Assessing the impact of paternal emigration on children 'left-behind'-A cohort analysis.

Background: Previous work has shown that children 'left-behind' as a consequence of parental migration experience worse outcomes, although the majority of this evidence focuses on short- rather than long-term effects. Methods: Using data from the Cebu Longitudinal Health and Nutrition Survey cohort (n = 1651), we assessed the association of paternal emigration (identified based on evidence of remittances sent back by mother's spouse) during childhood with the mental health and educational attainment at age 18 of Filipino children, adjusted for sex, socioeconomic position and paternal education. We explored whether timing of emigration, and household composition modified associations observed. Findings: Children who had migrant fathers were found to be 1.24 times more likely to have high educational attainment at age 18 than children who did not have migrant fathers, although the association was imprecise (95 % confidence intervals: 0.83-1.85). We found no statistical evidence of a difference between children who experienced paternal migration compared to those who did not in terms of depressive symptoms or suicidal ideation at age 18. There was evidence that experiencing paternal migration in older childhood (≥10 years) was associated with better mental health. We found evidence that household composition modified associations for depressive symptoms. Interpretation: This study does not suggest a detrimental long-term impact of paternal emigration on children 'left-behind, either for educational attainment or mental health. This may reflect beneficial effects of paternal migration and/or pre-existing socioeconomic and health differences amongst families who do and do not experience paternal migration.