Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Highly Accessed Research article

Morbidity at elementary school entry differs by sex and level of residence urbanization: a comparative cross-sectional study

Rea-Jeng Yang1, Jiunn-Jye Sheu2, Huey-Shys Chen3, Kuan-Chia Lin1 and Hsiu-Li Huang1*

Author Affiliations

1 Department of Nursing, National Taipei College of Nursing, Pei-Tou, 11219 Taipei City, Taiwan

2 Department of Health Education and Behavior, University of Florida, Gainesville, Florida, 32611-8210, USA

3 School of Nursing, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, 07107-3001, USA

For all author emails, please log on.

BMC Public Health 2007, 7:358  doi:10.1186/1471-2458-7-358

Published: 25 December 2007



Health is vital to a child's learning in school and success in life. Therefore, early physical examination, and follow-up if necessary, would bring parents' attention to their child's health and would likely improve outcomes. The purposes of this study are twofold: to assess the health status of first-graders and to examine the health status differences between sexes, levels of residence urbanization, and quantity of available medical resources.


This is a comparative descriptive study. Data from the 2002 Student Entry Physical Examination (SEPE) and Student Medical History Inventory (SMHI) were obtained from 203 public and private elementary schools in northern Taiwan where a population of 53,053 students was included. Frequencies, independent sample t test, one-way ANOVA along with Scheff's post hoc test, and Pearson's correlation were conducted using SPSS.


This study showed that 13.7% of students had at least one diagnosed disease from the SMHI reported by parents. Moreover, the SEPE indicated that 79.5% students had at least one health concern. Dental caries, myopia, and obesity were the most prevalent health problems among the first-graders (69.6%, 27.1%, and 9.5%, respectively). Research results show that there were significant differences in the prevalence of dental caries, myopia, and obesity between different sexes and among levels of urbanization. However, the quantity of available medical resources made no significant difference.


Elementary school entry physical examination is an important way to detect students' health problems. It is suggested that school health interventions consider students' health profiles along with their sex and level of urbanization in planning. More research is needed to find the risk factors of the health problems. Additionally, the creation of a school health committee is suggested to implement and evaluate the entry health examination program.