Social factors associated with self-reported changes in mental health symptoms among youth in the COVID-19 pandemic: a cross-sectional survey

Stephana Julia Moss; Maia Stelfox; Eric McArthur; Cynthia Sriskandarajah; Sofia B Ahmed; Kathryn Birnie; Donna M Halperin; Scott A Halperin; Micaela Harley; Jia Hu; Josh Ng Kamstra; Laura Leppan; Angie Nickel; Nicole Racine; Kristine Russell; Stacie Smith; May Solis; Perri R Tutelman; Henry T Stelfox; Kirsten M Fiest; Jeanna Parsons Leigh

doi:10.1186/s12889-024-18087-8

Social factors associated with self-reported changes in mental health symptoms among youth in the COVID-19 pandemic: a cross-sectional survey

BMC Public Health. 2024 Feb 28;24(1):631. doi: 10.1186/s12889-024-18087-8.

Authors

Stephana Julia Moss¹, Maia Stelfox¹, Eric McArthur², Cynthia Sriskandarajah¹, Sofia B Ahmed³, Kathryn Birnie^{4

5}, Donna M Halperin⁶, Scott A Halperin⁷, Micaela Harley⁸, Jia Hu⁵, Josh Ng Kamstra⁹, Laura Leppan¹, Angie Nickel¹, Nicole Racine¹⁰, Kristine Russell¹, Stacie Smith¹¹, May Solis¹, Perri R Tutelman¹², Henry T Stelfox¹³, Kirsten M Fiest¹⁴, Jeanna Parsons Leigh¹⁵

Affiliations

¹ Faculty of Health, Dalhousie University, Halifax, NS, Canada.
² London Health Sciences Centre, London, ON, UK.
³ Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
⁴ Departments of Anesthesiology, Perioperative, and Pain Medicine, Calgary, AB, Canada.
⁵ Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
⁶ Rankin School of Nursing, St. Francis Xavier University, Antigonish, NS, Canada.
⁷ Canadian Center for Vaccinology, Departments of Pediatrics and Microbiology & Immunology, Dalhousie University, Halifax, NS, Canada.
⁸ Frayme, Cornwall, ON, Canada.
⁹ Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
¹⁰ Faculty of Social Sciences, University of Ottawa, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
¹¹ Young Canadian Roundtable On Health, Toronto, ON, Canada.
¹² Department of Oncology, University of Calgary, Calgary, AB, Canada.
¹³ Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
¹⁴ Department of Critical Care Medicine and O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
¹⁵ Faculty of Health, Dalhousie University, Halifax, NS, Canada. j.parsonsleigh@dal.ca.

Abstract

Background: Children and youth experienced marked impacts on day-to-day life in the COVID-19 pandemic that were associated with poorer familial and friend relationships, and greater mental health challenges. Few studies provide self-report data on mental health symptoms from children and youth themselves. We sought to examine the associations between social factors and child and youth self-reported symptoms of worsened mood, anxiety, and irritability during the COVID-19 pandemic.

Methods: A nationally representative cross-sectional survey was administered online to collect self-report data across 10 Canadian provinces among children (11-14 years) and youth (15-18 years), April-May 2022. Age-appropriate questions were based on The Partnership for Maternal, Newborn & Child Health and the World Health Organization of the United Nations H6 + Technical Working Group on Adolescent Health and Well-Being consensus framework and the Coronavirus Health and Impact Survey. Associations between a priori defined social factors (e.g., relationship quality) and respondent self-reported mental health were evaluated using ordinal logistic regression models adjusted for age, sex, and geographic location.

Results: We analyzed data from 483 (51.7%) children (11-14 years; 227, 47.0% girls) and 450 (48.3%) youth (15-18 years; 204, 45.3% girls). The parents of most children and youth had resided in Canada for over 20 years (678, 72.7%). Over one-quarter of children and youth self-identified as Black, Indigenous, or a Person of Color (134, 27.7%; 134, 29.8%, respectively). Over one-third of children and youth self-reported symptoms of worsened mood (149, 30.9%; 125, 27.8%, respectively), anxiety (181, 37.5%; 167, 37.1%, respectively), or irritability (160, 33.1%; 160, 35.6%, respectively) during, compared to pre-pandemic. In descending order of odds ratios (OR), for children and youth, worsened familial relationships (during compared to pre-pandemic) was associated with the self-reported symptoms of worsened mood (child: OR 4.22, 95%CI 2.51-6.88; youth: OR 6.65 95%CI 3.98-11.23), anxiety (child: OR 4.24, 95%CI2.69-6.75; youth: OR 5.28, 95%CI 3.17-8.86), and irritability (child: OR 2.83, 95%CI 1.76-4.56; youth: OR 6.46, 95%CI 3.88-10.90).

Conclusions: Self-reported data from a nationally representative sample of children and youth suggest strong associations between social factors and mental health during the COVID-19 pandemic. Interventions targeting child and youth familial relationships may positively impact child and youth mental health.

Keywords: COVID-19; Child; Mental Health; Sociodemographics; Youth.

MeSH terms

Adolescent
COVID-19* / epidemiology
Canada / epidemiology
Child
Cross-Sectional Studies
Female
Humans
Infant, Newborn
Male
Mental Health*
Pandemics
Self Report
Social Factors