Effect of economic reforms on child growth in urban and rural areas of China

N Engl J Med. 1996 Aug 8;335(6):400-6. doi: 10.1056/NEJM199608083350606.


Background: Beginning in 1978, China implemented economic reforms to transform the economy to a free-market system. We compared the effect of the reforms on the growth of children in urban and rural areas.

Methods: Using data from five large cross-sectional surveys conducted between 1975 and 1992, we examined the trends in height for age of children two to five years of age in urban and rural areas. Mean height for age was expressed as the height in centimeters adjusted to a reference value of 99.1 cm for a 42-month-old boy.

Results: Height increased before and during the economic reforms. In 1975, the average height of children in periurban rural areas was about 3.5 cm less than that of children in urban areas. Between 1975 and 1985, the average height of children in periurban rural areas increased by 2.0 cm, as compared with 1.3 cm in urban children. Between 1987 and 1992, the average height of both urban and rural children increased, but the net increase for rural children was only one fifth that for urban children (0.5 vs. 2.5 cm). In a 1990 survey of seven provinces, the rural mean height was 92.5 cm, as compared with the urban mean of 96.9 cm and the reference value of 99.1 cm; 38 percent of rural children had moderate stunting of growth and 15 percent had severe stunting, as compared with 10 percent and 3 percent of urban children, respectively. Differences in height between rural and urban children were greater in provinces in which the average height of children was lower.

Conclusions: Despite an overall improvement in child growth during the economic reforms in China, the improvement has not been equitable, as judged by increased differences in height between rural and urban children and increased disparities within rural area.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Analysis of Variance
  • Body Height
  • Child
  • Child Nutritional Physiological Phenomena
  • Child Welfare / economics*
  • Child Welfare / trends
  • Child, Preschool
  • China
  • Cross-Sectional Studies
  • Economic Competition
  • Female
  • Growth*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Public Policy
  • Reference Values
  • Rural Health / trends*
  • Urban Health / trends*