Understanding the disease burden of mental disorders in children and adolescents in China, especially at the sub-national level, is important for effective prevention and intervention. This study aims to assess the prevalence and related health burden of mental disorders in children and adolescents in China. Following the same approach as the Global Burden of Disease Study 2021, we systematically analyze epidemiological and demographic information for mental disorders, and assess the prevalence, disability-adjusted life-years (DALYs), and years lived with disability (YLDs) in the children and adolescents for mental disorders and their ten subtypes across national and provinces in China from 1990 to 2021. In 2021, the age-standardized prevalence of mental disorders in children and adolescents was 8.9% (uncertainty intervals [UI]: 8.1, 9.8) in China, accounting for 30.8 million cases (26.0, 36.3) and 2.8 million DALYs (2.0, 3.7). Among mental disorders, attention-deficit/hyperactivity disorder had the highest age-standardized prevalence, at 3.6% (3.0, 4.5). From 1990 to 2021, the age-standardized prevalence increased by 4.8%, but the number of mental disorders cases decreased by 21.9%. DALYs for mental disorders are higher in boys than in girls across all age groups. At the provincial level, the age-standardized prevalence of mental disorders in some provinces was much greater than that in other provinces (e.g., bipolar disorder in Hebei was more than two times greater than that in other provinces). Although disparities in the distribution of mental disorder burden were observed across provinces, there was a reduction in income-related inequality, where the gap in the age-standardized DALY rates between the highest and lowest income provinces decreased by 61.7% between 1990 and 2021. In 2021, among 22 health condition groups in China, mental disorders accounted for the largest proportion of health life lost. Mental disorders are the leading causes of disability in children and adolescents in China, and the disease burden varies geographically. Careful planning of health services, including consideration of the local situation, is needed. China National Natural Science Foundation (Grant No. 72104113, 72204112), Social Science Fund of Jiangsu Province (Grant No. 21GLD008), ShuangChuang Doctor Program of Jiangsu Province (Grant No. JSSCBS20210359), and the Fundamental Research Funds for the Central Universities (Grant No. 30923011101).

China has the largest obese population in the world, and the prevalence of central obesity is increasing dramatically in China. Moreover, the rapid economic growth of China in recent decades has led to rapid urbanization in rural China. However, studies comparing the prevalence trends of different types of obesity and the association of obesity with hypertension between urban and rural areas in China are very scarce, and most studies have focused only on the difference in the prevalence of overweight and general obesity or hypertension among rural and urban populations. Therefore, the focus of this study was to examine the shifts in the overall distribution of the prevalence of different types of obesity and to estimate the risk of hypertension in different types of obesity among urban and rural adults aged 18–65 years. Seven iterations of the China Health and Nutrition Survey (CHNS), conducted in 1993, 1997, 2000, 2004, 2006, 2009 and 2011, were used in this study. A total of 53,636 participants aged 18–65 years were included. Obesity was classified into three types based on body mass index (BMI) and waist circumference (WC). A log-binomial model was constructed to estimate the prevalence ratio (PR) of hypertension with three types of obesity. The age-standardized prevalence of central obesity only, general obesity only, and both central and general obesity increased from 15.8, 0.2 and 2.9% in 1993 to 30.3, 0.9 and 10.3% in 2011, respectively. The prevalence of central obesity only (urban vs. rural: 20.8% vs. 13.4% in 1993, 29.6% vs. 30.6% in 2011) and both central and general obesity (urban vs. rural: 3.5% vs. 2.5% in 1993, 10.0% vs. 10.6% in 2011) in rural adults exceeded that in urban adults in 2011. Participants with both central and general obesity had the highest risk for incident hypertension compared with those with normal body measurements (adjusted PR, urban: 2.30 (95% CI, 2.01–2.63), rural: 2.50 (95% CI, 2.25–2.77)). Both WC and BMI should be considered measures of obesity and targeted in hypertension prevention. More attention should be paid to the incidence of central obesity in adults in rural China.

Although the awareness of mental health problems in late life is rising, the association between financial transfers to the older generations from children and mental health at older ages in China has received little attention. This study examines the association between financial transfers from children and depressive symptoms among the mid-aged and elderly residents (from 45 years of age and older) in China. We used the data from the China Health and Retirement Longitudinal Study (CHARLS, 2013) (n = 10,935) This included data on financial transfers from all non-co-resident children to their parents, and the individual scores on depressive symptoms as measured by the 10-item Center for Epidemiologic Studies–Depression Scale (CESD-10). A two-level - individual and community levels - mixed linear model was deployed to explore their association. Financial transfers from children to parents was the major component of inter-generational financial transfers in Chinese families. A higher financial support from non-co-resident children was signivicantly and positively related to fewer depressive symptoms (coef. = − 0.195,P-value< 0.001) among both the mid-aged and elderly parents. Financial transfers from non-co-resident children are associated with depressive symptoms among mid-aged and elderly residents in the China situation. Taxation and other policy measures should encourage and facilitate these type of financial transfers and prevent a decrease of support from children to parents.

In 2013, China launched the Belt and Road (B&R) Initiative in an effort to promote trade and economic collaboration. This study examined the change in life expectancy (LE) among countries along B&R and studied the impact of economic development on LE. Data from 65 B&R countries from 2000 to 2014 were compiled and analyzed. Trend of LE was examined by sex and country. Linear quantile mixed model was used to study the associations between LE and economic factors. In 2014, the average LE in all B&R countries was 69.7 years for men and 73.7 years for women. Across countries in 2014, LE for men ranged from 58.6 years in Afghanistan to 80.2 years in Israel. LE for women ranged from 61.3 years in Afghanistan to 85.9 in Singapore. GDP per capita was positively associated with longevity across B&R countries. The unemployment rate was positively associated with LE only for countries in the top LE quantiles. GDP growth rate and Inflation were negatively associated with LE for the countries in the bottom LE quantiles for men, not for women. LE increased substantially among B&R countries during 2000–2014. The influence of macroeconomic factors on LE was related to the distribution of LE.

Lifestyle choices are important determinants of individual health. Few studies have investigated changes in health behaviors and preventive activities brought about by the 2007 implementation of Urban Resident Basic Health Insurance (URBMI) in China. This study, therefore, aimed to explore whether URBMI has reduced individuals’ incentives to adopt healthy behaviors and utilize preventive care services. Data were drawn from two waves of the China Health and Nutrition Survey. Respondents were categorized according to their insurance situation before and after the URBMI reform in 2006 and 2011. Propensity score matching and difference-in-differences methods were used to measure levels of preventive care and behavior changes over time. Estimations were also made based on gender, self-reported health, and income. We found that URBMI implementation did not change residents’ utilization of preventive care services or their smoking habits, drinking habits, or other risky behaviors overall. However, the likelihood of sedentariness did increase by five percentage points. Females tended to be more sedentary while males were less likely to drink soft drinks. Residents with poor self-reported health exercised less while those who reported good health were more likely to be sedentary. Low- and middle-income residents were likely to be sedentary while middle-income people tended to smoke after becoming insured. Since URBMI implementation, some unhealthy behaviors like sedentariness have increased among those who were newly insured, and different subgroups have reacted differently. This suggests that the insurance design needs to be optimized and effective measures need to be adopted to help improve people’s lifestyle choices.