Objective: To analyze the urban-rural disparity of childhood stunting and its association with subnational economic growth among Chinese Han students aged 7-18 years. Methods: 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. Results: 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] (P<0.001). The stunting prevalence of Chinese urban students (0.4%) was statistically significant lower than that of rural students (1.1%) (P<0.001), which was consistent in all age groups (P<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 (r=-0.62, P<0.001). In economically underdeveloped areas, the risk of stunting for rural students aged 7-9 years was 4.69 (95%CI: 2.93-7.52) times that for urban children, while for students aged 10-18 years, the odds ratio was 2.44 (95%CI: 2.02-2.96). In economically developed areas, the risk of stunting for rural students aged 7-9 years was 5.43 (95%CI: 3.67-8.03) times that for urban children, while for students aged 10-18 years, the odds ratio was 2.15 (95%CI: 1.85-2.49). Conclusions: 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.
目的： 分析中国7~18岁汉族中小学生生长迟缓城乡差异及其与地区经济发展的关系。 方法： 采用2014年中国学生体质与健康调研数据，以调研数据中的7~18岁汉族学生为研究对象，共选取身高记录资料完整的学生213 940名。依据《学龄儿童青少年营养不良筛查标准》（WS/T 456－2014），计算生长迟缓率。根据人均国内生产总值（gross domestic product，GDP），将研究对象分为经济发展欠发达地区（人均GDP<46 629元）和发达地区（人均GDP≥46 629元）。通过Spearman相关分析探索城乡生长迟缓率差与人均GDP的关联，并采用logistic回归模型分析生长迟缓的城乡差异。 结果： 城市学生为107 033名（50.0%）。城市学生总体身高和18岁学生身高[分别为（152.9±15.7）、（166.1±8.7）cm]均高于农村学生[分别为（150.7±16.0）、（165.1±8.6）cm]（P值均<0.001）。城市学生总体生长迟缓率（0.4%）低于农村学生（1.1%）（P<0.001）。各年龄组农村学生生长迟缓率均高于城市学生（P值均<0.05），60%（18/30）省份的城乡学生生长迟缓率差异具有统计学意义。城乡学生生长迟缓率差与人均GDP呈负相关（r=-0.62，P<0.001）。在经济发展欠发达地区，7~9岁农村学生生长迟缓风险是城市学生的4.69倍（95%CI：2.93~7.52），10~18岁农村学生生长迟缓风险是城市学生的2.44倍（95%CI：2.02~2.96）；在经济发展发达地区，7~9岁农村学生生长迟缓风险是城市学生的5.43倍（95%CI：3.67~8.03），10~18岁农村学生生长迟缓风险是城市学生的2.15倍（95%CI：1.85~2.49）。 结论： 我国7~18岁学生生长迟缓城乡差异普遍存在，生长迟缓城乡差异与地区经济发展有关联。.
Keywords: Child development; Cross-sectional studies; Economic development; Stunting; Urban-rural disparity.