Impact of COVID-19 Pandemic-related Social Determinants of Health (SDoH) on Child Mental Health and Suicide Trajectory and Phenotypes: Temporal and Geographic Patterns
Yunyu Xiao, PhD; Paul Siu-Fai Yip, PhD; Jyotishman Pathak, PhD; J. John Mann, MD
April 27, 2022Research Overview
This prospective longitudinal cohort study analyzed data from 8,493 US children to examine how social determinants of health (SDoH) and vaccination eligibility/rates affected child mental health during the COVID-19 pandemic. The research identified that preexisting and time-varying social determinants at both individual and structural levels were associated with mental health trajectories, with disproportionate impacts on racial and ethnic minority groups.
Key Findings
Study Population
8,493 children from the Adolescent Brain Cognitive Development (ABCD) study cohort
Mental Health Trajectories
Stress, sadness, and COVID-19-related worry decreased after adult vaccination rollout
Risk Factors
Food insecurity, disrupted healthcare, neighborhood deprivation, and low vaccination rates associated with worse mental health
Racial Disparities
Asian, Black, and Hispanic children experienced disproportionate mental health impacts
Research Background
The COVID-19 pandemic disproportionately affected mental health in socioeconomically disadvantaged children in the US. This study examined the relationship of preexisting and time-varying social determinants of health (SDoH) at individual and structural levels, vaccination eligibility/rates, and racial and ethnic differences to trajectories of child mental health during the pandemic.
Study Methods
This prospective longitudinal cohort study, conducted from May 16, 2020, to March 2, 2021, integrated structural-level, pandemic-related data with the Adolescent Brain Cognitive Development (ABCD) cohort data across 21 US sites (in 17 states). The study measured perceived stress, NIH-Toolbox emotion measures, and COVID-19-related worry.
Key Results
Children experiencing food insecurity, disrupted healthcare access, and those living in economically deprived neighborhoods or states with lower vaccination rates showed increased stress, sadness, and COVID-19 worry. Asian, Black, and Hispanic children reported higher COVID-19-related worry compared to White children. Trajectories of stress, sadness, and COVID-19-related worry decreased after adult vaccination rollout.
Conclusions
The study identified disproportionate adverse effects of the COVID-19 pandemic on child mental health among racial and ethnic minority groups. These disparities may be improved by addressing modifiable individual factors (food insecurity, unemployment, health services, parental supervision) and structural factors (area deprivation, job protection, vaccination). Adult vaccination rollout was associated with improved child mental health trajectories.
Research Visualizations
Figure 1: Conceptual Framework showing how individual and structural social determinants of health (SDoH) impact child mental health during COVID-19
Figure 2: Trajectories of stress, sadness, and COVID-19-related worry decreased after adult vaccination rollout (December 13, 2020)
Figure 3: Predicted Probabilities of Self-reported Perceived Stress, COVID-19 Worry, National Institutes of Health (NIH)–Toolbox Sadness, and NIH-Toolbox Positive Affect with 95% CIs by Date of Survey Completion Among US Children