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As markets around the world slump, sputter and slump again, China maintains the fastest-growing economy. But despite the country’s boom, it has fallen behind in making sure its children will be healthy, strong and smart enough to cash in on it.

About 30% of children living in China’s rural areas are anemic – sick with an iron deficiency that Stanford researcher Scott Rozelle and his colleagues with the Rural Education Action Project have proven leads to bad school performance. And a poor education coupled with anemia’s physical blow puts those kids at risk for lives of poverty and missed opportunities.

But things are changing. Influenced in part by the research Rozelle has conducted and presented to Chinese officials, the government recently launched a policy to improve school lunches for about 20 million children across the country.

The plan invests $2.5 billion a year during the next nine years to ensure the meals are more nutritious for elementary and middle school students. That doubles the amount spent on lunches for China’s neediest children.

“For 5,000 years it was OK to be anemic if you’re never going to leave the farm,” said Rozelle, an economist and senior fellow at Stanford’s Freeman Spogli Institute for International Studies who is still experimenting with ways to improve children’s health in rural China and get the government to adopt the most effective methods.

“But we’re looking 20 years into the future where there are much fewer farms and you need at least a high school education to make a living in the city,” Rozelle said. “If you are sick with anemia, it is going to affect your cognitive ability, educational performance and ultimately your chances of going on in school.”

Rozelle began studying anemia and its links to school performance in 2008.

After conducting an initial study of about 4,000 primary school students in Shaanxi province, he found that nearly 40% of the children were anemic – the result of diets that consisted mostly of rice and noodles in regions where meat, fruit and fresh vegetables are expensive and often hard to come by.

Those survey results were presented to the government in a 2009 policy brief written by Rozelle and his collaborators. Officials adopted the brief, making rural primary school nutrition part of China’s official policy discussion.

A second study conducted between 2008 and 2009 found that anemia rates dropped when schoolchildren were given vitamins fortified with iron. And as their iron levels rose, so did their test scores.

An experiment followed to back up those findings, while another set of large-scale surveys across four provinces reinforced that childhood anemia was indeed a widespread problem.

The findings from those surveys and tests were packaged in another policy brief that was accepted by the government earlier this year, prompting a government directive urging more concrete action in the area of student nutrition.

Those documents, along with several presentations Rozelle has made to government officials and commissions, have culminated in a move to pour $22.5 billion into more nutritious school lunches between now and 2020. It will likely be up to local government and school officials to decide exactly what those meals will include, but Rozelle is hopeful they’ll lead to diets with more meat, vegetables and iron supplements.

“Research-based results are an important avenue for affecting policy in China,” said Chen Zhili, vice chair of the Standing Committee of the National People’s Congress and a former minister of education. “The new programs for child nutrition were only made possible by the work of groups (like the Rural Education Action Project).”

And a national policy aimed at improving nutrition and curbing anemia helps ensure that China maintains its foothold in the world’s economy and grow in a more stable, equitable way, Rozelle said.

“The social return is huge,” Rozelle said. “These kids will be able to do better in school, work harder and sustain China’s growth.”

-Adam Gorlick

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