Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Stanford Center on China's Economy and Institutions, Stanford University, Stanford, CA 94305, USA.
Int J Environ Res Public Health. 2022 Oct 25;19(21):13845. doi: 10.3390/ijerph192113845.
Over the past two decades, the literature has shown a clear gradient between child health and wealth. The same health-wealth gradient is also observed among children in China, with a large gap in health between rural and urban children. However, there are still unanswered questions about the main causes of China's rural-urban child health inequality. This paper aims to review the major factors that have led to the relatively poor levels of health among China's rural children. In addition to the direct income effect on children's health, children in rural areas face disadvantages compared with their urban counterparts from the beginning of life: Prenatal care and infant health outcomes are worse in rural areas; rural caregivers have poor health outcomes and lack knowledge and support to provide adequate nurturing care to young children; there are large disparities in access to quality health care between rural and urban areas; and rural families are more likely to lack access to clean water and sanitation. In order to inform policies that improve health outcomes for the poor, there is a critical need for research that identifies the causal drivers of health outcomes among children. Strengthening the pediatric training and workforce in rural areas is essential to delivering quality health care for rural children. Other potential interventions include addressing the health needs of mothers and grandparent caregivers, improving parenting knowledge and nurturing care, improving access to clean water and sanitation for remote families, and most importantly, targeting poverty itself.
在过去的二十年中，文献表明儿童健康与财富之间存在明显的梯度关系。中国的儿童也存在同样的健康-财富梯度，农村和城市儿童的健康状况存在较大差距。然而，关于中国农村-城市儿童健康不平等的主要原因仍有一些未解决的问题。本文旨在回顾导致中国农村儿童健康水平相对较差的主要因素。除了对儿童健康的直接收入影响外，农村地区的儿童从生命开始就面临着与城市地区儿童相比的劣势：农村地区的产前保健和婴儿健康结果较差；农村照顾者的健康结果较差，缺乏知识和支持，无法为幼儿提供充足的养育护理；农村地区和城市地区在获得优质医疗保健方面存在巨大差距；农村家庭更有可能无法获得清洁水和卫生设施。为了为贫困人口提供改善健康结果的政策信息，迫切需要研究确定儿童健康结果的因果驱动因素。加强农村地区的儿科培训和劳动力队伍对于为农村儿童提供优质医疗保健至关重要。其他潜在的干预措施包括解决母亲和祖辈照顾者的健康需求，提高育儿知识和养育护理水平，改善偏远家庭获得清洁水和卫生设施的机会，最重要的是，要针对贫困本身。
