Introduction Land fragmentation is a persistent feature of China’s rural tenure system, yet its psychological ramifications remain underexplored. This study investigates the causal association between land fragmentation and depressive symptoms among rural households, drawing on the Social Determinants of Health framework. Methods Using data from the 2022 China Land Economic Survey, we employ an instrumental variable approach based on agricultural machinery subsidies to address endogeneity. Results We identify a robust positive impact of fragmentation on depressive symptoms. Mechanism analyses reveal that fragmentation exacerbates depression through three distinct pathways: increasing agricultural production costs, intensifying labor burdens leading to time poverty, and eroding risk coping capabilities by reducing crop insurance participation. Furthermore, land transfer acts as a crucial moderator that significantly attenuates these adverse mental health effects. Discussion These findings underscore that land consolidation is not merely an economic imperative but a public health intervention. Policy efforts should integrate land tenure reform with targeted mental health support for vulnerable smallholders.
Zhou et al. (2026) studied this question.