[Association between family socioeconomic status and child neglect among preschool children in rural areas of Xi'an].

Objective: To explore the association between family socioeconomic status (SES) and child neglect among preschool children in rural areas of Xi'an. Methods: A cross-sectional study was conducted. A total of 7 052 parents of children aged 3-6 years from kindergartens in 9 rural districts (counties) of Xi'an from March to April 2025, were investigated using a multistage cluster sampling method. The "Chinese rural norm evaluation scale for neglect assessment of children aged 3-6 years" was used to calculate scores across 6 dimensions and an overall neglect score to determine neglect status. A comprehensive SES score was constructed based on household income, parental occupation (the higher one), and parental educational level (the higher one). Logistic regression models were used to analyze the association of SES and its components with child neglect. The robustness of the results was verified using receiver operating characteristic (ROC) curves, restricted cubic spline (RCS) plots, subgroup analyses, and sensitivity analyses. Results: A total of 5 506 children were included, among whom 2 790 (50.7%) were boys and 2 716 (49.3%) were girls; 2 549 (46.3%) in senior class, 2 032 (36.9%) in middle class, and 925 (16.8%) in junior class. The overall prevalence of child neglect was 27.6% (1 519/5 506). The neglect rate of boys was higher than girls (30.8% (858/2 790) vs. 24.3% (661/2 716), χ²=28.35, P<0.001). After adjusting for all covariates, compared with the low SES score group, the high SES score group had a lower neglect risk in both boys (OR=0.44, 95%CI 0.34-0.56, P<0.001) and girls (OR=0.58, 95%CI 0.44-0.76, P<0.001). A significant linear dose-response relationship was observed between SES score and child neglect risk both in boys and girls (both P<0.001).When SES score alone predicted child neglect, the area under the curve (AUC) values (0.62 for boys, 0.61 for girls) were both higher than those of each individual SES component. Analysis of SES components showed that parental educational level had the strongest protective effect (high SES score group boys: OR=0.31, 95%CI 0.14-0.68, P=0.004; girls: OR=0.28, 95%CI 0.10-0.82, P=0.019). Subgroup analysis (most subgroups, P<0.05) and sensitivity analysis (E-values for high-score boys and girls were 4.01 and 2.87, 95%CI 2.94-5.35 and 1.97-4.00, respectively) comfirmed the robustness of the association. Conclusions: Family SES is negatively associated with child neglect in rural areas of Xi'an with a clear dose-response relationship. Parental educational level is a key protective factor in reducing child neglect risk. Comprehensive interventions targeting low-income and low-education families are recommended.