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儿童营养不良结果的社会决定因素:来自中国健康与营养调查(CHNS)的证据。

Social determinants of child malnutrition outcomes: Evidence from CHNS in China.

作者信息

Li Sa, Mohamed Nor Norashidah, Kaliappan Shivee Ranjanee

机构信息

School of Business and Economics, Universiti Putra Malaysia, 43400, UPM, Serdang, Selangor, Malaysia.

School of Business, Zhengzhou College of Finance and Economics, Zhengzhou, 450000, China.

出版信息

Heliyon. 2023 Dec 15;10(1):e23887. doi: 10.1016/j.heliyon.2023.e23887. eCollection 2024 Jan 15.

Abstract

China is committed to reduce child malnutrition outcomes (CMO) rates to less than 5 % by 2030 in order to meet the Sustainable Development Goal (SDG). Yet, this is still an enormous challenge for China, particularly in disadvantaged areas, due to regional and urban-rural disparities. Using China Health and Nutrition Survey (CHNS) data from 1991 to 2015 and fixed-effect models, this study investigates the social determinants of stunting (n = 4012) measured by height-for-age z score (HAZ) and wasting (n = 4229) measured by weight-for-height z score (WHZ) in children under the age of five. According to the empirical findings, the significant social determinants of child stunting encompassed whether the child is insured (p < 0.01), maternal education level (primary school (p < 0.01) low middle school (p < 0.01); vocational school (p < 0.01)), maternal employment status (p < 0.05), mother's average working days (p < 0.05), average household per capita income (p < 0.01), household asset index (p < 0.01), urbanization index living in a community (medium (p < 0.05); higher (p < 0.01); highest (p < 0.01)) and living regions (west (p < 0.01); northeast (p < 0.05)). Children's maternal employment status (p < 0.05), mother's average working days (p < 0.05), living areas (p < 0.05) and living regions (central (p < 0.01); west (p < 0.01); north-east (p < 0.05)) are the significant factors impacting child wasting. Furthermore, the interaction impact between maternal employment and have one additional working day per week is positive. To attain SDGs, the Chinese government should priorities lowering stunting and wasting among 5-year-olds in the western region, particularly in impoverished regions. Also, it is possible to develop tailored policies for the growth and development of children under the age of five by addressing pertinent socio-economic factors.

摘要

中国致力于到2030年将儿童营养不良率降至5%以下,以实现可持续发展目标。然而,由于地区和城乡差距,这对中国来说仍是一项巨大挑战,尤其是在贫困地区。本研究利用1991年至2015年中国健康与营养调查(CHNS)数据及固定效应模型,调查了五岁以下儿童中以年龄别身高Z评分(HAZ)衡量的发育迟缓(n = 4012)和以身高别体重Z评分(WHZ)衡量的消瘦(n = 4229)的社会决定因素。根据实证结果,儿童发育迟缓的显著社会决定因素包括儿童是否参保(p < 0.01)、母亲教育水平(小学(p < 0.01)、初中(p < 0.01)、职业学校(p < 0.01))、母亲就业状况(p < 0.05)、母亲平均工作日(p < 0.05)、家庭人均收入平均值(p < 0.01)、家庭资产指数(p < 0.01)、居住社区的城市化指数(中等(p < 0.05)、较高(p < 0.01)、最高(p < 0.01))以及居住地区(西部(p < 0.01)、东北部(p < 0.05))。儿童的母亲就业状况(p < 0.05)、母亲平均工作日(p < 0.05)、居住面积(p < 0.05)以及居住地区(中部(p < 0.01)、西部(p < 0.01)、东北部(p < 0.05))是影响儿童消瘦的显著因素。此外,母亲就业与每周多工作一天之间的交互影响是正向的。为实现可持续发展目标(SDGs),中国政府应优先降低西部地区尤其是贫困地区五岁儿童的发育迟缓和消瘦率。此外,通过解决相关社会经济因素,有可能为五岁以下儿童的生长发育制定针对性政策。

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Household air pollution and childhood stunting in China: A prospective cohort study.
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