Regional differences in short stature in England between 2006 and 2019: A cross-sectional analysis from the National Child Measurement Programme.
Regional differences in short stature in England between 2006 and 2019: A cross-sectional analysis from the National Child Measurement Programme.
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DOI：
10.1371/journal.pmed.1003760
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发表时间：
2021-09
期刊：
影响因子：
15.8
通讯作者：
Prendergast AJ
中科院分区：
文献类型：
--
作者：
Orr J;Freer J;Morris JK;Hancock C;Walton R;Dunkel L;Storr HL;Prendergast AJ
矮个子的定义是身高比人口中位数低2个标准差以上，是儿童健康的重要指标。矮小(通常被称为发育迟缓)在低收入和中等收入国家(LMIC)得到了广泛的研究，但对高收入国家的矮小程度和负担知之甚少。我们的目标是绘制2006年至2019年期间英国4-5岁儿童身材矮小的流行情况。我们使用了2006-2007学年至2018-2019学年国家儿童测量计划(NCMP)的数据。所有在英格兰公立小学就读的儿童都被邀请参加NMP，并对总共7062,071名4-5岁儿童的身高进行了分析。我们使用英国世卫组织的参考文献，按性别、多重剥夺指数、种族和地区评估矮小身材，定义为低于−2的身高标准差分数。利用空间分析软件SATScan对矮小身高的地理聚集性进行了分析。英国人身材矮小的患病率为1.93%(95%可信区间为1.92~1.94)。经种族调整的空间分析显示矮小的地理异质性，北部和中部地区更有可能出现高患病率集群，导致矮小患病率最高和最低的地方当局(LAS)之间的差异达到4倍。身材矮小与IMD呈线性相关，最贫困人群的患病率几乎是最贫困人群的2倍(2.56%(2.53-2.59)比1.38%(1.35-1.41))。存在种族异质性：黑人儿童矮小的患病率最低(0.64%(0.61-0.67))，印度儿童(2.52%(2.45-2.60))和其他种族儿童(2.57%(2.51-2.64))最高。女孩比男孩更有可能身材矮小(2.09%(2.07-2.10)比1.77%(1.76-1.78))。身材矮小的患病率随着时间的推移而下降，从2006-2010年的2.03%(2.01-2.05)下降到2016-2019年的1.82%(1.80-1.84)。矮小身高在所有地区的贫困程度上都有所下降，在贫困程度越高的地区下降得更快，但IMD五分之一的差距持续存在。这项研究是在地区层面上进行的，因此，我们不能对身材矮小的个体原因做出任何推断。在这项研究中，我们观察到英格兰的矮个子存在明显的社会梯度和显著的地区差异，包括南北鸿沟。这些发现为进一步研究对身高的潜在社会经济影响和潜在的地区差异因素提供了动力。乔安娜·奥尔和合著者使用对国家儿童测量计划数据的横断面分析，调查了2006-2019年英国儿童身材矮小的地区差异。年龄矮小可能是幼儿存在潜在的健康状况或不利的社会经济环境的迹象。对低收入和中等收入国家身材矮小儿童的研究发现，与较差的终身健康和教育结果有许多关联。在英国，身材矮小的儿童的患病率和特征此前从未被调查过。我们使用了7,062,071名4岁和5岁儿童的数据，这些儿童是作为国家儿童测量计划(NCMP)的一部分进行测量的，以计算按地区、种族、性别和地区贫困划分的矮小儿童的百分比。我们使用区域分析来评估全国是否存在身材矮小的热点地区。我们发现，1.93%的儿童身材矮小，这与区域剥夺密切相关，越贫困的地区身材矮小的比例越高。在非洲黑人或加勒比海裔儿童中，身材矮小的可能性也较小，而在印度儿童或种族编码为“其他”的儿童中，身材矮小的可能性更大。英格兰有各种矮小的热点，其中大部分集中在该国的北部和中部。矮个子在英国比较少见。然而，身材矮小与地区层面的贫困密切相关，最贫困地区的儿童矮小的可能性几乎是最贫困地区儿童的两倍。进一步调查贫困地区的儿童个子较矮的原因很重要。
Short stature, defined as height for age more than 2 standard deviations (SDs) below the population median, is an important indicator of child health. Short stature (often termed stunting) has been widely researched in low- and middle-income countries (LMICs), but less is known about the extent and burden in high-income settings. We aimed to map the prevalence of short stature in children aged 4–5 years in England between 2006 and 2019. We used data from the National Child Measurement Programme (NCMP) for the school years 2006–2007 to 2018–2019. All children attending state-maintained primary schools in England are invited to participate in the NCMP, and heights from a total of 7,062,071 children aged 4–5 years were analysed. We assessed short stature, defined as a height-for-age standard deviation score (SDS) below −2 using the United Kingdom WHO references, by sex, index of multiple deprivation (IMD), ethnicity, and region. Geographic clustering of short stature was analysed using spatial analysis in SaTScan. The prevalence of short stature in England was 1.93% (95% confidence interval (CI) 1.92–1.94). Ethnicity adjusted spatial analyses showed geographic heterogeneity of short stature, with high prevalence clusters more likely in the North and Midlands, leading to 4-fold variation between local authorities (LAs) with highest and lowest prevalence of short stature. Short stature was linearly associated with IMD, with almost 2-fold higher prevalence in the most compared with least deprived decile (2.56% (2.53–2.59) vs. 1.38% (1.35–1.41)). There was ethnic heterogeneity: Short stature prevalence was lowest in Black children (0.64% (0.61–0.67)) and highest in Indian children (2.52% (2.45–2.60)) and children in other ethnic categories (2.57% (2.51–2.64)). Girls were more likely to have short stature than boys (2.09% (2.07–2.10) vs. 1.77% (1.76–1.78), respectively). Short stature prevalence declined over time, from 2.03% (2.01–2.05) in 2006–2010 to 1.82% (1.80–1.84) in 2016–2019. Short stature declined at all levels of area deprivation, with faster declines in more deprived areas, but disparities by IMD quintile were persistent. This study was conducted cross-sectionally at an area level, and, therefore, we cannot make any inferences about the individual causes of short stature. In this study, we observed a clear social gradient and striking regional variation in short stature across England, including a North–South divide. These findings provide impetus for further investigation into potential socioeconomic influences on height and the factors underlying regional variation. Joanna Orr and coauthors investigate regional differences in short stature among children in England, between 2006-2019, using a cross-sectional analysis of the National Child Measurement Program data. Short height for age can be a sign that there are underlying health conditions or adverse socioeconomic circumstances in young children. Research into children who have short stature in low- and middle-income countries (LMICs) has found numerous associations with poorer lifelong health and education outcomes. The prevalence and characteristics of children with short stature in England have not previously been investigated. We used data from 7,062,071 children aged 4 and 5 who were measured as part of the National Child Measurement Programme (NCMP) to calculate percentages of children with short stature by region, ethnicity, sex, and area deprivation. We used regional analyses to assess whether there were hotspots of short stature around the country. We found that 1.93% of children had short stature, and this was strongly related to area deprivation, with more deprived areas having higher rates of short stature. Short stature was also less likely in children who were Black African or Caribbean and more likely in Indian children or children whose ethnicity was coded as “Other.” There were various short stature hotspots in England, and most of these were concentrated in the North and Midlands of the country. Short stature is relatively uncommon in England. However, short stature is strongly related to area-level deprivation, with children in the most deprived areas nearly twice as likely to be short as children in the least deprived areas. Further investigation into why children in poorer areas are shorter is important.
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DOI：
10.1016/s2468-2667(18)30045-8
发表时间：
2018-04
期刊：
The Lancet. Public health
影响因子：
--
作者：
Bann D;Johnson W;Li L;Kuh D;Hardy R
通讯作者：
Hardy R
影响因子：
5.2
作者：
Li, L;Manor, O;Power, C
通讯作者：
Power, C
影响因子：
3.2
作者：
Lundeen, Elizabeth A.;Behrman, Jere R.;Crookston, Benjamin T.;Dearden, Kirk A.;Engle, Patrice;Georgiadis, Andreas;Penny, Mary E.;Stein, Aryeh D.
通讯作者：
Stein, Aryeh D.
影响因子：
3.4
作者：
de Onis M;Branca F
通讯作者：
Branca F
影响因子：
3.8
作者：
Garza, Cutberto;de Onis, Mercedes;Martines, Jose
通讯作者：
Martines, Jose