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Shu L, Zhu H, Zhang L, Jia L, Zhang J, Wang L. Nutritional status of children left behind by migrant parents: Evidence from a survey in rural Anhui, eastern China. NUTR BULL 2024; 49:146-156. [PMID: 38363028 DOI: 10.1111/nbu.12666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/17/2024]
Abstract
We aimed to explore and analyse the dietary intake patterns of 3-6 year-old children left behind by one or both parents and to assess their associations with body mass index (BMI) and the prevalence of childhood anaemia in rural Anhui, eastern China. We used random cluster sampling to recruit rural children aged 3-6 years in two rural areas in Anhui province. Sociodemographic information and dietary intake were collected by self-reported questionnaires. Height, weight and prevalence of anaemia were measured by trained nurses blinded to parental migration status. Factor analysis was applied to determine that major dietary patterns, binary logistic regression and generalised linear regression were used to explore the associations between anaemia and BMI Z-score with dietary patterns. Of 1720 children aged 3-6 years, 236 were left by both parents and 388 were left by a single parent. The prevalence of stunting and underweight among left-behind children with migration of both parents (BLBC) was significantly higher than that of non-left-behind children (NLBC). Three dietary patterns-"grain-vegetable," "meat-egg" and "fast food-sweet"-were identified in our study, and the total variance explained was 46.9%. The meat-egg dietary pattern was associated with a decreased risk of anaemia after adjustment for confounding factors in the left-behind children with migration of both parents (BLBC), left-behind children with single parent migration (SLBC) and non-left-behind children (NLBC) groups. After adjusting for confounding factors, the fast food-sweet dietary pattern was found to be associated with an increased risk of anaemia (OR [95% CI]: Q4: 2.21 [1.14, 4.57], p = 0.034). In addition, children with obesity had a lower intake of vegetables and fruits (β = -0.08, 95% CI: -0.13, -0.02) compared with children with a normal weight. In conclusion, there are correlations between different types of parental migration and children's nutritional status in rural Anhui. The meat-egg dietary pattern may have a preventive effect on anaemia in comparison with other dietary patterns, irrespective of whether children are left behind or not. Children with overweight and obesity had a higher intake of pork and red meat and snacks compared with children with normal BMI.
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Affiliation(s)
- Li Shu
- Department of Nutrition and Food Hygiene, School of Public Health, Bengbu Medical University, Bengbu, Anhui Province, China
| | - Hao Zhu
- Department of Nutrition and Food Hygiene, School of Public Health, Bengbu Medical University, Bengbu, Anhui Province, China
| | - Li Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Bengbu Medical University, Bengbu, Anhui Province, China
| | - Linlin Jia
- Department of Nutrition and Food Hygiene, School of Public Health, Bengbu Medical University, Bengbu, Anhui Province, China
| | - Jiaye Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Bengbu Medical University, Bengbu, Anhui Province, China
| | - Liying Wang
- Bengbu Health Board, Bengbu, Anhui Province, China
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Zhao X, Wang S, Yu Y, Zhang A, Tao F, Liu D, Sun Y. Association of Early Parent-Child Separation With Multidomain Implications in Adolescence and Emerging Adulthood: A Prospective Cohort Study in China. J Adolesc Health 2023; 73:53-60. [PMID: 37037691 DOI: 10.1016/j.jadohealth.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 04/12/2023]
Abstract
PURPOSE The aim of the study was to explore the long-term impacts of parent-child separation on a broad set of health and well-being indicators during adolescence and emerging adulthood. METHODS Participants were from the China Family Panel Studies, a national representative prospective cohort, and 2710 adolescents aged 7-15 years recruited from 25 provinces after an 8-year follow-up were eventually included in this study. We examined the association of prolonged parent-child separation with educational, social, emotional, and health-related outcomes by comparing participants with experience of prolonged parent-child separation and their counterparts staying with parents. RESULTS Participants who experienced prolonged parent-child separation in childhood were more likely to have lower educational attainment (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.03, 2.76; p = .04), depression (OR: 2.63, 95% CI: 1.28, 5.41; p = .008), marriage or cohabitation (OR: 2.79, 95% CI: 1.40, 5.57; p = .004), and ever-smoke (OR: 3.39, 95% CI: 1.95, 5.91; p < .001). Prolonged parent-child separation was also associated with a 0.64-year loss in educational attainment, 2.99- and 2.39-unit decreases in math and word test score, as well as 2.08 kg/m2 decreases in body mass index. DISCUSSION This nationally representative study indicates that prevention efforts that reduce exposure to parent-child separation in childhood could substantially reduce the lifetime prevalence of educational, emotional, behavioral, and cognitive problems in the general population.
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Affiliation(s)
- Xudong Zhao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Shihong Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Yue Yu
- Department of Pediatrics, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Anhui Zhang
- Wuhu Maternity & Child Health Care Center, Wuhu, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Deyun Liu
- Department of Pediatrics, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Ying Sun
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China.
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Liu F, Wang G, Yao B, Ye J, Wang J, Wang H, Liu H. Cross-sectional investigation of quality of life determinants among children with tic disorders: The roles of family environmental and clinical factors. Heliyon 2023; 9:e13228. [PMID: 36785827 PMCID: PMC9918760 DOI: 10.1016/j.heliyon.2023.e13228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/08/2023] [Accepted: 01/21/2023] [Indexed: 01/26/2023] Open
Abstract
Objective To examine the association between family environmental and clinical factors with the whole range of quality of life (QOL) in children with tic disorders (TD). Methods A hospital-based cross-sectional study was conducted among children with TD. All participants were given a family environmental survey and scale evaluations with Yale Global Tic Severity Scale (YGTSS), Achenbach Child Behavior Checklist (CBCL) and PedsQL-Generic Core Scale of the Chinese Version (PedsQL). Variable selection and data analysis was done by the least absolute shrinkage and selection operator (LASSO) method and multivariate logistic regression analysis. Results A total of 363 TD cases were included in the analysis. YGTSS scores, total CBCL score had significant negative correlations with PedsQL scores (P < 0.05). Of the total 15 factors, 8, 6, 11, 7, 5, 10 potential predictors with nonzero coefficients were identified by LASSO regression models of physical functioning, emotional functioning, social functioning, school functioning, social-psychological domain and PedsQL total scale respectively. Results of multivariate logistic regression analysis showed older age (physical functioning, ORs: 1.77, 3.67; total scale: ORs: 1.73, 2.28), no presence of chronic conditions (school functioning, OR: 1.61), moderate/severe tic severity (physical functioning, OR: 0.57; social functioning, OR: 0.44; social-psychological domain, OR: 0.57), co-morbid behavioral problems (physical functioning, OR: 0.52; emotional functioning, OR: 0.31; social functioning, OR: 0.30; school functioning, OR: 0.35; social-psychological domain, OR: 0.34; total scale, OR: 0.30), no fully parental involvement in care (physical functioning, OR: 0.62), higher paternal (physical functioning, ORs: 2.89, 2.07) and maternal education level (social functioning, ORs: 1.74, 2.03), democratic parenting pattern (emotional functioning, OR: 1.89; social functioning, OR: 2.17; social-psychological domain, OR: 2.33; total scale, OR: 2.11) and inharmony family relationship (emotional functioning, OR: 0.47; total scale, OR: 0.50) were the most important determinants to QOL of TD. Conclusions This study identifies several QOL determinants among children with TD. Clinicians should be encouraged to screen for family environmental and clinical factors in TD patients, and take tailored interventions to help TD children improve their QOL.
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Affiliation(s)
- Fang Liu
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China,Corresponding author.
| | - Baozhen Yao
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jingping Ye
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Junling Wang
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Huaqian Wang
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Hong Liu
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, 430060, China
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Cai J, Wang Y, Wang F, Lu J, Li L, Zhou X. The Association of Parent-Child Communication With Internet Addiction in Left-Behind Children in China: A Cross-Sectional Study. Int J Public Health 2021; 66:630700. [PMID: 34744584 PMCID: PMC8565268 DOI: 10.3389/ijph.2021.630700] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 08/24/2021] [Indexed: 01/24/2023] Open
Abstract
Objective: Internet addiction has emerged as a growing concern worldwide. This study aimed to compare the prevalence of Internet addiction between left-behind children (LBC) and non-left-behind children (non-LBC), and explore the role of paternal and maternal parent-child communication on LBC. Methods: We conducted a cross-sectional survey in rural areas in Anhui, China. The complete data were available from 699 LBC and 740 non-LBC. Multivariable logistic regression was used to examine 1) whether LBC were more likely to develop Internet addiction, and 2) the association between parent-child communication and Internet addiction among LBC. Results: LBC had a higher likelihood to report Internet addiction when compared to non-LBC (OR = 2.03, 95%CI = 1.43–2.88, p < 0.001). Among LBC, parent-child communication (both mother-child and father-child) was protective factor for children’s Internet addiction. The role of mother-child communication played well among male LBC. Conclusions: The lack of parental supervision may lead to Internet addiction. It is highly recommended for migrant parents to improve the quality of communication with their children. Also, gender-matching effects should be considered in the relationship between children’s behavior and parental factors.
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Affiliation(s)
- Jingjing Cai
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yun Wang
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, California, CA, United States
| | - Feng Wang
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jingjing Lu
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lu Li
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xudong Zhou
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China
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Wu H, Cai Z, Yan Q, Yu Y, Yu NN. The Impact of Childhood Left-Behind Experience on the Mental Health of Late Adolescents: Evidence from Chinese College Freshmen. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052778. [PMID: 33803365 PMCID: PMC7967284 DOI: 10.3390/ijerph18052778] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/27/2021] [Accepted: 03/05/2021] [Indexed: 01/22/2023]
Abstract
A paucity of public service afforded to migrant workers often begets a wide range of social problems. In China, hundreds of millions of migrant worker parents have to leave children behind in their hometowns. This paper investigated the long-term effects of the childhood experience of being left behind on the mental well-being of late adolescents. Mandatory university personality inventory (UPI) surveys (involving psychosomatic problems such as anxiety, depression, and stress) were conducted at a university in Jiangsu, China, during 2014–2017. The study sample consisted of 15,804 first-year college students aged between 15 and 28 years. The PSM method and the OLS regression model were employed. Controlling for the confounding factors (gender, age, single-child status, hometown location, ethnicity, and economic status), our empirical investigation demonstrated that childhood left-behind experience significantly worsened the mental health of the study sample, increasing the measure of mental ill-being by 0.661 standard deviations (p < 0.01). Moreover, the effects were consistently significant in subsamples divided by gender, single-child status, and hometown location; and the effects were greater for females, single-child students, and urban residents.
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Affiliation(s)
- Huajun Wu
- School of Economics, Nanjing Audit University, Nanjing 211815, China; (H.W.); (Y.Y.)
| | - Zhiyong Cai
- School of Psychology, Nanjing Normal University, Nanjing 210023, China;
- Commission of Student Affairs, Nanjing Audit University, Nanjing 211815, China
| | - Qing Yan
- Wuxi Development and Reform Research Center, Wuxi 214000, China;
| | - Yi Yu
- School of Economics, Nanjing Audit University, Nanjing 211815, China; (H.W.); (Y.Y.)
| | - Ning Neil Yu
- Institute for Social and Economic Research, Nanjing Audit University, Nanjing 211815, China
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA 94305, USA
- Correspondence:
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Račaitė J, Lindert J, Antia K, Winkler V, Sketerskienė R, Jakubauskienė M, Wulkau L, Šurkienė G. Parent Emigration, Physical Health and Related Risk and Preventive Factors of Children Left Behind: A Systematic Review of Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1167. [PMID: 33561093 PMCID: PMC7908227 DOI: 10.3390/ijerph18031167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022]
Abstract
The aim of our study was to systematically review the literature on physical health and related consequences of internal and international parental migration on left-behind children (LBC). This review followed PRISMA guidelines. We searched the PubMed, Web of Science, Academic Search Complete, PsycINFO, and Cochrane databases and included studies reporting physical health-related outcomes of children affected by parental migration. The quality of the studies was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. We selected 34 publications from a total of 6061 search results. The study found that LBC suffer from poor physical health as compared with non-LBC. Physical health-related risk factors such as underweight, lower weight, stunted growth, unhealthy food preferences, lower physical activity, smoking, alcohol consumption, injuries, and incomplete vaccination tend to be more prevalent among LBC in China. Studies focussing on international migration argue that having migrant parents might be preventive for undernutrition. Overall, our study showed that children affected by internal or international migration tend to have similar physical health outcomes. Moreover, we identified a lack of evidence on international parental migration that may have influenced the overall impacts. Further studies addressing international migration would contribute to better understand the impacts of migration for LBC.
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Affiliation(s)
- Justina Račaitė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania; (R.S.); (M.J.); (G.Š.)
| | - Jutta Lindert
- Department of Social Work and Health, University of Applied Sciences Emden/Leer, Constantiaplatz 4, 26723 Emden, Germany; (J.L.); (L.W.)
- WRSC, Brandeis University, Epstein Building, MS 079, 515 South Street, Waltham, MA 02453, USA
| | - Khatia Antia
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130/3, 69120 Heidelberg, Germany; (K.A.); (V.W.)
| | - Volker Winkler
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130/3, 69120 Heidelberg, Germany; (K.A.); (V.W.)
| | - Rita Sketerskienė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania; (R.S.); (M.J.); (G.Š.)
| | - Marija Jakubauskienė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania; (R.S.); (M.J.); (G.Š.)
| | - Linda Wulkau
- Department of Social Work and Health, University of Applied Sciences Emden/Leer, Constantiaplatz 4, 26723 Emden, Germany; (J.L.); (L.W.)
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Genė Šurkienė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania; (R.S.); (M.J.); (G.Š.)
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Shi H, Zhang J, Du Y, Zhao C, Huang X, Wang X. The association between parental migration and early childhood nutrition of left-behind children in rural China. BMC Public Health 2020; 20:246. [PMID: 32070327 PMCID: PMC7029458 DOI: 10.1186/s12889-020-8350-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 02/13/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND More than one-third of children under 3 years old are left behind at home due to parental migration in rural China, and we know very little about early childhood nutrition of left-behind children (LBC) because of the dearth of research. This study examined the association between parental migration and early childhood nutrition of LBC in rural China. METHODS We used repeated cross-sectional data of rural children aged 6-35 months who participated in two surveys in six counties of northern and southern China in 2013 and 2016 respectively. The length, weight, and hemoglobin concentration were measured by trained health-care workers blinded to parental migration status. Stunting, underweight, wasting, and anemia were identified with the standards recommended by WHO. Generalized linear regressions and multivariate logistic regressions were employed to explore the association between parental migration and these nutritional outcomes at each time point. RESULTS Two thousand three hundred thirty-six and 2210 children aged 6-35 months were enrolled in 2013 and 2016, respectively. The results show a reduction of the risks of stunting, underweight, and wasting from 2013 (16.4, 8.5, and 3.5%, respectively) to 2016 (12.1, 4.0, and 1.5%, respectively) but highlight a constantly and alarmingly high risk of anemia among these children (44.8% in 2013 and 43.8% in 2016). Children with migrant fathers performed as well as or better than those with non-migrants on these indicators. Children with migrant parents performed slightly worse in 2013, but equal or slightly superior in 2016 on these indicators compared with children with non-migrants and migrant fathers. Children aged 6-17 months with migrant parents had a significantly lower risk of anemia than those living with their mothers or with both parents (43.1% vs. 63.6% and 61.5 in 2013, and 42.5 vs. 60.1 and 66.2% in 2016), even after controlling for children's sociodemographic characteristics. CONCLUSIONS Parental migration may be not detrimental and even beneficial to early childhood nutrition of LBC in rural China. Continued nutritional support is needed for all rural children, especially interventions for preventing micronutrient deficiency. Programs for LBC are recommended to continue to focus on nutrition but pay more attention to other important health issues.
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Affiliation(s)
- Huifeng Shi
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jingxu Zhang
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yufeng Du
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Chunxia Zhao
- Section of Health, Nutrition, and Water, Environment and Sanitation, UNICEF China, 12 Sanlitun Road, Chao Yang District, Beijing, 100600, China
| | - Xiaona Huang
- Section of Health, Nutrition, and Water, Environment and Sanitation, UNICEF China, 12 Sanlitun Road, Chao Yang District, Beijing, 100600, China
| | - Xiaoli Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Michou M, Panagiotakos DB, Costarelli V. Low health literacy and excess body weight: a systematic review. Cent Eur J Public Health 2019; 26:234-241. [PMID: 30419628 DOI: 10.21101/cejph.a5172] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE There is recent evidence that poor health literacy (HL) could be implicated in the aetiology of obesity and could be an important reason behind obese people's inability to encounter difficulties in overcoming obesity issues. The current study reviews the recent scientific evidence investigating the possible link between poor HL levels and excess body weight in adults and children. METHODS The authors performed a thorough systematic computer-assisted literature search from 1 January 2005 up to 31 May 2017. Only English original studies in healthy people, investigating the relationship between HL and excess body weight, were included. RESULTS Twenty-two studies in total were included in this literature review, 17 studies were conducted in adults and 5 in children. In 17 out of 22 studies reviewed, low HL was significantly associated with increased body mass index, overweight and obesity. In case of children and adolescents, the above association seems to be more consistent compared to adults. CONCLUSION There is good evidence that low levels of HL are associated with excess body weight, particularly in children. Initiatives to improve health literacy levels could be a useful tool in the management of the obesity epidemic.
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Affiliation(s)
- Maria Michou
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
| | | | - Vassiliki Costarelli
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
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Fellmeth G, Rose-Clarke K, Zhao C, Busert LK, Zheng Y, Massazza A, Sonmez H, Eder B, Blewitt A, Lertgrai W, Orcutt M, Ricci K, Mohamed-Ahmed O, Burns R, Knipe D, Hargreaves S, Hesketh T, Opondo C, Devakumar D. Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis. Lancet 2018; 392:2567-2582. [PMID: 30528471 PMCID: PMC6294734 DOI: 10.1016/s0140-6736(18)32558-3] [Citation(s) in RCA: 239] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/14/2018] [Accepted: 10/09/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Globally, a growing number of children and adolescents are left behind when parents migrate. We investigated the effect of parental migration on the health of left behind-children and adolescents in low-income and middle-income countries (LMICs). METHODS For this systematic review and meta-analysis we searched MEDLINE, Embase, CINAHL, the Cochrane Library, Web of Science, PsychINFO, Global Index Medicus, Scopus, and Popline from inception to April 27, 2017, without language restrictions, for observational studies investigating the effects of parental migration on nutrition, mental health, unintentional injuries, infectious disease, substance use, unprotected sex, early pregnancy, and abuse in left-behind children (aged 0-19 years) in LMICs. We excluded studies in which less than 50% of participants were aged 0-19 years, the mean or median age of participants was more than 19 years, fewer than 50% of parents had migrated for more than 6 months, or the mean or median duration of migration was less than 6 months. We screened studies using systematic review software and extracted summary estimates from published reports independently. The main outcomes were risk and prevalence of health outcomes, including nutrition (stunting, wasting, underweight, overweight and obesity, low birthweight, and anaemia), mental health (depressive disorder, anxiety disorder, conduct disorders, self-harm, and suicide), unintentional injuries, substance use, abuse, and infectious disease. We calculated pooled risk ratios (RRs) and standardised mean differences (SMDs) using random-effects models. This study is registered with PROSPERO, number CRD42017064871. FINDINGS Our search identified 10 284 records, of which 111 studies were included for analysis, including a total of 264 967 children (n=106 167 left-behind children and adolescents; n=158 800 children and adolescents of non-migrant parents). 91 studies were done in China and focused on effects of internal labour migration. Compared with children of non-migrants, left-behind children had increased risk of depression and higher depression scores (RR 1·52 [95% CI 1·27-1·82]; SMD 0·16 [0·10-0·21]), anxiety (RR 1·85 [1·36-2·53]; SMD 0·18 [0·11-0·26]), suicidal ideation (RR 1·70 [1·28-2·26]), conduct disorder (SMD 0·16 [0·04-0·28]), substance use (RR 1·24 [1·00-1·52]), wasting (RR 1·13 [1·02-1·24]) and stunting (RR 1·12 [1·00-1·26]). No differences were identified between left-behind children and children of non-migrants for other nutrition outcomes, unintentional injury, abuse, or diarrhoea. No studies reported outcomes for other infectious diseases, self-harm, unprotected sex, or early pregnancy. Study quality varied across the included studies, with 43% of studies at high or unclear risk of bias across five or more domains. INTERPRETATION Parental migration is detrimental to the health of left-behind children and adolescents, with no evidence of any benefit. Policy makers and health-care professionals need to take action to improve the health of these young people. FUNDING Wellcome Trust.
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Affiliation(s)
- Gracia Fellmeth
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Kelly Rose-Clarke
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Chenyue Zhao
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Laura K Busert
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Alessandro Massazza
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Hacer Sonmez
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Ben Eder
- Institute for Global Health, University College London, London, UK
| | - Alice Blewitt
- Institute for Global Health, University College London, London, UK
| | - Wachiraya Lertgrai
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Miriam Orcutt
- Institute for Global Health, University College London, London, UK
| | - Katharina Ricci
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany
| | | | - Rachel Burns
- Institute for Global Health, University College London, London, UK
| | - Duleeka Knipe
- Department of Population Science, University of Bristol, Bristol, UK
| | - Sally Hargreaves
- Institute for Infection and Immunity, St George's, University of London, London, UK; International Health Unit, Section of Infectious Diseases and Immunity, Imperial College London, London, UK
| | - Therese Hesketh
- Institute for Global Health, University College London, London, UK; Centre for Global Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Charles Opondo
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Delan Devakumar
- Institute for Global Health, University College London, London, UK.
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10
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Qiu R, Li Y, Malla M, Yao J, Mo D, Dhakal N, Huang H. Impact of parental migration on oral health outcomes of left-behind school-aged children in Luchuan, southern China. BMC Oral Health 2018; 18:207. [PMID: 30537963 PMCID: PMC6290493 DOI: 10.1186/s12903-018-0683-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 11/30/2018] [Indexed: 11/18/2022] Open
Abstract
Background With rapid urbanization in China, an increasing number of rural adults have migrated to cities to seek job opportunities, leaving their school-aged children behind. These left-behind children (LBC) without one or both parents usually receive less attention from their caregivers. Whether the parental migration affects the children’s oral health is not well understood. This study aimed to explore the differences in dental caries status and oral health-related behaviors between children with different parental migration experiences in a rural area of Southern China. Methods A cross-sectional study was conducted in Luchuan County of Guangxi Province in 2015. A total of 1085 school children aged 8–12 participated in this study. Participants’ demographic characteristics, parental migration information, and eating and oral hygiene habits were collected using a self-administered questionnaire. Dental caries of permanent teeth was examined using the decayed, missing, and filled tooth (DMFT) index recommended by the World Health Organization. Dental caries experience and oral health-related behaviors were compared between LBC and non-LBC, as well as children with different experiences of parental migrations. The impact of various parental migration attributes on LBC oral health outcomes was examined by univariate and multivariate analyses. Results Among the school-aged children examined, 60.9% of them were LBC. Only 29.7% of the children brushed their teeth regularly; 86.5% of them did not know what fluoride toothpaste was. Caries prevalence was 51.4% for LBC and 40.8% for non-LBC (p < 0.001). The LBC experienced a greater DMFT mean (1.20 ± 1.59) compared to the non-LBC (0.85 ± 1.30) (p < 0.001). Oral health-related behaviors were not significantly different between LBC and non-LBC. Dental caries experience and oral health-related behaviors were not related to the type or duration of parental migration. Multiple regression analyses showed that parental migration was one of significant predictors of children’s caries outcome; LBC had a higher risk to caries than non-LBC (95% CI =1.26, 2.09). Conclusions These findings indicate that parental migration could be a significant risk factor for caries development among 8- to 12-year-old school children in rural China. Electronic supplementary material The online version of this article (10.1186/s12903-018-0683-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rongmin Qiu
- Department of Pediatric Dentistry, College &Hospital of Stomatology, Guangxi Key Laboratory of the Rehabilitation and Reconstruction of Oral and Maxillofacial Research, Guangxi Key Laboratory of Treatment and Research for Oral and Maxillofacial Surgery Disease, Guangxi Medical University, 10 Shuangyong Road, 530021, Nanning, Guangxi Province, China.
| | - Yihong Li
- Department of Basic Science Craniofacial Biology, College of Dentistry, New York University, New York, 10010, USA
| | - Manisha Malla
- Department of Pediatric Dentistry, College &Hospital of Stomatology, Guangxi Key Laboratory of the Rehabilitation and Reconstruction of Oral and Maxillofacial Research, Guangxi Key Laboratory of Treatment and Research for Oral and Maxillofacial Surgery Disease, Guangxi Medical University, 10 Shuangyong Road, 530021, Nanning, Guangxi Province, China
| | - Junyu Yao
- Department of Pediatric Dentistry, College &Hospital of Stomatology, Guangxi Key Laboratory of the Rehabilitation and Reconstruction of Oral and Maxillofacial Research, Guangxi Key Laboratory of Treatment and Research for Oral and Maxillofacial Surgery Disease, Guangxi Medical University, 10 Shuangyong Road, 530021, Nanning, Guangxi Province, China
| | - Dan Mo
- Department of Pediatric Dentistry, College &Hospital of Stomatology, Guangxi Key Laboratory of the Rehabilitation and Reconstruction of Oral and Maxillofacial Research, Guangxi Key Laboratory of Treatment and Research for Oral and Maxillofacial Surgery Disease, Guangxi Medical University, 10 Shuangyong Road, 530021, Nanning, Guangxi Province, China
| | - Neha Dhakal
- Department of Pediatric Dentistry, College &Hospital of Stomatology, Guangxi Key Laboratory of the Rehabilitation and Reconstruction of Oral and Maxillofacial Research, Guangxi Key Laboratory of Treatment and Research for Oral and Maxillofacial Surgery Disease, Guangxi Medical University, 10 Shuangyong Road, 530021, Nanning, Guangxi Province, China
| | - Hua Huang
- Department of Pediatric Dentistry, College &Hospital of Stomatology, Guangxi Key Laboratory of the Rehabilitation and Reconstruction of Oral and Maxillofacial Research, Guangxi Key Laboratory of Treatment and Research for Oral and Maxillofacial Surgery Disease, Guangxi Medical University, 10 Shuangyong Road, 530021, Nanning, Guangxi Province, China
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11
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Does parental migration have any impact on nutritional disorders among left-behind children in Bangladesh? Public Health Nutr 2018; 22:95-103. [PMID: 30428953 DOI: 10.1017/s1368980018002963] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Rates of migration have increased substantially in recent years and so has the number of left-behind children (LBC). We investigated the impact of parental migration on nutritional disorders of LBC in Bangladesh. DESIGN We analysed data from the nationally representative cross-sectional Multiple Indicator Cluster Survey 2012-2013. Child stunting, wasting and underweight were used as measures of nutritional disorders. Descriptive statistics were used to describe characteristics of the respondents and to compare nutritional outcomes based on status of parental migration. Multivariate logistic regression models were used to examine the associations between parental migration and child nutritional disorders. SETTING Bangladesh.ParticipantsData of 23 402 children (aged <5 years), their parents and households. RESULTS In the unadjusted models, parental migration was found significantly protective for stunting, wasting and underweight - both separately and jointly. After potential confounders were controlled for, no difference was found between LBC and non-LBC in any of these three nutritional outcome measures. Household wealth status and maternal educational status were found to significantly influence the nutritional development of the children. CONCLUSIONS At the population level there is no negative impact of parental migration on stunting, wasting and underweight of LBC in Bangladesh. Remittance from parental migration might enhance affordability of better foods, health care and supplies for a cleaner environment. This affordability is crucial for the poorest section of the society.
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12
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Qin C, Li Y, Wang D, Shi Z, Yao R, Wang D, Tang S. Maternal factors and preoperative nutrition in children with mild cases of congenital heart disease. Jpn J Nurs Sci 2018; 16:37-46. [PMID: 29569860 DOI: 10.1111/jjns.12211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 10/19/2017] [Accepted: 01/24/2018] [Indexed: 01/14/2023]
Abstract
AIM The preoperative poor nutrition of children with congenital heart disease (CHD) impacts the postoperative rehabilitation process of pediatric CHD cases. The factors of these children's preoperative poor nutrition, excluding the disease, have been underreported. The aim was to investigate the preoperative nutritional status of children with CHD who required a simple surgical repair and to analyze the maternal characteristics that are associated with poor nutrition in these sick children. METHODS This was a cross-sectional survey. The weight and height of the children were measured, maternal data were collected via a questionnaire and a univariate analysis and multivariate logistic regression were used to analyze the association between maternal factors and the preoperative poor nutrition of the children with CHD. RESULTS A total of 119 children with simple CHD were recruited to the study. The prevalence of poor nutrition was higher in the children with CHD ("cases") than in the healthy children ("controls"). An increased risk of poor nutrition was associated with lower mothers' perception, education level, understanding of the disease, and higher anxiety. CONCLUSIONS Paying attention to maternal anxiety, depression, and knowledge and providing interventions for the mothers of children with CHD are important in order to promote the nutritional status of these children.
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Affiliation(s)
- Chunxiang Qin
- Obstetric Department, Third Xiangya Hospital, Xiangya School of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ying Li
- Neonatology Department, Third Xiangya Hospital, Central South University, Changsha, China
| | - Dianjun Wang
- Cardiac Surgery Department, Third Xiangya Hospital, Central South University, Changsha, China
| | - Zeya Shi
- Nursing Department, People's Hospital of Hunan Province, Changsha, China
| | - Rui Yao
- Psychological Counseling Center, Hunan University of Chinese Medicine, Changsha, China
| | - Dan Wang
- Genetics Department, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
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Xu W, Yan N, Chen G, Zhang X, Feng T. Parent-child separation: the relationship between separation and psychological adjustment among Chinese rural children. Qual Life Res 2018; 27:913-921. [PMID: 29344765 DOI: 10.1007/s11136-017-1776-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE The current study aimed to explore the characteristics of psychological adjustment among Chinese left-behind children (LBC) in rural areas, and to examine the association between separation duration from parent/parents (SDP) and children's psychological adjustment and the extent to which personality mediates this hypothesized link. METHODS We surveyed 534 rural children and adolescents aged 10-17 years at school (440 LBC and 94 non-LBC) in 2013, who were selected for participation using stratified cluster sampling from two counties in Chongqing, China. Measures used included socio-demographic variables, age at the commencement and end of the separation from parents, the revised Chinese Juvenile Eysenck Personality Questionnaire, and the Adolescent Psychological Adaptability Scale. RESULTS Most children (82.4%) had experienced separation from parents. t test results showed a marginally significant difference (p = .08) in psychological adjustment between LBC (mean = 64.44, SD = 8.62) and non-LBC (mean = 66.16, SD = 9.26). LBC's mean SDP was 5.64 years (SD = 3.90). Correlation analysis showed that children's SDP was negatively associated with psychological adjustment. Structural equation modeling showed that neuroticism, but not extraversion or psychoticism, fully mediated the link between children's SDP and psychological adjustment. CONCLUSION Personality (neuroticism) is one of the mediating pathways through which long-term SDP may predict poor psychological adjustment among children. Given the detrimental impact of long-term SDP, interventions should target the mediating pathway to buffer against the negative impact of parental separation on the affected rural children and to improve their mental health.
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Affiliation(s)
- Wenjian Xu
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Ni Yan
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Gang Chen
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Xing Zhang
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Tingyong Feng
- Faculty of Psychology, Center for Child Development and Family Counseling, Southwest University, Chongqing, 400715, China.
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A comparative analysis of suicide attempts in left-behind children and non-left-behind children in rural China. PLoS One 2017; 12:e0178743. [PMID: 28594874 PMCID: PMC5464573 DOI: 10.1371/journal.pone.0178743] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 05/18/2017] [Indexed: 11/19/2022] Open
Abstract
To estimate the prevalence of suicide attempts and explore the shared and unique factors influencing suicide risk in left-behind children (LBC) and non-left-behind children (NLBC) in rural China, this study collected data using a multi-stage cluster random sampling method from 13,952 children including 6,034 LBC and 7,918 NLBC. Sociodemographic characteristics, suicide attempts, neglect and physical abuse, negative life events, and loneliness were measured by self-reported questionnaires. Data were analyzed using logistic regression models. Gender and mother's education level were unique influential factors for NLBC while family structure type was a unique influential factor for LBC. The study provides two novel findings regarding NLBC specifically: 1. Children with optimal family socioeconomic status are more likely to report suicide attempts (odds ratio OR = 1)than are those in the general children population, OR 0.52 (95% CI: 0.39-0.70), and 2. Children with higher mother's education level are subject to higher suicide rates in high school, OR 1.67 (95% CI: 1.13-2.46), and post-secondary education, OR 2.14 (95% CI: 1.37-3.37). The unique characteristics of LBC and NLBC in China suggest that investigating risk factors and determining the factors that might be targeted in intervention programs are urgently needed currently.
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