Skip to main content
Top
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Disparity of anemia prevalence and associated factors among rural to urban migrant and the local children under two years old: a population based cross-sectional study in Pinghu, China

Authors: Shiyun Hu, Hui Tan, Aiping Peng, Hong Jiang, Jianmei Wu, Sufang Guo, Xu Qian

Published in: BMC Public Health | Issue 1/2014

Login to get access

Abstract

Background

Number of internal rural to urban migrant children in China increased rapidly. The disparity of anemia prevalence among them and children of local permanent residents has been reported, both in big and middle-size cities. There has been no population-based study to explore the associated factors on feeding behaviors in small size cities of China. This study aimed to identify whether there was a difference in the prevalence of anemia between children of rural to urban migrant families and local children under 2 years old in a small coastal city in China, and to identify the associated factors of any observed difference.

Methods

A community-based, cross-sectional survey was conducted in Pinghu, a newly-developing city in Zhejiang Province, China, among the caregivers of 988 children (667 who were identified as children of migrants and 321 locals) aged 6–23 months. Disparity of anemia prevalence were reported. Association between anemia prevalence and socio-economic status and feeding behaviors were explored among two groups respectively.

Results

Anemia prevalence among the migrant and local children was 36.6% and 18.7% respectively (aPR 1.86, 95% CI 1. 40 to 2.47). Results from adjusted Poisson models revealed: having elder sibling/s were found as an associated factor of anemia with the aPR 1.47 (95% CI 1.16 to 1.87) among migrant children and 2.58 (95% CI 1.37 to 4.58) among local ones; anemia status was associated with continued breastfeeding at 6 months (aPR = 1.57, 95% CI 1.15 to 2.14) and lack of iron-rich and/or iron-fortified foods (aPR = 0.68, 95% CI 0.50 to 0.89) among the migrant children but not among local ones.

Conclusion

Anemia was more prevalent among migrant children, especially those aged 6–11 months. Dislike their local counterparts, migrant children were more vulnerable at early life and seemed sensitive to feeding behaviors, such as, over reliance on breastfeeding for nutrition after aged 6 months, lack of iron-rich and/or iron-fortified foods. Future strategies to narrow the gap of anemia prevalence between the migrant and local children should target more susceptible groups and through improvement of feeding practices among younger children in those kinds of newly-developing areas of China.
Appendix
Available only for authorised users
Literature
1.
go back to reference Seeborg MC, Jin Z, Zhu Y: The new rural–urban labor mobility in China: causes and implications. J Socio-Econ. 2000, 29 (1): 39-56. 10.1016/S1053-5357(00)00052-4.CrossRef Seeborg MC, Jin Z, Zhu Y: The new rural–urban labor mobility in China: causes and implications. J Socio-Econ. 2000, 29 (1): 39-56. 10.1016/S1053-5357(00)00052-4.CrossRef
2.
3.
go back to reference Shen JJ: Changing patterns and determinants of interprovincial migration in China. Popul Space Place. 2012, 18 (3): 384-402. 10.1002/psp.668.CrossRef Shen JJ: Changing patterns and determinants of interprovincial migration in China. Popul Space Place. 2012, 18 (3): 384-402. 10.1002/psp.668.CrossRef
4.
go back to reference National Bureau of Statistics of China: China Statistic Year Book. 2012, Beijing: China Statistics Press National Bureau of Statistics of China: China Statistic Year Book. 2012, Beijing: China Statistics Press
6.
go back to reference Yusuf S, Saich T: China urbanizes: consequences, strategies, and policies. 2008, Washington DC: World Bank PublicationsCrossRef Yusuf S, Saich T: China urbanizes: consequences, strategies, and policies. 2008, Washington DC: World Bank PublicationsCrossRef
7.
go back to reference Chen W, Liu J: Family patterns of the floating population in Beijing. Popul J. 2012, 196 (06): 3-8. Chen W, Liu J: Family patterns of the floating population in Beijing. Popul J. 2012, 196 (06): 3-8.
8.
go back to reference Duan CR, Yang K: Study on the latest situation of floating children in China: a study based on sampled survey among 1% national-wide population in 2005. Popul J. 2005, 2008 (6): 23-31. Duan CR, Yang K: Study on the latest situation of floating children in China: a study based on sampled survey among 1% national-wide population in 2005. Popul J. 2005, 2008 (6): 23-31.
9.
go back to reference Gong P, Liang S, Carlton EJ, Jiang Q, Wu J, Wang L, Remais JV: Urbanisation and health in China. Lancet. 2012, 379 (9818): 843-852. 10.1016/S0140-6736(11)61878-3.CrossRefPubMedPubMedCentral Gong P, Liang S, Carlton EJ, Jiang Q, Wu J, Wang L, Remais JV: Urbanisation and health in China. Lancet. 2012, 379 (9818): 843-852. 10.1016/S0140-6736(11)61878-3.CrossRefPubMedPubMedCentral
10.
go back to reference Salant T, Lauderdale DS: Measuring culture: a critical review of acculturation and health in Asian immigrant populations. Soc Sci Med. 2003, 57 (1): 71-90. 10.1016/S0277-9536(02)00300-3.CrossRefPubMed Salant T, Lauderdale DS: Measuring culture: a critical review of acculturation and health in Asian immigrant populations. Soc Sci Med. 2003, 57 (1): 71-90. 10.1016/S0277-9536(02)00300-3.CrossRefPubMed
11.
go back to reference Frisbie WP, Cho Y, Hummer RA: Immigration and the health of Asian and Pacific Islander adults in the United States. Am J Epidemiol. 2001, 153 (4): 372-380. 10.1093/aje/153.4.372.CrossRefPubMed Frisbie WP, Cho Y, Hummer RA: Immigration and the health of Asian and Pacific Islander adults in the United States. Am J Epidemiol. 2001, 153 (4): 372-380. 10.1093/aje/153.4.372.CrossRefPubMed
12.
go back to reference Bao SM, Bodvarsson OB, Hou JW, Zhao YH: The regulation of migration in a transition economy: China’s Hukou system. Contemp Econ Policy. 2011, 29 (4): 564-579. 10.1111/j.1465-7287.2010.00224.x.CrossRef Bao SM, Bodvarsson OB, Hou JW, Zhao YH: The regulation of migration in a transition economy: China’s Hukou system. Contemp Econ Policy. 2011, 29 (4): 564-579. 10.1111/j.1465-7287.2010.00224.x.CrossRef
13.
go back to reference Kuang L, Liu L: Discrimination against rural-to-urban migrants: the role of the hukou system in China. Plos One. 2012, 7 (11): e46932-10.1371/journal.pone.0046932. doi:10.1371/journal.pone.0046932CrossRefPubMedPubMedCentral Kuang L, Liu L: Discrimination against rural-to-urban migrants: the role of the hukou system in China. Plos One. 2012, 7 (11): e46932-10.1371/journal.pone.0046932. doi:10.1371/journal.pone.0046932CrossRefPubMedPubMedCentral
14.
go back to reference Yan S, Chen X, Duan J, Liu G: State and demand of health care service among floating children under 5 year old in Beijing. Chinese J Child Health Care. 2008, 16 (5): 542-543. Yan S, Chen X, Duan J, Liu G: State and demand of health care service among floating children under 5 year old in Beijing. Chinese J Child Health Care. 2008, 16 (5): 542-543.
16.
go back to reference Lozoff B, Jimenez E, Smith JB: Double burden of iron deficiency in infancy and low socioeconomic status: a longtudinal analysis of cognitive test scores to age 19 years. Arch Pediatr Adolesc Med. 2006, 160 (11): 1108-1113. 10.1001/archpedi.160.11.1108.CrossRefPubMedPubMedCentral Lozoff B, Jimenez E, Smith JB: Double burden of iron deficiency in infancy and low socioeconomic status: a longtudinal analysis of cognitive test scores to age 19 years. Arch Pediatr Adolesc Med. 2006, 160 (11): 1108-1113. 10.1001/archpedi.160.11.1108.CrossRefPubMedPubMedCentral
17.
go back to reference Gao W, Wang Q, Xi YJ: Survey on anaemia prevalence among 4127 children aged 0 to 3 years in Shenzhen. Matern Child Health China. 2011, 29: 4586- Gao W, Wang Q, Xi YJ: Survey on anaemia prevalence among 4127 children aged 0 to 3 years in Shenzhen. Matern Child Health China. 2011, 29: 4586-
18.
go back to reference Ai XL: Analysis of anaemia among 9481 children aged 6 to 59 months in Canghai District of Xiamen. Chinese J Child Health Care. 2012, 20 (12): 1146-1148. Ai XL: Analysis of anaemia among 9481 children aged 6 to 59 months in Canghai District of Xiamen. Chinese J Child Health Care. 2012, 20 (12): 1146-1148.
19.
go back to reference Ding WQ, Feng SF: Analysis of the state of health care service among floating children and resident children under 5 years old in Yinchuan. Modern Preventive Medicine. 2011, 38 (20): 4130-4132. Ding WQ, Feng SF: Analysis of the state of health care service among floating children and resident children under 5 years old in Yinchuan. Modern Preventive Medicine. 2011, 38 (20): 4130-4132.
20.
go back to reference Shi X, Lin XQ, Liang HN, Tan HW, Long X: Anaemia among preschool children and its relationship with parents’ KAP in Nanning. Chinese J Child Health Care. 2008, 29 (9): 839-840. Shi X, Lin XQ, Liang HN, Tan HW, Long X: Anaemia among preschool children and its relationship with parents’ KAP in Nanning. Chinese J Child Health Care. 2008, 29 (9): 839-840.
21.
go back to reference WHO: Maternal, newborn and child health household survey guidelines (Draft). 2009, Switzerland: Geneva: World Health Organization WHO: Maternal, newborn and child health household survey guidelines (Draft). 2009, Switzerland: Geneva: World Health Organization
22.
go back to reference Chang S, He W, Jia F, Chen C: Analysis on the changes of nutritional status in China: anemia status of children under 5 in China. J Hygiene Res. 2007, 36 (2): 210-212. Chang S, He W, Jia F, Chen C: Analysis on the changes of nutritional status in China: anemia status of children under 5 in China. J Hygiene Res. 2007, 36 (2): 210-212.
23.
go back to reference Cui Y, Qu Q, Yang L, Wu Q: Analysis on anemia status of children under 3 years old in western China. Chinese J Public Health. 2008, 24 (9): 1052-1053. Cui Y, Qu Q, Yang L, Wu Q: Analysis on anemia status of children under 3 years old in western China. Chinese J Public Health. 2008, 24 (9): 1052-1053.
24.
go back to reference Chang SY, He W, Chen CM: The Growth characteristics of children under 5 in the past 15 years: changing pattern of growth and development of children under age 5. J Hygiene Res. 2006, 35 (6): 768-771. Chang SY, He W, Chen CM: The Growth characteristics of children under 5 in the past 15 years: changing pattern of growth and development of children under age 5. J Hygiene Res. 2006, 35 (6): 768-771.
25.
go back to reference Ba L: Anemia investigation of migrant children under 5 in Chaoyang district. Chinese J Child Health Care. 2011, 19 (4): 357-359. Ba L: Anemia investigation of migrant children under 5 in Chaoyang district. Chinese J Child Health Care. 2011, 19 (4): 357-359.
28.
go back to reference Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera J: Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008, 371 (9608): 243-260. 10.1016/S0140-6736(07)61690-0.CrossRefPubMed Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera J: Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008, 371 (9608): 243-260. 10.1016/S0140-6736(07)61690-0.CrossRefPubMed
29.
go back to reference Pasricha SR, Black J, Muthayya S, Shet A, Bhat V, Nagaraj S, Prashanth NS, Sudarshan H, Biggs BA, Shet AS: Determinants of anemia among young children in rural India. Pediatrics. 2010, 126 (1): e140-e149. 10.1542/peds.2009-3108.CrossRefPubMed Pasricha SR, Black J, Muthayya S, Shet A, Bhat V, Nagaraj S, Prashanth NS, Sudarshan H, Biggs BA, Shet AS: Determinants of anemia among young children in rural India. Pediatrics. 2010, 126 (1): e140-e149. 10.1542/peds.2009-3108.CrossRefPubMed
30.
go back to reference Os O, Rio MM: Determinant factors of anemia in children. J Pediatr (Rio J). 2002, 78 (4): 269-278. 10.2223/JPED.860.CrossRef Os O, Rio MM: Determinant factors of anemia in children. J Pediatr (Rio J). 2002, 78 (4): 269-278. 10.2223/JPED.860.CrossRef
31.
go back to reference Zeng L, Yan H, Chen Z, Dang S, Xie H: Analysis on the prevalence of anemia among children under 3-year-old in 5 provinces in Western China. Chin J Epidemiol. 2004, 25 (3): 47-50. Zeng L, Yan H, Chen Z, Dang S, Xie H: Analysis on the prevalence of anemia among children under 3-year-old in 5 provinces in Western China. Chin J Epidemiol. 2004, 25 (3): 47-50.
32.
go back to reference Zhang A, Zhang J, Wang Y: Study on anemia of 6 ~ 35 months old children in 46 counties of midwestern China. Chinese J Child Health Care. 2009, 17 (3): 260-261. Zhang A, Zhang J, Wang Y: Study on anemia of 6 ~ 35 months old children in 46 counties of midwestern China. Chinese J Child Health Care. 2009, 17 (3): 260-261.
33.
go back to reference Yang WF, Li X, Li Y, Zhang SP, Liu SP, Wang X, Li WM: Anemia, malnutrition and their correlations with socio-demographic characteristics and feeding practices among infants aged 0–18 months in rural areas of Shaanxi province in northwestern China: a cross-sectional study. BMC Public Health. 2012, 12: 1127-10.1186/1471-2458-12-1127.CrossRefPubMedPubMedCentral Yang WF, Li X, Li Y, Zhang SP, Liu SP, Wang X, Li WM: Anemia, malnutrition and their correlations with socio-demographic characteristics and feeding practices among infants aged 0–18 months in rural areas of Shaanxi province in northwestern China: a cross-sectional study. BMC Public Health. 2012, 12: 1127-10.1186/1471-2458-12-1127.CrossRefPubMedPubMedCentral
35.
go back to reference Wharton BA: Iron deficiency in children: detection and prevention. Br J Haematol. 1999, 106 (2): 270-280. 10.1046/j.1365-2141.1999.01511.x.CrossRefPubMed Wharton BA: Iron deficiency in children: detection and prevention. Br J Haematol. 1999, 106 (2): 270-280. 10.1046/j.1365-2141.1999.01511.x.CrossRefPubMed
36.
go back to reference Ma Y, Bi Y, Yan H, Deng L, Liang W, Wang B, Zhang X: The application of decision tree in the research of anemia among rural children under 3-year-old. Zhonghua Yu Fang Yi Xue Za Zhi. 2009, 43 (5): 434-437.PubMed Ma Y, Bi Y, Yan H, Deng L, Liang W, Wang B, Zhang X: The application of decision tree in the research of anemia among rural children under 3-year-old. Zhonghua Yu Fang Yi Xue Za Zhi. 2009, 43 (5): 434-437.PubMed
37.
go back to reference Hadler MC, Juliano Y, Sigulem DM: Anemia in infancy: etiology and prevalence. J Pediatr (Rio J). 2002, 78 (4): 321-326. Hadler MC, Juliano Y, Sigulem DM: Anemia in infancy: etiology and prevalence. J Pediatr (Rio J). 2002, 78 (4): 321-326.
38.
go back to reference Shi Z, Zhen S, Wittert GA, Yuan B, Zuo H, Taylor AW: Inadequate riboflavin intake and anemia risk in a Chinese population: five-year follow up of the Jiangsu nutrition study. PLoS One. 2014, 9 (2): e88862-10.1371/journal.pone.0088862. doi:10.1371/journal.pone.0088862CrossRefPubMedPubMedCentral Shi Z, Zhen S, Wittert GA, Yuan B, Zuo H, Taylor AW: Inadequate riboflavin intake and anemia risk in a Chinese population: five-year follow up of the Jiangsu nutrition study. PLoS One. 2014, 9 (2): e88862-10.1371/journal.pone.0088862. doi:10.1371/journal.pone.0088862CrossRefPubMedPubMedCentral
39.
go back to reference Lynch S, Stoltzfus R, Rawat R: Critical review of strategies to prevent and control iron deficiency in children. Food Nutr Bull. 2007, 28 (4 Suppl): S610-S620.CrossRefPubMed Lynch S, Stoltzfus R, Rawat R: Critical review of strategies to prevent and control iron deficiency in children. Food Nutr Bull. 2007, 28 (4 Suppl): S610-S620.CrossRefPubMed
40.
go back to reference Calis JC, Phiri KS, Faragher EB, Brabin BJ, Bates I, Cuevas LE, Haan RJ, Phiri AI, Malange P, Khoka M, Hulshof PJM, Lieshout L, Beld MGHM, Teo YY, Rockett KA, Richardson A, Kwiatkowski DP, Molyneux M, Hensbroek MB: Severe anemia in Malawian children. N Engl J Med. 2008, 358 (9): 888-899. 10.1056/NEJMoa072727.CrossRefPubMed Calis JC, Phiri KS, Faragher EB, Brabin BJ, Bates I, Cuevas LE, Haan RJ, Phiri AI, Malange P, Khoka M, Hulshof PJM, Lieshout L, Beld MGHM, Teo YY, Rockett KA, Richardson A, Kwiatkowski DP, Molyneux M, Hensbroek MB: Severe anemia in Malawian children. N Engl J Med. 2008, 358 (9): 888-899. 10.1056/NEJMoa072727.CrossRefPubMed
41.
go back to reference Zhan Y, Chen R, Zheng W, Guo C, Lu L, Ji X, Chi Z, Yu J: Association between serum magnesium and anemia: China health and nutrition survey. Biol Trace Elem Res. 2014, doi:10.1007/s12011-014-9967-x Zhan Y, Chen R, Zheng W, Guo C, Lu L, Ji X, Chi Z, Yu J: Association between serum magnesium and anemia: China health and nutrition survey. Biol Trace Elem Res. 2014, doi:10.1007/s12011-014-9967-x
42.
go back to reference Shi Z, Hu X, He K, Yuan B, Garg M: Joint association of magnesium and iron intake with anemia among Chinese adults. Nutrition. 2008, 24 (10): 977-84. 10.1016/j.nut.2008.05.002.CrossRefPubMed Shi Z, Hu X, He K, Yuan B, Garg M: Joint association of magnesium and iron intake with anemia among Chinese adults. Nutrition. 2008, 24 (10): 977-84. 10.1016/j.nut.2008.05.002.CrossRefPubMed
44.
go back to reference Leung AK, Chan KW: Iron deficiency anemia. Adv Pediatr. 2001, 48: 385-408.PubMed Leung AK, Chan KW: Iron deficiency anemia. Adv Pediatr. 2001, 48: 385-408.PubMed
46.
go back to reference Meinzen-Derr JK, Guerrero ML, Altaye M, Ortega-Gallegos H, Ruiz-Palacios GM, Morrow AL: Risk of infant anemia is associated with exclusive breast-feeding and maternal anemia in a Mexican cohort. J Nutr. 2006, 136 (2): 452-458.PubMed Meinzen-Derr JK, Guerrero ML, Altaye M, Ortega-Gallegos H, Ruiz-Palacios GM, Morrow AL: Risk of infant anemia is associated with exclusive breast-feeding and maternal anemia in a Mexican cohort. J Nutr. 2006, 136 (2): 452-458.PubMed
Metadata
Title
Disparity of anemia prevalence and associated factors among rural to urban migrant and the local children under two years old: a population based cross-sectional study in Pinghu, China
Authors
Shiyun Hu
Hui Tan
Aiping Peng
Hong Jiang
Jianmei Wu
Sufang Guo
Xu Qian
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-601

Other articles of this Issue 1/2014

BMC Public Health 1/2014 Go to the issue