Profiling Expenditure Patterns of Low-Income Families in China: Impact on Child Developmental Outcomes and Suicidal Risks

Background and Purpose

Low-income families in urban China have been benefited from the Minimum Living Standard Assistance (MLSA, aka dibao) policy since 1999 as a safety net. Previous studies show positive effects of MLSA on improving family economic well-being. However, little is known about the family expenditure patterns across diverse categories among low-income families. Few studies investigate how expenditure patterns, as a parental investment and family processes, influence child developmental outcomes, including academic performance, mental health, and physical health conditions.

Using latent profile analysis, this is the first study of its kind to 1) identify the patterns of family expenditures among low-income families, 2) examine the associations between expenditure patterns and child developmental outcomes, and 3) explore sex differences in the differential impact of expenditure patterns on child developmental outcomes across the MLSA and marginalized families (i.e., low-income families without MLSA). Understanding sex disparities linking family expenditures and child developmental outcomes informs more targeted health policy that incorporate social justice and equality.

Methods

Data and Sample

A total of 2,531 families with children ages 8-16 were extracted from the National Survey of Social Policy Support System for Low-Income Families in Urban and Rural China. Measurement

Child development outcomes were measured by self-report academic performance (ranking from 1-121), mental health (summed scores of 25 items), suicide risks (yes/no), and parent-report overall health. Family expenditures were measured using the values of monetary spending on children in seven categories (food, apparel, housing, transportation, pocket money, after-school education, and other educational resources). Sociodemographic variables (e.g., family size, family income, parent marital status, and rural residence) were adjusted.

Statistical analysis

Latent profile analysis was used to identify the homogenous patterns of family expenditure across the seven categories. Mixed effect logistic and linear regressions were used to examine the impact of identified expenditure patterns on child outcomes, accounting for clustering and variations at the provincial levels. Statistical analyses were performed using Mplus v.8.2, Stata 16, and R.

Results

The sample consisted of 1,534 (60.61%) MLSA and 997 (39.39%) marginalized families. The 2-class model was chosen based on its best fit of the data with the largest entropy (0.998). Class 1 families showed consistently-low expenditure on children, especially among housing and transportation. Class 2 families significantly prioritized after-school education resources. There were no significant differences in child outcomes across expenditure patterns. However, male children from marginalized families in Class 1 are 11 times (95% CI 1.10-109.52) more likely to think about suicide, and 10.7 times (95% CI 1.25-91.58) more likely to show obsessive-compulsive behaviors than female children from MLSA families in Class 2.

Conclusions and Implications

Low-income families in China have distinct patterns of family expenditures. Expenditure patterns heavily invested in after-school programs may increase mental distress among males from marginalized families who do not receive MLSA. Future studies should investigate the mechanisms linking expenditure patterns and different child outcomes. Service providers and policymakers can assess family expenditure patterns to identify at-risk children. Interventions promoting educational expenditure support can improve child developmental outcomes among the urban poor.