Background: High rates of iron-deficiency anemia among school-age children have been a common issue in developing countries. In 2012, China rolled out a school feeding program (SFP) to address this issue. This study assesses changes in anemia rates, as well as potential factors driving these changes, both 3 and 10 years after the SFP was implemented.

Methods: Data were from two cross-sectional surveys (n = 1510) in northwestern China. T-tests were used to compare the differences in health outcomes of students and their dietary diversity across the different sample years. Regressions were used to examine the associations between health outcomes and dietary diversity.

Results: After the SFP was launched, hemoglobin levels of students improved from 126 to 131 g/L between 2015 and 2022/2023; the rates of anemia and stunting decreased from 17% to 6% and 9% to 1%, respectively. A rise in student dietary diversity and an increase in the share of students that consumed iron-rich foods are two main contributing factors.

Implications for School Health Policy, Practice, and Equity: Increase in funding allotted to the SFP over time appears to be a key element in improving the health and nutrition of rural students.

Conclusions: SFP in rural China exemplifies the concrete advantages in improving the health and potential educational outcomes of students.

The connections between bullying and student well-being in rural areas are not well understood, particularly among younger, more vulnerable students. This study aims to explore the relationship between bullying experiences and the academic performance and mental health of primary and junior high school students in rural China. The sample comprised 1609 students from 30 schools (20 primary schools and 10 junior high schools) in Gansu province. A self-report questionnaire was used to collect data on students’ demographics, bullying experiences, mental health, and social support. Additionally, a 30-minute standardized math test was administered to assess academic performance. Results indicated that bullying was prevalent in rural settings, with 42.64% of students reporting being bullied and 12.74% experiencing it weekly. A significant correlation was found between bullying experiences and both lower academic performance and higher risk of mental health problems, such as depression and anxiety. These correlations became more pronounced with increased frequency of bullying incidents. We also found that female students and younger students who were bullied were more likely to report mental health issues. Furthermore, social support could diminish, but not entirely counteract, the adverse associations between bullying and mental health. These findings highlight the prevalence of bullying among rural students in this age group and demonstrate the associated negative outcomes for their mental health and academic performance. They also emphasize the need for targeted attention and the development of intervention programs, including enhanced school-based anti-bullying initiatives and improved social support systems.

Background: Poor mental health affects caregivers' parenting practices and threatens the early development of children under 2 years old. This study examined the correlations between caregivers' mental health and parenting practices among 5- to 24-month-old children in rural China.

Methods: Data were collected in two cohorts (October 2022 and March 2023) from 948 households randomly sampled from 120 villages. Dependent variable: parenting practices measured by the Family Care Indicators (FCI). Independent variables: caregiver mental health (DASS-21), perceived social support (MSPSS) and socioeconomic status (SES; household asset index, caregiver education). Models adjusted for child age, child sex, caregiver age and household size, with standard errors clustered at the village level.

Results: Although caregivers provided more play materials for their children compared to previous research, the variety of play materials did not improve. Depressive symptoms among caregivers were associated with inadequate parenting practices, particularly with providing a lower variety of play materials. Both lower SES and more severe caregiver depressive symptoms were linked to less stimulating parenting, whereas higher perceived social support was associated with more stimulating practices and partially attenuated these SES- and mental health–related disparities.

Conclusion: Although rural Chinese caregivers now supply more play materials, limited diversity and widespread caregiver mental health risks persist. Strengthening caregiver mental health and social support could enrich home stimulation and improve early childhood development.