Socio-economic disparities in child-to-adolescent growth trajectories in China: Findings from the China Health and Nutrition Survey 1991–2015

Knowledge, attitudes, and practices of patients with recurrent pregnancy loss toward pregnancy loss

Objective

Self-management is crucial in managing recurrent pregnancy loss (RPL). This study explored the knowledge, attitudes, and practices (KAP) of patients with RPL toward RPL.

Methods

This cross-sectional study was conducted among patients with RPL between January 2023 and June 2023 at the Second Hospital of Lanzhou University. Participants' demographic characteristics and KAP were determined using a self-designed questionnaire (Cronbach's α = 0.818). Structural equation modeling (SEM) was used to observe the correlations among KAP and different factors.

Results

This study analyzed 497 valid questionnaires. The mean knowledge, attitude, and practice scores were 11.59 ± 4.30 (possible range: 0-20, 57.95%), 44.17 ± 3.18 (possible range: 13-65, 67.95%), and 32.39 ± 5.22 (possible range: 8-40, 80.98%), indicating poor knowledge, moderate attitude, and proactive practice. Age was non-linearly associated with the KAP dimensions, with a positive impact of age on KAP among those aged <32 years old. Knowledge was directly influenced by education (β = 1.49, p < 0.001) and income (β = 1.08, p < 0.001). The attitude was directly influenced by knowledge (β = 0.25, p < 0.001) and indirectly influenced by education (β = 0.37, p = 0.001) and income (β = 0.27, p < 0.001). Practice was directly influenced by knowledge (β = 0.26, p < 0.001), attitude (β = 0.28, p < 0.001), and income (β = 0.68, p = 0.012), and indirectly influenced by knowledge (β = 0.07, p = 0.001), education (β = 0.59, p = 0.001), and income (β = 0.42, p < 0.001).

Conclusion

Women with RPL in Lanzhou show poor knowledge, moderate attitude, and proactive practice toward RPL. This study identified specific KAP items that would require improvements. The study also identified categories of patients who would need more attention.

Secular trends and urban-rural disparities in height of Chinese adolescents aged 18 years from 1985 to 2019

OBJECTIVES

To examine the secular trends and urban-rural disparities in height of Chinese adolescents aged 18 years from 1985 to 2019.

METHODS

Data were extracted from the Chinese National Surveys on Students' Constitution and Health from 1985 to 2019, and the heights of a total of 76 554 boys and 75 908 girls aged 18 years were measured. The Mann-Kendall trend test was used to analyze the secular trends in height. Changes in different periods and urban-rural disparities were tested by z-tests and calculating the ratios of the coefficient of variation (CV) of height.

RESULTS

The height of Chinese boys and girls aged 18 years increased from 168.21 and 157.10 cm in 1985 to 172.15 cm and 160.11 cm in 2019, respectively, with a larger increase in rural areas. The secular trends in height were the largest for boys from 1995 to 2005 and for girls from 2014 to 2019, and the same results were observed in urban and rural areas. The urban-rural disparities for boys and girls decreased by 1.79 and 0.91 cm, respectively, with significant decreases for boys in all regions and for girls in the eastern region. The overall CVs of height increased by 0.13% and 0.25% for boys and girls, respectively, with the largest increase among rural girls.

CONCLUSIONS

The height of Chinese adolescents aged 18 years continued to increase between 1985 and 2019. The urban-rural disparities narrowed, and inequalities within rural areas for girls increased.

Structural Determinants of Child Health in Rural China: The Challenge of Creating Health Equity

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.

The Effect of Household Technology on Child Health: Evidence from China's "Home Appliances Going to the Countryside" Policy

This paper examined the effects of household technology on child health using evidence from the Chinese government's "Home Appliances Going to the Countryside" policy. A difference-in-differences approach was employed to examine 2000 to 2015 data from the China Health and Nutrition Survey data from before the policy in 2007 to after the policy was implemented. It was found that the policy-induced household technology adoption significantly increased child health, especially girls' health. Various sensitivity tests proved this finding to be robust. The potential paths through which household technology improved child health were also examined from which it was found that parental care for children and increased nutrition were effective paths between household technology and health status. These results could guide policymakers when constructing and developing a supportive child health system in China.