Background. Despite growing wealth and the growing commitment of China’s government to providing quality education, a significant share of children across rural China still have no access to regular sources of iron-rich foods, vitamins and other micronutrients. Such poor diets may not only result in high incidences of nutritional problems, including anemia, good nutrition has been shown to be an effective input into the creation of human capital.

Objective. To increase our understanding of the extent of anemia in poor Shaanxi Province’s primary schools, and identify structural correlates of anemia in this region. Methods. A cross-section survey was conducted. Data were collected from 4000 grade fourth grand students (ages 9 to 11) in 70 primary schools in poor rural areas of Shaanxi province. Structured questionnaires and standard test were used to gather data. Trained nurses carried out the hemoglobin tests (using Hemocue finger prick kits) and anthropomorphic measurements using high quality equipment.

Results. The paper shows that the overall anemia rate is 21.5% (39%) when using a blood hemoglobin cutoff of 115 g/L (120 g/L). We find that those students that are boarding at school and those students that eat lunch away from home are more likely to be anemic. Children with anemia are found to have lower height for age (HAZ) scores and have higher incidences of stunting.

Conclusions. If this part of Shaanxi province is representative of the rest of Shaanxi’s poor rural areas (or all national designed poor counties in China), this means that tens of thousands (or millions) of children in rural Shaanxi (all national designed poor counties in China) may be anemic. Although we were not able to pinpoint the exact determinates and causal effects of anemia, the main implication of this work is that anemia remains a serious health problem for educators and health officials in rural China.