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.

Information on the mental wellness of lay counselors in Uganda is unavailable. Sixty representatives of three sub counties in Gulu District in Northern Uganda were equipped with counseling skills through 40 hours of training over 5 days. The trainees completed the 32-item Response Inventory for Stressful Life Events (RISLE) immediately before the commencement of the training and soon after the completion of the training. Pretest prevalence of suicide ideation was 9.3%, and posttest prevalence was 11.1%. Immediate post-training assessment showed better overall mental wellbeing as judged by overall RISLE scores, which were statistically significantly lower post-training than pre-training for gender (P = 0.05) and marital status (P = 0.001) on most RISLE scores. Qualitative assessment after 3 months of training showed that trainees were less suicidal, and they had improved psychosocial functioning. The current results point to the need to pay attention to the mental wellness of volunteer counselors and support them in their role in preventing suicide in areas of mass trauma. We recommend robust randomized community trials to determine the role of the mental wellbeing of volunteer lay counselors in the provision of psychological first aid to communities exposed to prolonged mass trauma.

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