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ObjectiveTo examine urban–rural disparity in childhood stunting, wasting and malnutrition at national and subnational levels in Chinese primary-school children in 2010 and 2014.DesignData were obtained from two nationwide cross-sectional surveys conducted in 2010 and 2014. Malnutrition was classified using the Chinese national ‘Screening Standard for Malnutrition of Children’.SettingAll twenty-seven mainland provinces and four municipalities of mainland China.ParticipantsChildren aged 7–12 years (n 215 214; 107 741 in 2010 and 107 473 in 2014) from thirty-one provinces.ResultsStunting, wasting and malnutrition prevalence were 1·9, 12·3 and 13·7 % in 2010, but decreased to 1·0, 9·4 and 10·2 % in 2014, respectively. The prevalence of stunting, wasting and malnutrition in both urban and rural children was higher in western provinces, while lower in eastern provinces. Although the prevalence of wasting and malnutrition was higher in rural children than their urban counterparts, the urban–rural disparity in both wasting and malnutrition decreased from 2010 to 2014 (prevalence OR: wasting, 1·35 to 1·16; malnutrition, 1·50 to 1·27). A reversal occurred in 2014 in several eastern provinces where the prevalence of wasting and malnutrition in urban children surpassed their rural peers. The urban–rural disparity was larger in western provinces than eastern provinces.ConclusionsThe shrinking urban–rural disparity and the reversal in wasting and malnutrition suggest that the malnutrition situation has improved during the post-crisis period, especially in the western provinces. Region-specific policies and interventions can be useful to sustainably mitigate malnutrition in Chinese children, especially in rural areas and the western provinces.

Abstract:On an individual and a population basis, an increased incidence of coronary heart disease is associated with classical cardiovascular risk factors, but many cases occur in people not identified as at high risk. Conversely, many people at high statistical risk do not develop coronary disease. We used a questionnaire to identify unrecognised coronary heart disease in people attending large-scale health survey centres. Participants were required to report the presence and characteristics of any chest pain. Those returning responses consistent with myocardial ischaemia were offered treadmill exercise ECG tests. Over 18 months, 4070 questionnaires were returned. Of 475 respondents offered testing, 229 (198 male, 131 female) accepted. Thirty-two subjects (15 male, 17 female: a detection rate of 13.9 per cent of those assessed as likely on questionnaire, or 0.8 per cent of all respondents) had results consistent with significant coronary heart disease. Follow-up was available in 30 cases. There was no difference in classical risk-factor distribution (including multivariate risk percentiles: 42.4 (male) and 46.7 (female)) between those newly diagnosed with coronary heart disease and their community counterparts. More women than men were identified as suffering from unrecognised coronary heart disease, with a preponderance of younger women. Cost per case identified was A$l220. Screening by self-administered questionnaire is a useful and relatively cost-effective means of identifjmg unrecognised coronary heart disease. (Aust N ZJPublic Health 1997; 21: 545-7) N a population basis, an increased incidence of coronary heart disease is associated with 0 higher levels of classical cardiovascular risk factors, considered to be clinical or biochemical markers of a statistically increased likelihood of having or developing the disease.' Much coronary heart disease morbidity and mortality occurs in people not classified as at excessively high risk. This is because, at least partly, of the high proportion of the population who fall into the mild-to-moderate-risk group and to the complex multifactorial interactions involved in the development of coronary heart disease. Population screening on the basis of classical risk factors is therefore likely to miss a significant number of people who warrant further investigation Correspondence to Dr

On an individual and a population basis, an increased incidence of coronary heart disease is associated with classical cardiovascular risk factors, but many cases occur in people not identified as at high risk. Conversely, many people at high statistical risk do not develop coronary disease. We used a questionnaire to identify unrecognised coronary heart disease in people attending large-scale health survey centres. Participants were required to report the presence and characteristics of any chest pain. Those returning responses consistent with myocardial ischaemia were offered treadmill exercise ECG tests. Over 18 months, 4070 questionnaires were returned. Of 475 respondents offered testing, 229 (198 male, 131 female) accepted. Thirty-two subjects (15 male, 17 female: a detection rate of 13.9 per cent of those assessed as likely on questionnaire, or 0.8 per cent of all respondents) had results consistent with significant coronary heart disease. Follow-up was available in 30 cases. There was no difference in classical risk-factor distribution (including multivariate risk percentiles: 42.4 (male) and 46.7 (female)) between those newly diagnosed with coronary heart disease and their community counterparts. More women than men were identified as suffering from unrecognised coronary heart disease, with a preponderance of younger women. Cost per case identified was A$l220. Screening by self-administered questionnaire is a useful and relatively cost-effective means of identifjmg unrecognised coronary heart disease. (Aust N ZJPublic Health 1997; 21: 545-7) N a population basis, an increased incidence of coronary heart disease is associated with 0 higher levels of classical cardiovascular risk factors, considered to be clinical or biochemical markers of a statistically increased likelihood of having or developing the disease.' Much coronary heart disease morbidity and mortality occurs in people not classified as at excessively high risk. This is because, at least partly, of the high proportion of the population who fall into the mild-to-moderate-risk group and to the complex multifactorial interactions involved in the development of coronary heart disease. Population screening on the basis of classical risk factors is therefore likely to miss a significant number of people who warrant further investigation Correspondence to Dr