Abstract
BACKGROUND: This study investigates the causal impact of family capital on the health of children and adolescents in China, focusing on the urban-rural divide. Despite research on factors like family income and parent-child relationships, causal relationships and urban-rural disparity remain underexplored. METHODS: The study incorporates factors like “family tradition” and “intergenerational care,” using longitudinal data from the China Family Panel Studies (2010–2020). Fixed effects models, lagged regression, and instrumental variable techniques explore family capital’s impact on self-rated health, depression, and frequency of being sick. RESULTS: Family social capital complements family economic capital and family cultural capital. Compared to urban children, family economic capital more significantly improves rural children’s self-rated health (β = 0.048, p < 0.001) and reduces depression (β=-0.059, p < 0.001). Family cultural capital helps reduce the frequency of being sick for rural (β=-0.013, p < 0.05) but not urban children. Family social capital helps reduce depression in urban (β=-0.056, p < 0.001) but not rural children. Network social interactions, interactions with relatives and friends, and intergenerational caregiving within family social capital demonstrate positive and healthy effects under “optimal” conditions. CONCLUSIONS: Family capital significantly influences child health, with notable differences between urban and rural areas. Health interventions should account for these differences to optimize outcomes for children in China. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-26193-y.