Diminishing benefits of urban living for children and adolescents’ growth and development

NCD Risk Factor Collaboration (NCD-RisC), Anu Mishra, Bin Zhou, Andrea Rodriguez-Martinez, Honor Bixby, Rosie K. Singleton, Rodrigo M. Carrillo-Larco, Kate E. Sheffer, Christopher J. Paciorek, James E. Bennett, Victor Lhoste, Maria L.C. Iurilli, Mariachiara Di Cesare, James Bentham, Nowell H. Phelps, Marisa K. Sophiea, Gretchen A. Stevens, Goodarz Danaei, Melanie J. Cowan, Stefan SavinLeanne M. Riley, Edward W. Gregg, Wichai Aekplakorn, Noor Ani Ahmad, Jennifer L. Baker, Adela Chirita-Emandi, Farshad Farzadfar, Günther Fink, Mirjam Heinen, Nayu Ikeda, Andre P. Kengne, Young Ho Khang, Tiina Laatikainen, Avula Laxmaiah, Jun Ma, Michele Monroy-Valle, Malay K. Mridha, Cristina P. Padez, Andrew Reynolds, Maroje Sorić, Gregor Starc, James P. Wirth, Leandra Abarca-Gómez, Ziad A. Abdeen, Shynar Abdrakhmanova, Johan G. Eriksson, Terho Lehtimäki, Rahman Shiri, Jaakko Tuomilehto, Hannu M.T. Uusitalo

Research output: Contribution to journalArticleScientificpeer-review

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Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

Original languageEnglish
Pages (from-to)874-883
Number of pages10
Issue number7954
Publication statusPublished - 30 Mar 2023
Publication typeA1 Journal article-refereed

Publication forum classification

  • Publication forum level 3

ASJC Scopus subject areas

  • General


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