ObjectiveTo investigate the association between maternal education and breast feeding in the Chinese population, with a consideration of household income and health-seeking behaviours.DesignA nationally representative population-based cross-sectional study.Setting77 counties from 12 geographically distinct regions in China.Participants10 408 mothers with children from 0 to 12 months of age, aged 15–53 years old (mean: 29.15, SD: 5.11) were classified into primary school or below group (n=781), middle school group (n=3842), high school/vocational school group (n=1990), college or above group (n=3795), according to their highest completed education.OutcomesFive breastfeeding outcomes, including early initiation of breast feeding (EIB), exclusive breast feeding (EBF) under 6 months, predominant breast feeding under 6 months, current breast feeding and children ever breast fed, were calculated based on the standardised questionnaire from the WHO and Wellstart International’s toolkit for monitoring and evaluating breastfeeding activities.ResultsThe absolute risk of EIB and EBF in the lowest maternal education level was 64.85% and 26.53%, respectively, whereas the absolute risk of EIB and EBF in the highest maternal education level was 77.21% and 14.06%, respectively. A higher level of maternal education was positively associated with EIB (risk ratio (RR): 1.22; 95% CI: 1.12 to 1.30) and was inversely associated with EBF (RR: 0.59; 95% CI: 0.38 to 0.88). Stratified by household income, a positive association with EIB was observed only in the group with the highest household income and an inverse association with EBF was found in both low household and high household income groups.ConclusionsMothers with a higher education were more likely to initiate early breast feeding when they were also from a high-income household while also being less likely to exclusively breast feed their babies. Routine and successful nursing is crucial for the health of infants and is influenced by maternal education. Future public health interventions to promote breast feeding should consider the issues related to the educational level of mothers.

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Background: Hypertension may be influenced by multiple factors, including social and individual determinants. Regional and individual economic disparity in China is closely associated with such factors that may give rise to diverse health outcomes. This study examines the relationship between regional economic development, household income, gender and hypertension prevalence in China. Methods: This study utilized data from the China Kadoorie Biobank (CKB), a population-based study on half a million Chinese adults from 10 geographically distinct regions. Hypertension was identified by a measured systolic blood pressure/diastolic blood pressure ≥ 140/90 mmHg or receiving treatment. Regional economic development was inferred from GDP per capita at the time of the study. A logistic regression based method was used in calculating the prevalence of hypertension in different household income, regional economic development, and gender groups, adjusting for demographic, social-economic and lifestyle factors. Results: The prevalence of hypertension was the lowest in the medium GDP per capita areas in both male (31.62, 95% CI: 31.26-31.98%) and female (22.85, 95% CI: 22.50-23.19%) as compared to that in the low GDP per capita regions (male: 32.75, 95% CI 32.41-33.08%; female: 32.12, 95% CI: 31.78-32.47%) and high GDP per capita areas (male: 39.74, 95% CI: 39.33-40.16%; female: 35.19, 95% CI: 34.74-35.65%). There was an inverse relationship between hypertension and household income in the low and high GDP areas and an U-shaped association in the medium GDP per capita areas. Higher hypertension prevalence was observed in males across all GDP per capita areas. The negative correlation between hypertension and household income (across all GDP per captia areas) was stronger in females than in males. Conclusions: The present study underlined the important influence of regional economic development, household income and gender on hypertension. Interventions for hypertension prevention and management should take into consideration the influence of sex difference and socioeconomic disparities at both micro-and macro-levels, in addition to a person-centered approach.

BackgroundFollowing the rapid economic growth, there has been a strong disparity of regional development and personal income in China. Type 2 diabetes mellitus (T2DM) may be influenced by socioeconomic status at both the societal and individual levels. This study examines the associations of regional economic development, household income and gender on T2DM.MethodData from the baseline of a Chinese population-based study of approximately 500 000 adults from 10 areas were analysed. Clinically identified and screen-detected T2DM were examined. Regional economic development was indicated by gross domestic product (GDP) per capita. A logistic regression-based method was used to calculate the adjusted prevalence.ResultThe prevalence of T2DM was significantly higher in medium GDP per capita areas for both males (7.04%, 95% CI 6.82% to 7.26%) and females (6.04%, 95% CI 5.86% to 6.22%) compared with areas of other levels of economic development. The different shapes of associations between household income and T2DM prevalence were observed in different GDP per capita areas. There were strong gender differences in terms of both the trend and strength of association between household income and T2DM prevalence.ConclusionsFindings from this study underscore the importance of economic conditions and gender difference on T2DM. It suggests that strategies for diabetes prevention should address social–economic differences besides a person-centred approach.