The Urban-Rural Difference in Child Mental Health in Vietnam: The Continuing Impacts of the COVID-19 Pandemic on Health

Abstract

Objectives: We aimed to explore the difference between rural and urban children's mental health and quality of life after the pandemic.

Methods: A total of 200 parents and their 11- to 15-year-old children were interviewed face to face in October 2022. This study measures child mental health and quality of life using the Strengths and Difficulties Questionnaire and Child Health Utility 9 Dimensions tools. The unadjusted effect sizes on health outcomes among demographic groups are calculated using Cohen's d. The school-specific fixed effects linear regression model with bootstrapped standard errors is applied.

Results: Rural children have significantly higher mean internalizing behavior scores than urban children (emotional problems, Cohen's d score = 0.38; peer difficulties, Cohen's d score = 0.39; P < .05). Although children living in urban areas who had COVID-19 had significantly higher peer problem scores (Cohen's d score = 0.82, P < .05), the result was not found in those residing in rural areas. After controlling all variables, the econometrics method confirms that infection status significantly affects children's peer problems, obviously in the urban sample.

Conclusions: Children may experience the consequences of the pandemic on their mental health related to peer difficulties, differently between urban and rural areas. Further research is required to investigate the different impacts of COVID-19 on health in urban and rural areas.

Keywords: COVID-19; Child Health Utility 9 Dimensions; Strengths and Difficulties Questionnaire; Vietnam; child mental health; regional gap.