Parental absence, child victimization and health-related outcomes in rural China

Parental absence is a potential contributor to child victimization and its negative impacts on health and well-being, constituting a pressing public issue. However, the associations and mechanisms linking parental absence, child victimization, and health outcomes remain unclear, particularly for left-behind children in rural China. This study aims to explore the associations between parental absence and child health-related outcomes, including health services utilization (visit a doctor), health-related quality of life (measured by the Child Health Utility 9D [CHU9D] and Pediatric Quality of Life Inventory™ 4.0 [PedsQL]), and subjective well-being (WHO-5), with a focus on the mediating role of child victimization. Self-reported data were collected from 1912 school-aged children (Mage = 12.23, 56 % boys) in western China. Logistic and linear regression models were employed to analyze the relationships among parental absence, child bullying/maltreatment victimization, and health-related outcomes. An instrumental variable approach was applied to assess the robustness of the associations. This study found that parental absence was associated with increased probabilities and frequencies of child victimization. It was also significantly associated with a higher likelihood of medical visits and reduced CHU9D, PedsQL, and WHO-5 scores. Victimization probability partially mediated the associations, while victimization frequency further amplified the impacts on medical visits. In addition, children with siblings experienced more pronounced negative effects on health-related outcomes. These findings underscore the importance of addressing individual and family factors in child health-related outcomes and suggest policy recommendations to support children facing adversity.