<0.05). The proportion of coarse grains to cereals was low, between 3.7% and 10.1%. The proportion of pork to meat and poultry was high, between 56.1% and 71.4%. In China, there are differences in daily intake of main food for children aged 6 to 17 years old in urban and rural areas, north and south areas, east, central and west areas.

This study aims to assess the secular changes in height of Chinese rural children and adolescents aged 718 years from 1985 to 2019. Height data for Chinese children and adolescents aged 718 years were obtained from the Chinese National Surveillance on Students Constitution and Health in 1985, 1995, 2005, 2014 and 2019. All provinces were divided into eastern, central, and western regions of China. T-tests were used to measure the differences in height between boys and girls by survey year. The height of rural children and adolescents aged 718 years in rural China increased progressively from 1985 to 2019. The average increase in height for boys and girls was 3.03 cm per decade and 2.37 cm per decade. There were geographical differences in the increase in height. The secular trend in height was most remarkable in the first 10 years, thereafter the increase in height slowed down, especially in the eastern region. The greatest increase in height for both boys and girls was observed in the central region, at 3.19 cm per decade and 2.54 cm per decade, respectively, during the entire period. The smallest increase in height was observed in the western region, at 2.80 cm per decade and 2.21 cm per decade during the entire period. However, the increase in height of boys and girls in the western regions (boys: 1.93 cm per decade; girls: 1.52 cm per decade) has been greater than in the central (1.47 cm and 1.31 cm per decade) and western regions (0.94 cm and 0.76 cm per decade) in the last five years. In conclusion, during the entire 34 years, the height of Chinese rural children and adolescents aged 718 years has continued to increase. More attention needs to be focused on the growth and development of children and adolescents in the western regions.

Beginning in 1978, China implemented economic reforms to transform the economy to a free-market system. We compared the effect of the reforms on the growth of children in urban and rural areas. Using data from five large cross-sectional surveys conducted between 1975 and 1992, we examined the trends in height for age of children two to five years of age in urban and rural areas. Mean height for age was expressed as the height in centimeters adjusted to a reference value of 99.1 cm for a 42-month-old boy. Height increased before and during the economic reforms. In 1975, the average height of children in periurban rural areas was about 3.5 cm less than that of children in urban areas. Between 1975 and 1985, the average height of children in periurban rural areas increased by 2.0 cm, as compared with 1.3 cm in urban children. Between 1987 and 1992, the average height of both urban and rural children increased, but the net increase for rural children was only one fifth that for urban children (0.5 vs. 2.5 cm). In a 1990 survey of seven provinces, the rural mean height was 92.5 cm, as compared with the urban mean of 96.9 cm and the reference value of 99.1 cm; 38 percent of rural children had moderate stunting of growth and 15 percent had severe stunting, as compared with 10 percent and 3 percent of urban children, respectively. Differences in height between rural and urban children were greater in provinces in which the average height of children was lower. Despite an overall improvement in child growth during the economic reforms in China, the improvement has not been equitable, as judged by increased differences in height between rural and urban children and increased disparities within rural area.

Trends in Physical Fitness Among 12-Year-Old Children in Urban and Rural Areas During the Social Transformation Period in China

Objective: To investigate and analyze the status of physical growth and its change in children under 7 years of age in 9 cities of China, and to provide scientific data for renewing and developing the new growth reference of Chinese children. Methods: Data of healthy children under 7 years of age were collected by stratified cluster sampling method in Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou and Kunming during the period from June to November in 2015. They were divided into 22 age groups. The sample size of boys or girls, urban or suburban was 150-200 in each age group in each city, and the total sample size in the 9 cities was 161 774. Weight, length/height, head circumference, sitting height, chest circumference and waist circumference were measured by the trained investigators using standard methods. There were strict quality control measures during investigation process. The t test was used to compare the difference of physical growth between two groups and one-way ANOVA was used to compare the difference of physical growth among three groups. Results: (1) The level of physical growth of children under 7 years were different between boys and girls, urban and suburban, as well as different regions of China in 2015. The urban-suburban difference was more significant in children older than 8 months, that is, the weight and height of urban children were greater than those of suburban children (0.01-0.48 kg and 0.1-1.1 cm respectively). (2) Weight and height of children in the 9 cities, whether urban or suburban areas, had been greater than WHO growth standards, for example, the Z-scores of height values of urban and suburban children were 0.43 ±0.99 (t=130.551, P<0.05) and 0.30 ±1.01 (t=87.407, P<0.05) higher than the WHO standards. (3) The physical growth of children in the 9 cities was improved in varying degrees during the past 10 years. For example, the changes of weight and height in urban children under 3 years were not significant, while there was significant improvement among children older than 3 years and the increasing trend became apparent along with the increasing of age (0.05-1.18 kg in weight and 0.5-1.8 cm in height). The urban-suburban difference of physical growth in each age group of boys and girls narrowed significantly during the past 10 years, which was clearly shown from the narrowing urban-suburban differences of weight and height in boys aged 5.5-<6.0 years (1.58 kg in 2005 vs. 0.44 kg in 2015 and 2.8 cm in 2005 vs. 0.9 cm in 2015) . (4) From the increments of each decade during 1975-2015, a rapid increments of physical growth during 1975-2005 were found, while the increments after 2005 had slowed comparing with that of the previous period in urban areas, for example, the increments of height in boys aged 5.5-<6.0 years were 1.5, 2.1, 2.7, 0.7 cm respectively in the 1(st), 2(nd), 3(rd) and 4(th) decade (1975-1985, 1985-1995, 1995-2005, 2005-2015) . In suburban areas, the trends of the previous 3 decades were similar with that of urban children, while the increments of the 4(th) decade were still bigger though they were slightly smaller than those of the 3(rd) decade, for example, the increments of height in boys aged 5.5-<6.0 years were 2.4, 2.3, 3.2, 2.6 cm in the 1(st), 2(nd), 3(rd) and 4(th) decade respectively. Conclusions: Physical growth of children under 7 years of age showed a slow positive secular trend during the last decade after a rapid increase. The increments of suburban children's physical growth were greater than those of urban children. The physical growth of children under 7 years in 9 Chinese cities exceeded the WHO standards.

Our study use the height and weight data of Chinese students aged 7-18 years from 1985 to 2014 to investigate the inequality and changing trend of height and weight of children and adolescents in different regions. Our study extracted data from the 1985, 2000, and 2014 Chinese National Survey on Students' Constitution and Health (CNSSCH) for a comparative analysis of the height and weight of children and adolescents aged 7-18 years in a developed city (Shanghai) and an underdeveloped province (Guizhou). The coefficients of variation (CVs) of height and weight between urban and rural boys and girls were also calculated. Since 1985, the height difference between urban and rural areas has decreased from 4.24 to 2.41 cm for boys and 3.72 to 1.99 cm for girls. The weight difference for boys and girls increased from 1.83 to 3.10kg and from 0.97 to 1.80 kg, respectively. However, from 1985 to 2014, the height and weight differences between Shanghai and Guizhou increased. In addition, from 1985 to 2014, the coefficient of height variation was greater for rural students than urban students while the coefficient of weight variation was greater for urban students than rural students. Although the difference between urban and rural areas has recently decreased, the difference between developed area (Shanghai) and underdeveloped area (Guizhou) has increased. In particular, the difference in height and weight between children in developed areas (Shanghai) and non-developed areas (Guizhou) has become larger since 1985-2014, rather than gradually decreasing over time.

Objective: To analyze the gender difference in secular trends of body height in Chinese Han adolescents aged 18 years from 1985 to 2014. Methods: Data were extracted from 1985, 1995, 2000, 2005, 2010 and 2014 Chinese National Surveys in Students' Constitution and Health. A total of 124 099 Chinese Han adolescents aged 18 years were included in the analysis. ANOVA test was used to compare the body height between different subgroups stratified by gender and the mean difference and ratio in body height were calculated. Quantile regression model was used to assess the association between body height and gender over time in the adolescents stratified by region or area. Results: The mean body height of adolescents aged 18 years increased significantly from 1985 to 2014 with the rate of 1.3 cm/decade in male adolescents and 0.8 cm/decade in female adolescents, and the highest increment occurred from 1995 to 2005 in both groups. Male adolescents were taller than female adolescents at each subgroup (P<0.05). Gender difference in body height increased from 11.1 cm in 1985 to 12.6 cm in 2014 and ratio remained to be 1.07-1.08. The body height was taller in adolescents in urban area than in rural area (P<0.05) and in northeastern China than in other regions (P<0.05) in both male and female adolescents. The body height of obese male adolescents had been taller since 2000 and the body height of obese female adolescents had been taller since 2010 than other groups. When adjusted for urban-rural areas, region, socioeconomic status and nutritional status, the body height increased over time at P5, P25, P50, P75 and P95 in both male and female adolescents, and the increments of gender difference in body height at different percentile ranged from 0.45 cm/decade to 0.57 cm/decade. When stratified by region, the gender difference in body height showed similar trend with total sample except P5 and P95 in northeastern China, the difference of increments were not significant. Conclusions: From 1985 to 2014, the gender difference in body height of Chinese Han adolescents aged 18 years increased, and male adolescents showed greater increase than female adolescents. Moreover, the adolescents in northeastern and eastern China had larger increment in body height. It is necessary to paid more attention to the adolescents in central and western China to promote their physical development.

A new surveillance system was initiated on selected growth and nutritional characteristics of children living in inner-city areas and children from ethnic minorities. The heights of Caucasian, Afro-Caribbean and Indo-Pakistani children in this study were compared with those of children in an existing surveillance study, who were chosen to be representative of the English population. Data for this representative sample were collected in 1982 and for the ethnic groups in inner city areas in 1983. The analysis included 13,107 boys and girls aged 5-11 years. Very large differences in height were detected between ethnic groups. The Afro-Caribbean children were the tallest, on average around 3.5 cm taller than the 1982 sample, while the Gujarati children were the shortest, on average about 3 cm below the 1982 sample. Adjustment for a large set of biological and social variables did not eliminate differences in height between ethnic groups. This would indicate that the use of British standards of height based on Caucasian children to assess growth of a child of another ethnic group in England should be interpreted with caution. Multiple regression analyses by ethnic group revealed differences in the pattern of associations between height and social and biological factors among groups. Generalizations from findings in one ethnic group to another in England are not appropriate.

BackgroundEquity is one of the major goals of China’s new medical reforms launched in 2009. This study aimed to analyze the disequilibrium in primary health care (PHC) workforce among various economic zones in China and to compare the fairness between urban and rural areas since the implementation of the new medical reforms.MethodAccording to China’s 11th Five-Year Plan, China is divided into eight economic regions. The data of this study were obtained from China Statistical Yearbook 2009–2016. The Atkinson index was used to depict the trend of PHC workforce fairness; the Gini coefficient was used to compare the fairness of workforce distribution between urban and rural areas; the health resource agglomeration degree was used to analyze the distributional equity of the workforce in the eight regions; and the Theil Index was used to compare the fairness of urban and rural workforce distribution across eight regions.ResultThe Atkinson index indicated that the equity of the entire PHC workforce allocation had generally improved during the new medical reforms; the Gini coefficient indicated that the fairness of the entire workforce allocation had improved in cities, but only the nurse allocation became fairer in rural areas. The agglomeration degree and the Theil index indicated that the fairness gaps across the eight regions were still large. These analyses differed from previous studies where China was divided into western, central and eastern regions. In what was previously defined as eastern region, the northeast was under-resourced, while the eastern coastal areas were observing a resource surplus. In western region, we found that the fairness in the northwest was significantly worse than southwest.ConclusionIn China, the distribution of healthcare workforce has been improved with continuous effort. The gaps in the distribution of PHC workforce across different economic regions and between urban and rural areas are still large, with different regions facing different problems. The government should consider the population and geographical factors in allocation of PHC workforce, especially nurses.

To examine the secular trends and urban-rural disparities in height of Chinese adolescents aged 18 years from 1985 to 2019. Data were extracted from the Chinese National Surveys on Students' Constitution and Health from 1985 to 2019, and the heights of a total of 76 554 boys and 75 908 girls aged 18 years were measured. The Mann-Kendall trend test was used to analyze the secular trends in height. Changes in different periods and urban-rural disparities were tested by z-tests and calculating the ratios of the coefficient of variation (CV) of height. The height of Chinese boys and girls aged 18 years increased from 168.21 and 157.10 cm in 1985 to 172.15 cm and 160.11 cm in 2019, respectively, with a larger increase in rural areas. The secular trends in height were the largest for boys from 1995 to 2005 and for girls from 2014 to 2019, and the same results were observed in urban and rural areas. The urban-rural disparities for boys and girls decreased by 1.79 and 0.91 cm, respectively, with significant decreases for boys in all regions and for girls in the eastern region. The overall CVs of height increased by 0.13% and 0.25% for boys and girls, respectively, with the largest increase among rural girls. The height of Chinese adolescents aged 18 years continued to increase between 1985 and 2019. The urban-rural disparities narrowed, and inequalities within rural areas for girls increased.

The commercial residential industry has high added value and comprehensive economic benefit so the commercial residential industry is naturally a hot-spot issue. The core issue of the commercial housing is the price. This thesis conducts the descriptive statistic analysis of residential real estate prices, urban resident income and other relevant data in China’s 30 provinces (excluding Tibet) from 1998 to 2006. The change trend and the difference feature of both the residential real estate price and the urban resident income in those regions are revealed, which is expected to make a contribution to the macro-control in China’s real estate. In recent years, the real estate market in China is growing rapidly. On the one hand, it plays a vital role in both promoting the national economic growth and improving the living standards of urban residents. On the other hand, some problems in the development of China’s current real estate market have been fully exposed, such as the overheated investment, the unbalance in supply and demand, insufficient financing channels, soaring property prices and so on. In particular, the rapid growth in the housing price has brought challenges to the sound development in both China’s real estate market and the whole national economy and it has also become a hot-spot and difficult issue in the current academia. Such relevant research as whether the rapid growth of China’s housing prices has become disjointed with resident income seriously or not and what the rules of the changes in income and housing prices in China’s different regions are is realistically significant for guiding the micro-control in China’s real estate. I. Index Selection and Disposal of Comparability The samples selected in this thesis are composed of the fluctuating residential real estate prices in China’s 30 provinces (excluding Tibet) from 1998 to 2006, urban resident income and other relevant panel data that are from various years of China Statistical Yearbook. The data of the real estate prices adopts the real estate prices in urban areas. The income indexes adopt the annual per capita disposable income of urban residents. In order to remove the impacts of the price and make indexes of various types had comparability in time series, the disposal of comparability has been conducted in indexes of different types in the thesis and their present value has been turned into the value of the constant price, namely, on the basis of the constant price in 1998, the concrete calculation method is that the housing price is deflated by the housing sales price index and the disposable income is deflated by the consumer price index of urban residents. II. Analysis of Commercial Housing Price Variance among Provinces According to the average housing prices and their growth rates in provinces from 1998 to 2006, thirty provinces, cities and autonomous regions across the country can be divided into three types in accordance with the mean and the growth rate of their average housing prices. It’s found that the provinces, cities and autonomous regions of the three types also have common in geographic areas so they can be divided into such three regions as the eastern region, the central region and the western region on the basis of their geographic areas. For the regional division of the average housing price in China, Figure 1 compares the changes in the average housing prices in the central, western and eastern regions from 1998 to 2006. It’s found that the average housing price in the east is prominently higher than those in the western and International Conference on Education Technology, Management and Humanities Science (ETMHS 2015) © 2015. The authors Published by Atlantis Press 1100 central regions and the trend of its average housing prices is on the rise. In particular, the rising trend of the average housing prices is obvious after 2004. The changes in the average housing prices in eastern and western regions are comparatively similar. However, the average prices in the central region are rising slowly while for the western region, a small decline also appears in its slightly rising process. Besides, the average housing prices in the eastern region surpass those in the western region after 2004. III. Analysis of the Differences in the Income Change among Regions Figure 1: Changes in the housing prices in the central, eastern and western regions Figure 2: Changes in the income in the central, eastern and western regions For the regional division of the average housing price in China, Figure 2 compares the changes in the income in the central, western and eastern regions from 1998 to 2006. It’s found that the per capita income in the east is prominently higher than those in the western and central regions and its trend is uniformly on the rise.

Objective: The epidemiological characteristics of tuberculosis deaths among Chinese residents from 2006 to 2021 were analyzed, and the tuberculosis mortality rate from 2022 to 2027 was predicted to provide a reference for tuberculosis prevention and control in China. Methods: The data set of tuberculosis deaths from 2006 to 2021 was published regularly by the China CDC, and the crude mortality rate (CMR) and age-standardized mortality rates (ASMR) were calculated according to the population structure of China in 2000. The distribution characteristics of age, sex, region, and time of tuberculosis deaths were analyzed, the Joinpoint regression analysis model was used to analyze the changing trend, and the grey model was applied to predict CMR and ASMR from 2022 to 2027. Results: From 2006 to 2021, the CMR and ASMR of tuberculosis showed a downward trend among males and females, urban and rural areas, and all age groups, in a word, all the Chinese residents. Except for the age group ≥85 years old, the mortality trend was insignificant. In the eastern, central, or western regions. CMR and ASMR were significantly higher in males than in females.CMR and ASMR were significantly lower in urban areas than in rural areas. In general, active tuberculosis patients present a higher mortality rate. The CMR and ASMR in the western region were higher than those in the eastern and central regions and lower in the eastern region than in the central region, but the differences were less obvious. The ASMR of the eastern cities was lower than that of the central and western regions, and the ASMR of the central cities was higher than that of the western region from 2006 to 2009 and 2012 and lower than that of the western region in other years. The ASMR in the western countryside was higher than that in the eastern and central regions and lower in the eastern part than in the central region, but the difference was not obvious. The grey model prediction results show that the CMR (/100 000) of Chinese residents from 2022 to 2027 is 1.585, 1.471, 1.360, 1.250, 1.143, and 1.038, and the ASMR (/100 000) is 0.779, 0.653, 0.531, 0.411, 0.295 and 0.181, respectively. Conclusions: The CMR and ASMR of tuberculosis will continue to decline, and extraordinary achievements have been made in tuberculosis prevention and control in Chinese residents from 2006 to 2021 and, presumably, from 2022 to 2027. However, tuberculosis screening and treatment programs in the western region, men, the elderly population, and rural areas should be further strengthened, and targeted prevention and control measures should be formulated to reduce mortality.

SummaryBackgroundUrban living affects children's nutrition and growth, which are determinants of their survival, cognitive development, and lifelong health. Little is known about urban–rural differences in children's height and weight, and how these differences have changed over time. We aimed to investigate trends in children's height and weight in rural and urban settings in low-income and middle-income countries, and to assess changes in the urban–rural differentials in height and weight over time.MethodsWe used comprehensive population-based data and a Bayesian hierarchical mixture model to estimate trends in children's height-for-age and weight-for-age Z scores by rural and urban place of residence, and changes in urban–rural differentials in height and weight Z scores, for 141 low-income and middle-income countries between 1985 and 2011. We also estimated the contribution of changes in rural and urban height and weight, and that of urbanisation, to the regional trends in these outcomes.FindingsUrban children are taller and heavier than their rural counterparts in almost all low-income and middle-income countries. The urban–rural differential is largest in Andean and central Latin America (eg, Peru, Honduras, Bolivia, and Guatemala); in some African countries such as Niger, Burundi, and Burkina Faso; and in Vietnam and China. It is smallest in southern and tropical Latin America (eg, Chile and Brazil). Urban children in China, Chile, and Jamaica are the tallest in low-income and middle-income countries, and children in rural areas of Burundi, Guatemala, and Niger the shortest, with the tallest and shortest more than 10 cm apart at age 5 years. The heaviest children live in cities in Georgia, Chile, and China, and the most underweight in rural areas of Timor-Leste, India, Niger, and Bangladesh. Between 1985 and 2011, the urban advantage in height fell in southern and tropical Latin America and south Asia, but changed little or not at all in most other regions. The urban–rural weight differential also decreased in southern and tropical Latin America, but increased in east and southeast Asia and worldwide, because weight gain of urban children outpaced that of rural children.InterpretationFurther improvement of child nutrition will require improved access to a stable and affordable food supply and health care for both rural and urban children, and closing of the the urban–rural gap in nutritional status.FundingBill & Melinda Gates Foundation, Grand Challenges Canada, UK Medical Research Council.