Early Childhood Care Trends and Associations with Child Health Well-being in China: Evidence from the CHNS 1991 to 2011 Data

It has become increasingly common for young children to be taken care of by multiple caregivers in China after the socio-economic reforms. Complex migration patterns and high female labour force participation have led to children receiving care from various individuals in different contexts. However, little is known about how childcare arrangements are associated with child health well-being. This study examines various early childhood caregivers and their influences on children’s physical health in China. Using data from the China Health and Nutrition Survey (CHNS 1991–2011) with 3,470 children aged 2 to 6, we first identified different types of childcare arrangements in and outside of the household based on who provides the care, where they provide the care, and the intensity of the care. Then we examined the relationship between various childcare arrangements and health outcomes for children. Overall, household members undertook early childhood care tasks in China, with an increase in grandparents as primary caregivers between 1991 and 2011. The proportion of children receiving formal childcare fluctuated around 20% during this period. The findings suggest that: 1) primary caregiver in the household other than parents is not associated with undesirable physical health outcomes; 2) formal childcare outside the household is associated with higher height and lower BMI scores; 3) primary caregivers in the household, particular grandparents, moderate the association between childcare arrangements outside the household and children’s health outcomes. It yields an implication that early childhood care policies incorporating multiple caregivers would benefit children’s well-being in China.