Peer-reviewed article
Urbanization, mental health, and oral health inequalities in left-behind youth: a systematic review and meta-analysis.
Ball J, Lin K, Rainbow Y, Sun J ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review examined mental and oral health outcomes in left-behind children whose parents migrated from rural areas to cities for work. The analysis of 33 studies found that left-behind children experience higher rates of depression and tooth decay compared to children living with their parents, and are less likely to receive dental care. Common factors affecting both mental and oral health include caregiver education, quality of communication with parents, and school environment. The findings suggest that integrated interventions addressing caregiving, health access, and school support could improve outcomes for these vulnerable children.
Key points
- Left-behind children showed significantly higher depressive symptoms compared to non-left-behind peers (standardized mean difference = 0.16)
- Left-behind children had 1.36 times higher risk of elevated depressive symptoms
- Left-behind children experienced higher rates of permanent tooth caries and were less likely to attend dental care in the past year
- Greater mental distress occurred with shorter parental separation periods and when both parents had migrated
- Caregiver education, parent-child communication quality, and school climate were consistent protective factors across both mental and oral health domains
Limitations
The review synthesizes evidence across different settings and populations, which may mask important contextual variations. The document does not provide detailed analysis of intervention effectiveness or implementation barriers in specific regional contexts.
Abstract
Purpose of review This systematic review and meta-analysis evaluated mental and oral health outcomes among left-behind children (LBC) affected by urbanization-driven rural-urban labour migration. Although mental health impacts of parental migration are increasingly recognized, oral health outcomes remain underexplored. This review synthesizes available evidence, quantifies disparities, and identifies shared social and structural determinants. Recent findings Thirty-three studies met inclusion criteria. Pooled analyses revealed significantly higher depressive symptoms among LBC compared to non-LBC peers [standardized mean difference (SMD) = 0.16, 95% confidence interval (CI): 0.03-0.29], with increased risk of elevated depressive symptoms [odds ratio (OR) = 1.36, 95% CI: 1.01-1.83]. LBC also experienced higher rates of permanent tooth caries (SMD = 0.15, 95% CI: 0.05-0.25) and were less likely to attend dental care in the past year (OR = 0.80, 95% CI: 0.67-0.94). Greater distress was observed in cases of shorter parental separation and when both parents had migrated. Factors such as caregiver education, quality of parent-child communication, and school climate consistently influenced outcomes across both mental and oral health domains. Summary LBC experience a dual burden of psychological distress and unmet dental need, reflecting the effects of urbanization-related parental migration. These disparities are shaped by caregiving discontinuity, reduced access to preventive services, and socio-environmental stressors. Findings highlight the need for integrated responses, including caregiver training, school-based prevention, and equitable health entitlements. Addressing shared determinants across mental and oral health domains offers a feasible path toward improved outcomes and greater equity. Trial registration PROSPERO ID: CRD420251152265.