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Children’s health benefits of city life are diminishing

According to a new global analysis of trends in child and adolescent height and body mass index (BMI) led by Imperial College London (ICL), the advantages of living in cities for children’s and adolescents’ healthy growth are currently declining across most of the world.

In the 20th century, cities have provided many opportunities for better education, nutrition, sports, and recreation to children and adolescents, helping them grow taller and have a healthier weight than their rural counterparts in all but a few wealthy countries. However, in the 21st century, this trend appears to reverse as a result of accelerating improvements in rural areas. 

The researchers analyzed height and weight data from 71 million children and adolescents aged five to 19 across both urban and rural areas in 200 countries from 1991 to 2020. The investigation revealed that, while height and BMI have generally increased around the world since 1990, the degree of change between urban and rural areas varied significantly among various middle- and low-income countries, while remaining largely stable across high-income countries. 

“Cities continue to provide considerable health benefits for children and adolescents. Fortunately, in most regions, rural areas are catching up to cities thanks to modern sanitation and improvements in nutrition and healthcare,” said study lead author Anu Mishra, a research associate in Global Environmental Health at ICL.

For instance, in countries such as Brazil, Chile, and Taiwan, the scientists found the biggest gains in rural children’s height during the study period. “These countries have made great strides in levelling up. Using the resources of economic growth to fund nutrition and health programs, both through schools and in the community, was key to closing the gaps between different areas and social groups,” said senior author Majid Ezzati, a professor of Public Health at ICL.

 “The issue is not so much whether children live in cities or urban areas, but where the poor live, and whether governments are tackling growing inequalities with initiatives like supplementary incomes and free school meal programs.”

For instance, worrisome trends were identified in sub-Saharan Africa, where children in rural areas have plateaued in height or even become shorter and gained weight more rapidly over the past three decades.

 “This is a serious problem at every level, from individual to regional. Faltering growth in school-aged children and adolescents is strongly linked to poor health through life, lost educational attainment, and the immense cost of unrealized human potential,” Ezzati explained.

“Our findings should motivate policies that counter poverty and make nutritious foods affordable to make sure that children and adolescents grow and develop into adults who have healthy and productive lives,” he concluded.

The study is published in the journal Nature.

By Andrei Ionescu, Staff Writer

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