Soil-transmitted helminths (STHs) are parasitic intestinal worms that infect more than two out of every five schoolchildren in rural China, an alarmingly high prevalence given the low cost and wide availability of safe and effective deworming treatment. Understanding of local knowledge, attitudes, and practices regarding STHs in rural China has until now, been sparse, although such information is critical for prevention and control initiatives. This study elucidates the structural and sociocultural factors that explain why deworming treatment is rarely sought for schoolchildren in poor villages of rural China with persistently high intestinal worm infection rates. In-depth, qualitative interviews were conducted in six rural villages in Guizhou Province; participants included schoolchildren, children’s parents and grandparents, and village doctors. We found evidence of three predominant reasons for high STH prevalence: lack of awareness and skepticism about STHs, local myths about STHs and deworming treatment, and poor quality of village health care. The findings have significant relevance for the development of an effective deworming program in China as well as improvement of the quality of health care at the village level. 

Although China has experienced rapid economic growth over the past few decades, significant health and nutritional problems remain. Little work has been done to track basic diseases, such as iron-deficiency anemia, so the exact prevalence of these health problems is unknown. The goals of this study were to assess the prevalence of anemia in China and identify individual, household and community-based factors associated with anemia. We used data from the 2009 China Health and Nutrition Survey (CHNS), including the measurement of he- moglobin levels among 7,261 individuals from 170 communities and 7 provinces in central and eastern China. The overall prevalence of anemia was 13.4% using the WHO’s blood hemoglobin thresholds (1968). This means in China’s more developed central and eastern regions up to 180 million people may be anemic. Some vulnerable subgroups were disproportionately affected by anemia. Seniors (aged 60 years and above) were more likely to be anemic than younger age cohorts, and females had higher anemia prevalence among all age groups except among children aged 7 to 14 years. We found a negative correlation between household wealth and the presence of anemia, suggesting anemia prevalence may decline as China’s economy grows. However, the prevalence of anemia was greater in migrant households, which should be experiencing an improved economic status.

Junior high dropout rates are up to 25% in poor, rural areas of China. Although existing studies have examined how factors such as high tuition and opportunity costs contribute to dropout, fewer studies have explored the relationship between dropout rates and mental health in rural China. The overall goal of this study is to examine the relationship between dropout and mental health problems in rural Chinese junior high schools. Correlational analysis was conducted among 4,840 students across 38 junior high schools in rural China. Ordinary least squares (OLS) regressions were used to determine the types of students most at risk for mental health problems and whether mental health problems are correlated with dropout behavior. Our measure for mental health is based on the Children’s Manifest Anxiety Scale. Mental health problems are widespread in the sample of rural children, with 74% of students at risk for mental health problems. The student and family characteristics that correlate with dropout (poverty and low achievement) also correlate with mental health problems. More importantly, even after controlling for these background characteristics, mental health problems remain correlated with dropout rates. Mental health problems, especially among low-achieving poor students, may be contributing to the high dropout rates in rural China today. This finding suggests that interventions focusing on mental health in rural areas may also help reduce dropout.

Empirical evidence suggests that the prevalence of soil-transmitted helminth (STH) infections in remote and poor rural areas is still high among children, the most vulnerable to infection. There is concern that STH infections may detrimentally affect children’s healthy development, including their cognitive ability, nutritional status, and school performance. Medical studies have not yet identified the exact nature of the impact STH infections have on children. The objective of this study is to examine the relationship between STH infections and developmental outcomes in 2,180 school-aged children in seven nationally-designated poverty counties in rural China. We conducted a large-scale survey in Guizhou province in southwest China in May, 2013. Overall, 42 percent of elementary school-aged children were infected with one or more of the three types of STH—Ascarislumbricoides (ascaris), Trichuris trichuria (whipworm) and the hookworms Ancylostoma duodenaleor Necator americanus. After controlling for socioeconomic status, we observed that children infected with one or more STHs have worse cognitive ability, worse nutritional status, and worse school performance than their uninfected peers.

Despite their recent deterioration, village clinics have historically been an important source of health care for the poor and elderly in rural China. In this paper, we examine the current role of village clinics, the patients who use them and some of the services they provide. We focus specifically on the role of village clinics in meeting the health-care needs of the rural poor and elderly. We find that although clinics are continuing to decline financially, they remain a source of care for the rural elderly and poor. We estimate that the elderly are 10–15 percent more likely than young individuals to seek care at a clinic. We show that clinics provide many unique services to support the rural elderly (and the elderly poor), such asin-home patient care, the option for patients to pay on credit, and free and discounted services.

Despite increasing institutional and financial support, certain public health issues are still neglected by the Chinese Government. The present paper examines the soil-transmitted helminth (STH) infection and reinfection rates by conducting a survey on 1724 children in Guizhou Province, China. Our results indicate that 37.5 percent of children had been infected with one or more of the three types of tested STH. However, only 50.4 percent of children reported having taken deworming medicine during the 18-month period before the survey. Of those who reported being dewormed, 34.6 percent tested positive for STH infections. Poverty and number of siblings are significantly and positively correlated with infection and reinfection, and parental education is significantly and negatively correlated with infection and reinfection. Given the ineffectiveness of treatment in these areas to date, for anthelminthic campaigns to actually succeed, China must pay more attention to locallevel incentives to improve children’s health.