中国西部农村小学生的健康与教育研究
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摘要
我国已经提出优先发展教育、建立人力资源强国的目标，然而我国目前仍然只能称作人力资源的大国，尤其是西部农村地区劳动力的平均教育水平还较低，这严重地制约着西部的经济发展。而且，近半个世纪以来国内外的经济发展、扶贫经验无不告诉我们落后地区要摆脱落后、实现经济追赶，必需要提高人们的健康和教育水平，人力资本追赶往往是经济追赶的先导。然而，改革开放以来，城乡、地区之间的各方面差距拉大，推进教育公平促进社会的和谐发展变得更加迫切。
儿童青少年的发展关系着国家和民族的未来，基础教育、卫生健康在他们的成长发展中处于不可或缺的重要地位。本研究旨在关注两部农村贫困地区小学生的健康与营养状况，关注健康和教育的互补性。论文从经济学的视角，采用计量经济方法分析小学生的营养健康状况对于其教育成绩的影响，揭示健康与教育的内在联系，为改善西部地区儿童青少年的健康和教育状况，推进两部农村学校卫生事业提供有益的探讨，为改善相关农村卫生政策、教育政策的针对性和提高政策措施效率提供可能的参考。
实证分析得出以下结论：(1)对身高、体重的分析发现，西部农村小学生的身体形态发育明显落后于全国平均水平。根据我国国家学生体质健康标准判断，样本小学生的营养状况分布为，正常体重占44．02％，超重和肥胖分别占3．34％、4．93％，较低体重和营养不良分别为42．26％、5．45％。分析发现，营养不良检出率随着年龄的增加而增加，10岁～14岁年龄段的营养不良和较低体重是比较突出的问题。(2)利用世界卫生组织的学龄儿童青少年生长标准对西部农村小学生的营养状况进行了筛查分析，结果不容乐观。小学生的总体营养不良检出率为30％，随着年龄的增长，小学生的营养不良检出率逐渐增加，ll岁以上的小学生中营养不良检出率已经超过了50％；14岁小学生的营养不良检出率超过了80％!无论是从发展趋势上看，还是从营养不良检出规模看，西部农村小学生的营养不良状况都是非常严峻的。(3)小学生缺铁问题比较普遍，45．21％的学生处于缺铁状态，40．42％的学生存在不同程度的缺铁性贫血。与全国同龄学生相比，西部孩子的低血红蛋白检出率要高出5～8个百分点。不过，样本小学生的视力状况要好于全国同龄平均水平。(4)工具变量法估计结果表明，小学生的健康状况对其学习成绩有着非常显著的正向影响，在其它因素保持不变的条件下，小学生的年龄别身高z评分每增加一分，其语文成绩、数学成绩、自然成绩将分别提高0．443、0．315、0．142个标准差；相当于按百分制评分，三科总成绩提高接近9分。年龄别BMI的z评分每提高一分，小学生的语文成绩、数学成绩将分别提高1．559、1．146个标准差；按百分制计算，其语文成绩、数学成绩将分别提高14．72分、11．41分，总成绩提高24．14分。(5)健康对教育的积极作用在健康状况较差的小学生身上的影响程度更大、更显著，而且同幅度的健康水平提高对男生的教育回报要高出女生约二分之一。
论文建议政府加强对小学生群体的营养干预，通过改善学校供餐；加强食物营养强化项目在西部的推广；强化对小学生的定期体检及健康营养教育；探索改进健康评价标准、推动营养立法等工作，为提高孩子的营养健康水平提供保证，通过采取营养健康干预措施提高教育投入的效率、促进西部农村教育事业发展，推进教育公平，促进西部经济发展。
China has set education development and establishing a great power of human resource as priority goals, nevertheless it can only be called as a country with huge human resources presently. The educational level of western rural labor is especially low, which severely impedes the economic development of western China. However, economic development and poverty reduction experiences home and abroad in the past 50 years tell us a unanimous truth: Human capital chase generally is the forerunner of economic chase. Less developed regions must enhance its citizens' health and education level before they can shake off laggard status and move forwards. In the wake of increasingly obvious urban-rural disparity and regional gap since China's reform and opening-up, it's imperative to promote education equity and harmonious development.
Children and adolescents development is closely linked to a nation's future, while primary education and health plays an indispensable role in their growth. This paper aims to study the health and nutrition status of elementary school students in poor western rural regions, and to understand the complementarity between health and education. In the perspective of economics, the paper, adopting econometric approach, examines the health impacts on educational achievement to reveal the inner link between health and education. This provides useful discussion on promoting children's nutrition and health status and pushing forward school health in western rural regions. The paper provides possible references for improving rural health and education policy pertinency and enhancing policy efficiency.
Empirical analysis finds that a) In terms of physical development, western rural elementary school children grow lagging behind national average obviously when examining height and weight. Judged by national standard for student health, sample elementary students' nutrition status distributes as the following, normal weight accounts for 44.02%, overweight and obesity account for 3.34% and 4.93%, underweight and malnutrition account for 42.26% and 5.45%. The paper finds that malnutrition incidence increases as age goes up, and malnutrition and underweight are the severe problems encountered by students aged between 10 years and 14 years, b) Judged by the WHO Growth Reference 2007 for school-aged children and adolescents, the nutritional status of western rural children under analysis is discouraging. Malnutrition incidence of the sample students is 30% and increases with age. Malnutrition incidence for students above 11-year old exceeds 50% and exceeds 80% for students aged 14 years. The malnutrition status of western rural children is severe whether in terms of trend or size, c) Iron deficiency is prevalent among sample students, with 45.21% encountering iron deficiency and 40.42% suffering from iron deficiency anemia. Compared with peers nationwide, the low hemoglobin incidence of western children is 5-8 percentages higher. But, the vision status of sample students is better than their peers at national level, d) Instrument variable estimation results show that students' health status has a significant positive impact on their test scores. Holding other factors constant, each additional point increase in a student's height-for-age z-score raises his Chinese test score by 0.443 standard deviation (SD), math test score by 0.315 SD, and 0.142 SD for science test score. Putting in 100%, this means that total test score will go up by 9 points. Each additional point increase in BMI-for-age z-score will raise a student's Chinese test score by 1.559 SD and math test score by 1.146 SD. Putting in 100%, this means that Chinese test score and math test score will increase by 14.72 points and 11.41 points respectively, with total score increased by 24.14 points, e) The positive impact of health on education is larger and more significant in terms of students with relatively poor health or nutritional status. The result indicates that improvement in health of same degree brings boys one third more educational returns than for girls.
This paper suggests that government should strengthen nutrition intervention on school-aged children and adolescents. It is recommended that the following measures or policies should be carried out to ensure improvement in students' health and nutritional condition. These measures include improving school-meal supply, promoting food nutrition fortification programs in western China, strengthening regular physical check for students, promoting health education, and advancing nutrition and health legislations. The proposed nutrition and health intervention will raise the efficiency of education input, boost education development in western rural regions, thus promote education equity and advance western economic development.
儿童青少年的发展关系着国家和民族的未来，基础教育、卫生健康在他们的成长发展中处于不可或缺的重要地位。本研究旨在关注两部农村贫困地区小学生的健康与营养状况，关注健康和教育的互补性。论文从经济学的视角，采用计量经济方法分析小学生的营养健康状况对于其教育成绩的影响，揭示健康与教育的内在联系，为改善西部地区儿童青少年的健康和教育状况，推进两部农村学校卫生事业提供有益的探讨，为改善相关农村卫生政策、教育政策的针对性和提高政策措施效率提供可能的参考。
实证分析得出以下结论：(1)对身高、体重的分析发现，西部农村小学生的身体形态发育明显落后于全国平均水平。根据我国国家学生体质健康标准判断，样本小学生的营养状况分布为，正常体重占44．02％，超重和肥胖分别占3．34％、4．93％，较低体重和营养不良分别为42．26％、5．45％。分析发现，营养不良检出率随着年龄的增加而增加，10岁～14岁年龄段的营养不良和较低体重是比较突出的问题。(2)利用世界卫生组织的学龄儿童青少年生长标准对西部农村小学生的营养状况进行了筛查分析，结果不容乐观。小学生的总体营养不良检出率为30％，随着年龄的增长，小学生的营养不良检出率逐渐增加，ll岁以上的小学生中营养不良检出率已经超过了50％；14岁小学生的营养不良检出率超过了80％!无论是从发展趋势上看，还是从营养不良检出规模看，西部农村小学生的营养不良状况都是非常严峻的。(3)小学生缺铁问题比较普遍，45．21％的学生处于缺铁状态，40．42％的学生存在不同程度的缺铁性贫血。与全国同龄学生相比，西部孩子的低血红蛋白检出率要高出5～8个百分点。不过，样本小学生的视力状况要好于全国同龄平均水平。(4)工具变量法估计结果表明，小学生的健康状况对其学习成绩有着非常显著的正向影响，在其它因素保持不变的条件下，小学生的年龄别身高z评分每增加一分，其语文成绩、数学成绩、自然成绩将分别提高0．443、0．315、0．142个标准差；相当于按百分制评分，三科总成绩提高接近9分。年龄别BMI的z评分每提高一分，小学生的语文成绩、数学成绩将分别提高1．559、1．146个标准差；按百分制计算，其语文成绩、数学成绩将分别提高14．72分、11．41分，总成绩提高24．14分。(5)健康对教育的积极作用在健康状况较差的小学生身上的影响程度更大、更显著，而且同幅度的健康水平提高对男生的教育回报要高出女生约二分之一。
论文建议政府加强对小学生群体的营养干预，通过改善学校供餐；加强食物营养强化项目在西部的推广；强化对小学生的定期体检及健康营养教育；探索改进健康评价标准、推动营养立法等工作，为提高孩子的营养健康水平提供保证，通过采取营养健康干预措施提高教育投入的效率、促进西部农村教育事业发展，推进教育公平，促进西部经济发展。
China has set education development and establishing a great power of human resource as priority goals, nevertheless it can only be called as a country with huge human resources presently. The educational level of western rural labor is especially low, which severely impedes the economic development of western China. However, economic development and poverty reduction experiences home and abroad in the past 50 years tell us a unanimous truth: Human capital chase generally is the forerunner of economic chase. Less developed regions must enhance its citizens' health and education level before they can shake off laggard status and move forwards. In the wake of increasingly obvious urban-rural disparity and regional gap since China's reform and opening-up, it's imperative to promote education equity and harmonious development.
Children and adolescents development is closely linked to a nation's future, while primary education and health plays an indispensable role in their growth. This paper aims to study the health and nutrition status of elementary school students in poor western rural regions, and to understand the complementarity between health and education. In the perspective of economics, the paper, adopting econometric approach, examines the health impacts on educational achievement to reveal the inner link between health and education. This provides useful discussion on promoting children's nutrition and health status and pushing forward school health in western rural regions. The paper provides possible references for improving rural health and education policy pertinency and enhancing policy efficiency.
Empirical analysis finds that a) In terms of physical development, western rural elementary school children grow lagging behind national average obviously when examining height and weight. Judged by national standard for student health, sample elementary students' nutrition status distributes as the following, normal weight accounts for 44.02%, overweight and obesity account for 3.34% and 4.93%, underweight and malnutrition account for 42.26% and 5.45%. The paper finds that malnutrition incidence increases as age goes up, and malnutrition and underweight are the severe problems encountered by students aged between 10 years and 14 years, b) Judged by the WHO Growth Reference 2007 for school-aged children and adolescents, the nutritional status of western rural children under analysis is discouraging. Malnutrition incidence of the sample students is 30% and increases with age. Malnutrition incidence for students above 11-year old exceeds 50% and exceeds 80% for students aged 14 years. The malnutrition status of western rural children is severe whether in terms of trend or size, c) Iron deficiency is prevalent among sample students, with 45.21% encountering iron deficiency and 40.42% suffering from iron deficiency anemia. Compared with peers nationwide, the low hemoglobin incidence of western children is 5-8 percentages higher. But, the vision status of sample students is better than their peers at national level, d) Instrument variable estimation results show that students' health status has a significant positive impact on their test scores. Holding other factors constant, each additional point increase in a student's height-for-age z-score raises his Chinese test score by 0.443 standard deviation (SD), math test score by 0.315 SD, and 0.142 SD for science test score. Putting in 100%, this means that total test score will go up by 9 points. Each additional point increase in BMI-for-age z-score will raise a student's Chinese test score by 1.559 SD and math test score by 1.146 SD. Putting in 100%, this means that Chinese test score and math test score will increase by 14.72 points and 11.41 points respectively, with total score increased by 24.14 points, e) The positive impact of health on education is larger and more significant in terms of students with relatively poor health or nutritional status. The result indicates that improvement in health of same degree brings boys one third more educational returns than for girls.
This paper suggests that government should strengthen nutrition intervention on school-aged children and adolescents. It is recommended that the following measures or policies should be carried out to ensure improvement in students' health and nutritional condition. These measures include improving school-meal supply, promoting food nutrition fortification programs in western China, strengthening regular physical check for students, promoting health education, and advancing nutrition and health legislations. The proposed nutrition and health intervention will raise the efficiency of education input, boost education development in western rural regions, thus promote education equity and advance western economic development.
引文
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