The double burden of malnutrition among young Chinese children: a hierarchical structure of socioeconomic inequality indicators

Extant studies have deployed variable-centered methods to examine predictors of children's nutritional status, and few focus on the double burden of malnutrition among young Chinese children. This paper adopts a person-centered approach and leverages data from large samples of Chinese families (the China Health and Nutrition Survey, CHNS 2004-2015, and China Family Panel Studies, CFPS 2010-2018) to examine trends in the prevalence of stunting, overweight, and stuntingoverweight in early childhood. We developed a hierarchical structure of socioeconomic indicators, including region (Eastern-Central-Western), urbanicity (urban-rural), and family socioeconomic status gradient (four quartiles). We assessed relative risks for malnutrition for 24 subgroups of children from varying socioeconomic strata. Results indicate that the prevalence of stunting decreased consistently while the prevalence of being overweight increased first, followed by a decreasing trend. Moreover, a small group of stuntedoverweight children (4.7%) was identified. Data from the CHNS indicated that children from affluent families in the Central region were prone to being overweight. Data from the CFPS indicate that underprivileged groups (children from poor rural families living in Western China) were at higher risk for both undernutrition and overnutrition than their more advantaged peers. The findings suggest that children in poor, rural areas in Western China should be targeted for malnutrition alleviation.