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There is now a growing interest in early-life influences on adult diseases in China. A number of birth cohorts have been established. This systematic review provided a better understanding of the development of mother–baby cohorts in China. Systematic review. We conducted a systematic review for research or profile papers in English/Chinese that reported data from mother–baby cohorts in mainland China, with ≥1y follow-up after birth. We identified 315 papers, corresponding to 31 cohorts from 19 provinces/megacities. All cohorts started in 1999–2017 (21 after 2010) and were set up with broad objectives or specific scientific focus. The baseline sample size varied, from <500 to >300,000 mothers. A majority of cohorts were initiated during pregnancy and followed children to <10y, only six to adolescence and none into adulthood. These cohorts mostly collected samples from mothers and babies, in addition to using interviews/questionnaires to collect information about pregnancy, birth and child health. Most cohorts were recruited from a single province/city. The large western region was understudied. Mother–baby cohorts have developed rapidly in China, but usually with a short follow-up duration. Extending the follow-up of children and developing cross-cohort collaboration will increase the diversity, size and coverage of the sample, allow studying early influences on life-course health and identify targets for early intervention in the Chinese population. [ABSTRACT FROM AUTHOR]

Early childhood education programs have been found to effectively promote children's social and cognitive development. However, the health impact of these programs is less understood. Using a quasi-experiment of the first universal child care reform in China from 2010, this paper aims to identify whether the preschool reform produces any short-term effects on health-related outcomes of preschoolers (3-6 years old). Specifically, this reform expands access to affordable preschools that provide full-day center-based education, with school meals and essential health services on campus. I exploit the variation in the number of newly established preschools across provinces and implement difference-in-differences and triple-difference strategies. Results confirm the effectiveness of this reform by showing a strong and positive impact on preschool attendance. This paper then documents the benefits to alleviating underweight among preschoolers. Estimates show a larger effect in rural areas, suggesting that the reform narrows rural-urban disparities in education access and undernutrition prevention. I also explore the impact on caregivers' health consciousness and find improved health-seeking behavior when children get sick. [ABSTRACT FROM AUTHOR]

Abstract Child nutritional health has always been a research focus and an essential indicator reflecting children's health and living conditions in developing countries. This study investigates how household income and other individual and family factors influence child nutritional status. The Chinese Health and Nutrition Survey data are used to analyze changing patterns of child malnutrition status, and to compare the gap between genders, rural and urban areas etc., and the WHO new child growth standards are used in this paper as the reference for each specific age and gender. The findings in this paper include three aspects. First of all, the headcount ratio of undernourished children in both stunting and underweight has declined over years from 1991 to 2009 in China. Second, regional disparity in child nutritional status was significant, and the economic growth was a key driver to improve the nutritional conditions of the poor children. Furthermore, this paper also employs the stepwise logistic regression models to illustrate the influencing mechanisms of family income and other factors on child nutrition, and finds that household income affected child nutritional status significantly through the mechanisms of community, household, parental and individual factors. Highlights • This paper studies stunting and underweight rates of Chinese children and finds both malnutritional indicators have declined from 1991 to 2009. • This paper studies the regional and demographic differences in child nutrition and finds certain heterogeneity in malnutritional indicators. • This paper studies the relationship between family income and child nutrition and reveals significant and positive correlation between the two. • This paper finds significant impact mechanisms of individual, parental, family and community factors on child nutrition. [ABSTRACT FROM AUTHOR]

With the rapid development of urbanization, children's health has been becoming one of the most prominent problems in many countries, of which the lack of friendliness in urban is a main reason. This paper, takes Children's Participation Work Camp of Changsha 2050 and Fengquan Furui child-friendly community as an example, systematically summaries the research and design methods of Chinese Child-Friendly City (CFC), evaluates its generalizability, and puts forward that conducting a regular and continuous survey of Children's Drawing Camp and transforming public environment and establishing connections between community residents based on children focus are referencable ways for building CFC in China. [ABSTRACT FROM AUTHOR]

Numerous questionnaire-based studies were conducted to investigate associations of home environment with childhood health, whereas few studies confirmed validity of parents-reported questionnaire regarding dwelling characteristics and dampness-related indicators. According to data obtained by standard questions regarding these items via on-site inspection in 454 residences with young children during 2013–2014, and data collected for these items from their parents-reported questionnaires in cross-sectional survey during 2011–2012 in Shanghai, China, this paper validated consistencies of information for these items between the two phases, thus to confirm validity of parents-reported questionnaire regarding these items. According to Kappa ( k ) values, parents and inspectors had moderate/substantial consistencies regarding dwelling characteristics ( k = 0.212–0.894), but had slight consistencies regarding dampness-related indicators and indoor odors (absolute k = 0.019–0.144). However, according to the observed, positive, and negative proportional agreement (P o , P pos , and P neg ), parents and inspectors had substantial/prefect consistencies in most of the studied items (P o = 0.45–0.96). These trends of consistencies for different items had no notable differences, regardless of father or mother as the questionnaire-reporter, and among the residences inspected in different seasons. This study suggests parents-reported questionnaire could be a reliable and valid method to indicate the overall status of dwelling characteristics and home dampness-related exposures. [ABSTRACT FROM AUTHOR]

There is a significant lack of scientific knowledge on population exposure to ultrafine particles (UFP) in China to date. This paper quantifies and characterises school children's personal UFP exposure and exposure intensity against their indoor and outdoor activities during a school day (home, school and commuting) in the city of Heshan within the Pearl River Delta (PRD) region, southern China. Time-series of UFP number concentrations and average size were measured over 24 h for 24 children (9–13 years old), using personal monitors over two weeks in April 2016. Time-activity diaries and a questionnaire on the general home environment and potential sources of particles at home were also collected for each participating child. The analysis included concurrently measured size distributions of ambient UFP at a nearby fixed reference site (Heshan Supersite). Hourly average UFP concentrations exhibited three peaks in the morning, midday and evening. Time spent indoors at home was found to have the highest average exposure (1.26 × 104 cm−3 during sleeping) and exposure intensity (2.41). While there is always infiltration of outdoor particles indoors (from nearby traffic and general urban background sources), indoor exposure at home was significantly higher than outdoor exposure. Based on the collected questionnaire data, this was considered to be driven predominantly by adults smoking and the use of mosquito repellent incense during the night. Outdoor activities at school were associated with the lowest average exposure (6.87 × 102 cm−3) and exposure intensity (0.52). Despite the small sample size, this study characterised, for the first time, children's personal UFP exposure in a city downwind of major pollution sources of the PRD region in China. Particularly, the results highlighted the impact of smoking at home on children's exposure. While the study could not apportion the specific contributions of second hand-smoking and mosquito coil burning, considering the prevalence of smokers among the parents who smoke at home, smoking is a very significant factor. Exposure to second-hand smoke is avoidable, and these findings point out to the crucial role of government authorities and public health educators in engaging with the community on the role of air quality on health, and the severity of the impact of second-hand smoke on children's health. • Epidemiological studies do not account for indoor UFP exposures. • Children's highest exposure and exposure intensity in Heshan were during time spent indoors at home. • Main indoor sources of UFP at home in Heshan were smoking and use of mosquito repellent incense. • The results highlighted the impact of smoking at home on children's exposure. [ABSTRACT FROM AUTHOR]