Reduction but not elimination: health inequalities among urban, migrant, and rural children in China-the moderating effect of the fathers' education level.

backgroundGiven the urban-rural structure and the increase in rural-to-urban migration, three types of children have emerged in contemporary China: rural, urban, and migrant children. Health disparities among these types of children have caused widespread concern, being the main contributor to health inequalities among children in China. The purpose of this study was to investigate health disparities among these children and the mechanisms underlining them.

methodsThis research applied multiple linear regression to data obtained from the Chinese Education Panel Survey (CEPS), a national representative survey of 7772 students from 2014 to 2015. Multiple linear regression with interactive terms was used to explore how gender and father's education moderate the degree of health inequalities among the children. 'Height for age Z-scores' (HAZ) was deployed as the indicator of the children's health status, with larger scores indicating better health status.

resultsThe findings of the current study were threefold: First, this study found significant health disparities among the three types of children. Urban children are generally the healthiest (M = 1.064), followed by migrant children, (M = 0.779) and rural children (M = 0.612). Second, fathers' education significantly compensates for the heath disparities among the children. Fathers' education has a larger effect in compensating a rural-migrant difference (b = - 0.018, P < 0.05) than a rural-urban difference (b = - 0.016, P < 0.1). Third, the compensating effect of the fathers' education varies by gender. The compensating effect is larger for boys (b = 0.028, P < 0.001) than for girls (b = 0.025, P < 0.01).

conclusionsThis study found significant health inequalities among urban, migrant, and rural children, which might be shaped by the distinction of urban-rural structure and the process of rural-to-urban migration in contemporary China. Fathers' education also plays an important role in narrowing-but not eliminating-the health inequality between urban and rural children. Furthermore, the compensating effect of fathers' education is higher for boys than for girls, reflecting the patriarchal tradition in China. The currents study suggests that to promote the healthy growth of children, it is necessary to consider the health inequalities among different types of children when developing health-related policies. Factors like family socioeconomic status and gender may likewise play an important role in the implementation of policies.