Qing Wang1, John A Rizzo2, Hai Fang3. 1. Shandong Multicenter Research Platform for Health Care Big Data, School of Public Health, Shandong University, Jinan, Shandong, 250012, China. 2. Department of Preventive Medicine, State University of New York at Stony Brook, Stony Brook, NY 11790, USA. 3. China Center for Health Development Studies, Peking University, 38 Xueyuan Road, Beijing, 100083, China. Electronic address: hfang@hsc.pku.edu.cn.
Abstract
BACKGROUND: Son preference is an enduring phenomenon in China and may often be related to childhood adverse experiences. According to a life-course perspective, adverse experiences during a childhood period may have a long-term effect on mental health in later age. However, little is known about this relationship between parents' son preference, childhood adverse experiences and adulthood mental health in China. OBJECTIVE: The study aims to evaluate the association of parents' son preference and individual mental health in old age in China. The mediating role of childhood adverse experiences was also estimated. PARTICIPANTS AND SETTING: The China Health and Retirement Longitudinal Study (CHARLS) 2015 combined with CHARLS life history survey was analyzed (N = 11,666). METHODS: Mental health was measured by a shortened modification of the Center for Epidemiologic Studies Depression scale including seven items, and higher scores indicated worse mental health status. A four-step mediating model was applied. RESULTS: Respondents growing in families with son preference had on average 0.75 (P < 0.001) points higher on the mental health scale than their counterparts, and the effects were consistent for both males and females. Childhood adverse experiences measured by physical maltreatment, emotional adverse experiences and witnesses of inter-parent violence mediated the relationship between parents' son preference and individual adulthood mental health by 47.87%. For females, physical maltreatment and emotional adverse experiences explained the most parts of health effects of parents' son preference, whereas witnesses of inter-parent violence was the most influential mediator for males. CONCLUSION: Parents' son preference led to adverse childhood experiences, which influenced mental health in adulthood.
BACKGROUND: Son preference is an enduring phenomenon in China and may often be related to childhood adverse experiences. According to a life-course perspective, adverse experiences during a childhood period may have a long-term effect on mental health in later age. However, little is known about this relationship between parents' son preference, childhood adverse experiences and adulthood mental health in China. OBJECTIVE: The study aims to evaluate the association of parents' son preference and individual mental health in old age in China. The mediating role of childhood adverse experiences was also estimated. PARTICIPANTS AND SETTING: The China Health and Retirement Longitudinal Study (CHARLS) 2015 combined with CHARLS life history survey was analyzed (N = 11,666). METHODS: Mental health was measured by a shortened modification of the Center for Epidemiologic Studies Depression scale including seven items, and higher scores indicated worse mental health status. A four-step mediating model was applied. RESULTS: Respondents growing in families with son preference had on average 0.75 (P < 0.001) points higher on the mental health scale than their counterparts, and the effects were consistent for both males and females. Childhood adverse experiences measured by physical maltreatment, emotional adverse experiences and witnesses of inter-parent violence mediated the relationship between parents' son preference and individual adulthood mental health by 47.87%. For females, physical maltreatment and emotional adverse experiences explained the most parts of health effects of parents' son preference, whereas witnesses of inter-parent violence was the most influential mediator for males. CONCLUSION: Parents' son preference led to adverse childhood experiences, which influenced mental health in adulthood.