How rural residence and gender associate with Mental Health: a cross-sectional study among Chinese early adolescents

Abstract

Background: Mental health disorders are the leading cause of disability in youth globally. China has the world’s second largest pediatric population with growing urban-rural inequalities.Objectives: 1) to examine the prevalence and gender differences in drug use, depressive symptoms, social support and externalizing behaviors in adolescents from an underserved rural community; 2) to compare results to a known urban sampleMethods: A cross-sectional study was conducted among children 12-14 years-old from rural Guizhou (N=76) using the 2003 Global School-based Student Health Survey. Prevalence and gender differences of 19 mental health outcomes were calculated and compared to those from a public urban Beijing sample (N=1,629). Associations of outcomes with gender and rural residence were assessed using multivariate logistic regression models in a combined analysis.Results: The prevalence of 9 out of the 19 investigated outcomes was significantly higher in the rural sample. In rural Guizhou, female gender was associated only with lower prevalence of physical fights. In the combined analysis, rural residence was associated with higher risks of lifetime troubles due to drinking, loneliness, insomnia, hopelessness, injuries and absenteeism. Girls had lower risks of recent drinking, inebriation, troubles due to drinking, recent smoking, fights, injures and bullying victimization compared to boys. Conclusion: Higher risks of excessive drinking, depressive symptoms, poor social support, and externalizing behaviors were found in rural adolescents compared to their urban peers. Girls had lower risks of drug use, poor peer support and externalizing behaviors. These findings call for targeted interventions informed by contextual and gender specifications.