Children's Physical Health and Parental Depression: A Caregiving Resource Supply and Demand Perspective

Sheng He, Li Jianxin 

Published in Population Journal, 2024, Issue 6, Vol. 46. 

Abstract: Adult depression has become a global public health issue. While much of the existing literature examines individual-level determinants of depression, less attention has been paid to the family context. In Chinese family culture, parents' expectations and sense of responsibility toward their children are strong, and children's illness can be a disruptive event for the family. It disrupts normal family functioning and imposes additional caregiving and financial demands, which may in turn affect parental mental health. Particularly in light of the escalating aging population and the significant influx of women into the labor force, traditional family-centered caregiving activities have become increasingly insufficient to meet the growing demands for care. Therefore, the balance between caregiving supply and demand forms the structural context for understanding this issue. Using data from the 2020 China Family Panel Studies (CFPS), this study examines the impact of children's health on parental depression and analyzes the heterogeneity within the caregiving supply and demand framework. The study finds that among parents with only one child aged 0–16, the child's illness or medical treatment significantly increases parental depression levels. Higher medical expenses are associated with greater parental depression. These results remain robust when the analysis accounts for illness frequency and when extended to families with multiple children. The study also reveals gender and socioeconomic differences in the effects of children's health on parental depression. Women, as the primary caregivers, experience significant increases in depression when their children fall ill, whereas the impact on fathers is not as pronounced. This shows the influence of traditional family roles in China. The negative impact of the child's poor health on parental depression is more pronounced among parents living in urban areas and those with higher educational attainment. Further analysis explores the effects of caregiving supply and demand. On the supply side, when grandparents are available to provide caregiving support or when one parent is not employed, the impact of children's illness on parental depression is mitigated. This indicates that increased caregiving supply serves as a "safety net," providing crucial support to the family. On the demand side, regardless of the total number of children in the family or their ages, children's illness consistently elevates parental depression levels. The findings offer important insights for optimizing child care policies. Drawing on the advanced experiences of other countries, it is crucial to place greater emphasis on social protection for children, address the imbalance between caregiving supply and demand, and prioritize increasing caregiving resources. Institutional support should be developed to help parents balance work and child care. Additionally, it is essential to promote gender equality in caregiving by encouraging fathers' involvement in child care and fostering a shared responsibility for family risks. This would not only alleviate the mental health burden on parents but also empower families to better manage caregiving challenges in a rapidly changing social context.

Keywords: Children's Physical Health, Parental Depression, Caregiving Resource, Supply and Demand