Guest Blog: Diminishing Health Benefits for Youngsters in Cities

Guest Blog: Diminishing Health Benefits for Youngsters in Cities

Elsabé Brits

Research conducted by a global coalition of more than 1 500 researchers and physicians has found that the healthy growth and development of children and adolescents living in cities have reduced during this century.

The study, published in Nature, was led by Imperial College London and included researchers from the South African Medical Research Council’s (SAMRC) Non-Communicable Disease Research Unit.

Historical growth and developmental advantages for children and adolescents living in cities over rural areas have diminished in most. However, urban advantages were amplified for boys living in some regions of Africa and Asia.

Based on an analysis of 71 million young people from 200 countries worldwide, the findings may help inform policies and programmes that aim to improve growth and development outcomes.

Optimal growth and development in childhood and adolescence are crucial for lifelong health and well-being; it is influenced by nutrition and the living environment at home, in the community and at

Height and weight data were collected from peopled aged 5 to 19, who lived in rural and urban areas in 200 countries between 1990 and 2020.

They found that in 1990, children and adolescents in cities were taller than their rural counterparts in all but a few countries. But, by 2020, the urban height advantage became smaller in most countries, and many wealthy Western countries — such as the UK, USA and France — reversed into a small urban disadvantage.

The exception was for boys in most countries in sub-Saharan Africa and in some countries in the Pacific, south Asia, and the Middle East. In these countries, successive cohorts of rural boys either did not gain height or possibly even became shorter.

Body-mass index (BMI), which measures whether a person is underweight or overweight for their height, increased slightly more in cities than in rural areas, except in South Asia, sub-Saharan Africa, and some countries in central and eastern Europe.

The experience in South Africa is one such example of the overall stagnating or reversing of height gains seen in sub-Saharan Africa. For South African boys, mean height stagnated in urban and rural areas over the last two decades, keeping the urban height advantage around 1.5cm by 2020. BMI increased for both South African boys and girls, but similar to their African peers, this increase happened faster for rural children and adolescents, and the urban-rural BMI difference was essentially closed by 2020.

The study also assessed children’s BMI – as a reflection of the quality of nutrition and healthiness of the environment during childhood and adolescence growth. These are important indicators of health and developmental outcomes throughout life, providing insight into whether they have a healthy weight for their height.

Researchers found that children living in cities had a slightly higher BMI than children in rural areas in 1990. By 2020, BMI averages rose for most countries, while faster for urban children, except in sub-Saharan Africa and South Asia, where BMI rose faster in rural areas.

Nevertheless, over 30 years, the gap between urban and rural BMI remained small—less than 1.1kg/m² globally (less than 2kg in weight for a child who is 130cm tall or less than 3kg in weight for an adolescent who is 160cm tall).

The South African Child Gauge, an annual publication of the Children’s Institute at the University of Cape Town, is probably one of the country’s best scientific reports and is of international standard.

They use “slow violence” to illustrate how food and nutrition insecurity during childhood is a silent threat to human development that casts a long shadow across the life course and contributes towards the intergenerational transfer of poverty, malnutrition, and ill-health.

Science shows that South Africa’s malnutrition story starts even before birth. The burden of care falls on women. South African women carry the primary burden of care for children. Only 34% of children live with biological parents, 43% with mother only, and 23% of children live with neither parent – most of whom are cared for by relatives (mostly grandmothers) to free women up to seek work elsewhere.

This shows how family forms are often stretched and fluid as children move between households and provinces. Yet despite these livelihood strategies, levels of unemployment are particularly high amongst women. In 2020 the Child Gauge showed that millions of mothers tragically only have one meal a day in that their children can have more food.

If we want our children to grow and flourish, we must support them, their mothers and all the grandmothers, sisters and aunties who care for them.

Views expressed are the writer’s only.

Leave a Reply

Your email address will not be published. Required fields are marked *

Search Centre


Fill in your details to

Sign Up for Our Monthly Newsletter

We don’t spam. Our newsletter is filled with research articles and HASA related content and announcements.