Gao Mingyue, Wells Jonathan C K, Johnson William, Li Leah
Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire LE11 3TU, UK.
Lancet Reg Health West Pac. 2022 Feb 26;21:100399. doi: 10.1016/j.lanwpc.2022.100399. eCollection 2022 Apr.
Socio-economic disparities in growth trajectories of children from low-/middle-income countries are poorly understood, especially those experiencing rapid economic growth. We investigated socio-economic disparities in child growth in recent decades in China.
Using longitudinal data on 5095 children/adolescents (7-18 years) from the China Health and Nutrition Survey (1991-2015), we estimated mean height and BMI trajectories by socio-economic position (SEP) and sex for cohorts born in 1981-85, 1986-90, 1991-95, 1996-2000, using random-effects models. We estimated differences between high (urbanization index ≥median, household income per capita ≥median, parental education ≥high school, or occupational classes I-IV) and low SEP groups.
Mean height and BMI trajectories have shifted upwards across cohorts. In all cohorts, growth trajectories for high SEP groups were above those for low SEP groups across SEP indicators. For height, socio-economic differences persisted across cohorts (e.g. 3.8cm and 2.9cm in earliest and latest cohorts by urbanization index for boys at 10 year, and 3.6cm and 3.1cm respectively by household income). For BMI, trends were greater in high than low SEP groups, thus socio-economic differences increased across cohorts (e.g. 0.5 to 0.8kg/m by urbanization index, 0.4 to 1.1kg/m by household income for boys at 10 year). Similar trends were found for stunting and overweight/obesity by SEP. There was no association between SEP indicators and thinness.
Socio-economic disparities in physical growth persist among Chinese youth. Short stature was associated with lower SEP, but high BMI with higher SEP. Public health interventions should be tailored by SEP, in order to improve children's growth while reducing overweight/obesity.
MG is supported by UCL Overseas Research Scholarship and China Scholarship Council for her PhD study. WJ is supported by a UK Medical Research Council (MRC) New Investigator Research Grant (MR/P023347/1) and acknowledges support from the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University, and the University of Leicester.
人们对低收入/中等收入国家儿童生长轨迹中的社会经济差异了解甚少，尤其是那些经历快速经济增长的国家。我们调查了近几十年来中国儿童生长方面的社会经济差异。
利用中国健康与营养调查（1991 - 2015年）中5095名儿童/青少年（7 - 18岁）的纵向数据，我们使用随机效应模型，按社会经济地位（SEP）和性别，对1981 - 85年、1986 - 90年、1991 - 95年、1996 - 2000年出生队列的平均身高和体重指数轨迹进行了估计。我们估计了高SEP组（城市化指数≥中位数、人均家庭收入≥中位数、父母教育程度≥高中或职业阶层为I - IV）和低SEP组之间的差异。
各队列的平均身高和体重指数轨迹均向上移动。在所有队列中，无论采用哪种SEP指标，高SEP组的生长轨迹都高于低SEP组。就身高而言，各队列间社会经济差异持续存在（例如，按城市化指数，最早和最晚队列中10岁男孩的差异分别为3.8厘米和2.9厘米，按家庭收入分别为3.6厘米和3.1厘米）。就体重指数而言，高SEP组的趋势比低SEP组更大，因此各队列间社会经济差异增大（例如，按城市化指数，10岁男孩的差异从0.5增加到0.8千克/平方米，按家庭收入从0.4增加到1.1千克/平方米）。按SEP划分，发育迟缓、超重/肥胖也呈现类似趋势。SEP指标与消瘦之间没有关联。
中国青少年在身体生长方面的社会经济差异依然存在。身材矮小与较低的SEP相关，但高体重指数与较高的SEP相关。公共卫生干预措施应根据SEP进行调整，以促进儿童生长，同时减少超重/肥胖。
MG在攻读博士期间获得了伦敦大学学院海外研究奖学金和中国国家留学基金委的支持。WJ获得了英国医学研究理事会（MRC）新研究员研究基金（MR/P023347/1）的支持，并感谢英国国家卫生研究院（NIHR）莱斯特生物医学研究中心的支持，该中心是莱斯特大学国民保健服务信托基金、拉夫堡大学和莱斯特大学的合作项目。
