Luo D M, Yan X J, Lei Y T, Hu P J, Zhang J S, Song Y, Ma J
School of Public Health/Institute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2019 Oct 6;53(10):1038-1042. doi: 10.3760/cma.j.issn.0253-9624.2019.10.016.
To analyze the urban-rural disparity of childhood stunting and its association with subnational economic growth among Chinese Han students aged 7-18 years. We used the data from 2014 Chinese National Survey on Students' Constitution and Health. 213 940 Chinese Han students aged 7-18 years with complete height records were included in this study. Stunting was defined according to the Screening Criteria of Malnutrition for School-age Children and Adolescents(2014 version, in Chinese). We divided students into two groups (economically developed and underdeveloped areas) according to the provincial GDP per capita. Spearman correlation coefficient was used to explore the association between the difference of urban-rural stunting prevalence and the provincial GDP per capita. Logistic regression models were established to assess the risk of stunting in rural children compared with urban children. Among 213 940 students, 107 033 (50.0%) were from urban areas. The average height of 7-18 years old and 18 years old [(152.9±15.7) and (166.1±8.7) cm] of urban students were both higher than those of rural students [(150.7±16.0) and (165.1±8.6) cm] (0.001). The stunting prevalence of Chinese urban students (0.4%) was statistically significant lower than that of rural students (1.1%) (0.001), which was consistent in all age groups (0.05). The urban-rural disparity was found in 60% (18/30) of Chinese provinces. The difference of urban-rural stunting prevalence was negatively associated with provincial GDP per capita (-0.62, 0.001). In economically underdeveloped areas, the risk of stunting for rural students aged 7-9 years was 4.69 (95: 2.93-7.52) times that for urban children, while for students aged 10-18 years, the odds ratio was 2.44 (95: 2.02-2.96). In economically developed areas, the risk of stunting for rural students aged 7-9 years was 5.43 (95: 3.67-8.03) times that for urban children, while for students aged 10-18 years, the odds ratio was 2.15 (95: 1.85-2.49). The urban-rural disparity of childhood stunting existed in most places in China. The difference of growth retardation between urban and rural areas was related to regional economic development.
分析中国7至18岁汉族学生儿童期发育迟缓的城乡差异及其与地区经济增长的关系。我们使用了2014年中国学生体质与健康调研的数据。本研究纳入了213940名有完整身高记录的7至18岁中国汉族学生。发育迟缓根据《学龄儿童青少年营养不良筛查标准（2014年版，中文版）》进行定义。我们根据人均省级GDP将学生分为两组（经济发达地区和欠发达地区）。采用Spearman相关系数探讨城乡发育迟缓患病率差异与人均省级GDP之间的关联。建立逻辑回归模型以评估农村儿童与城市儿童相比发育迟缓的风险。在213940名学生中，107033名（50.0%）来自城市地区。城市学生7至18岁和18岁的平均身高[（152.9±15.7）和（166.1±8.7）厘米]均高于农村学生[（150.7±16.0）和（165.1±8.6）厘米]（P<0.001）。中国城市学生的发育迟缓患病率（0.4%）显著低于农村学生（1.1%）（P<0.001），在所有年龄组中均如此（P<0.05）。在中国60%（18/30）的省份中发现了城乡差异。城乡发育迟缓患病率差异与人均省级GDP呈负相关（-0.62，P<0.001）。在经济欠发达地区，7至9岁农村学生发育迟缓的风险是城市儿童的4.69（95%CI：2.93-7.52）倍，而10至18岁学生的比值比为2.44（95%CI：2.02-2.96）。在经济发达地区，7至9岁农村学生发育迟缓的风险是城市儿童的5.43（95%CI：3.67-8.03）倍，而10至18岁学生的比值比为2.15（95%CI：1.85-2.49）。中国大部分地区存在儿童期发育迟缓的城乡差异。城乡生长发育迟缓的差异与地区经济发展有关。
