Background: One in seven members of China's population are migrants. There are an estimated 41 million children left behind in rural areas who are living without one or both of their parents. The impact of two- and single-parent migration on child mental health and risk behaviors is unclear. The aim of this study was to compare the mental health and risk behaviors among children whose parents are either both migrating (B-LBC), have one parent migrating (O-LBC) or those whose parents do not migrate (N-LBC). Methods: This study was a cross-sectional survey using a self-administered questionnaire conducted in rural areas with high proportions of left behind children (LBC) in Anhui Province, southeast China. The tools used were the Strength and Difficulties Questionnaires, Youth Risk Behavior Survey and the Young's Internet Addiction Test for Chinese. Results: Full data were available for 699 B-LBC, 552 O-LBC and 741 N-LBC. After adjusting for gender, age, grade, number of siblings and self-rated socio-economic status, B-LBC were significantly more likely to have higher emotional symptoms scores (B(SE) = 0.36(0.11), p < 0.01), higher hyperactivity scores (B(SE) = 0.22(0.11), p < 0.01) and higher total difficulties scores (B(SE) = 0.79(0.29), p < 0.01) than N-LBC. B-LBC were also more likely to be an addicted internet user (OR(95%CI) = 1.91(1.33, 2.76), p < 0.01) compared to N-LBC. However, there were no identified differences between O-LBC and N-LBC or between O-LBC and B-LBC in any measures. Conclusions: Our findings found that living with one parent or both parents was associated with better mental health and fewer risk behaviors than was being separated from both parents. Future research is needed to consider the implications of these findings for policies and programs to protect LBC, especially for those with two migrating parents. © 2019 The Author(s).

China Rural-urban migration Mental health Left-behind children Risk behaviors

China rural area sibling Chinese mental health human controlled study priority journal cross-sectional study social status self administration test Adolescent male female questionnaire scoring system Article high risk behavior major clinical study gender migration age parental attitude internet addiction health survey