BMC Public Health. 2026 Jul 14. doi: 10.1186/s12889-026-28450-6. Online ahead of print.
ABSTRACT
BACKGROUND: China’s rapid urbanization has coincided with a substantial rise in poor vision (PV) and myopia prevalence among youth. Understanding this association is crucial for formulating evidence-based ocular health strategies.
METHODS: We analyzed nationally representative data from 640,266 children and adolescents (7-18 years) across three waves (2010, 2014, 2019) of the Chinese National Surveys on Students’ Constitution and Health. Urbanization-related characteristics were derived from official statistical data and satellite remote sensing data. Six urbanization factors were extracted by exploratory factor analysis, and a composite score of urbanization was constructed. Bivariate spatial autocorrelation analysis and β mixed-effects models are utilized to evaluate the associations of urbanization with PV and myopia prevalence.
RESULTS: The prevalence of PV and myopia increased from 2010 to 2019, and both show a similar spatial correlation with urbanization scores. Urbanization scores were positively associated with PV prevalence (β: 0.03; 95% CI: 0.00-0.05), whereas the association with myopia prevalence was non-significant (β: 0.03; 95% CI: -0.00-0.05). After adjusting for all factors, economic factors (PV: β: 0.12; 95%CI: 0.07 ~ 0.18. Myopia: 0.14; 0.08 ~ 0.20) and innovative capacity (PV: β: 0.08; 95%CI: 0.02 ~ 0.14. Myopia: β: 0.07; 95%CI: 0.01 ~ 0.13) were positively associated with PV and myopia prevalence.
CONCLUSIONS: The positive association between urbanization and both PV and myopia prevalence underscores the imperative to integrate health into all policies. This calls for aligning urban development with preventive eye health strategies through enhanced eye care services and optimized urban environments, with a particular focus on economically dynamic regions.
PMID:42443833 | DOI:10.1186/s12889-026-28450-6
