| Summary: | The hukou household registration system in China is being relaxed in small and medium-sized cities, which makes it easier for migrant worker parents to take their children with them to cities for work. The aim of this study was determine the potential impact on psychological well-being of this change for children by migration and hukou status. We conducted a cross-sectional survey using the Chinese version of the Strengths and Difficulties Questionnaire (SDQ) in urban and migrant schools in the capital, Hangzhou, and in schools in two rural counties of Zhejiang Province. Completed questionnaires were obtained from 2965 children, aged 10 to 15: 867 urban children with urban hukou, 625 migrant children with rural hukou, 695 rural children with rural hukou living with parents, and 778 left behind children. The crude SDQ scores showed that children directly affected by migration (migrant children and left behind children) were most at risk of psychological problems; urban and rural children living with their parents in their accustomed environment were least vulnerable. After adjustment for confounders, migrant children were the most vulnerable to psychological problems. Given that migration with children is on the increase, efforts should be made to improve conditions in urban areas for these children, and especially to ensure access to urban public schools.
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