COVID-19–related family financial difficulties—not schooling disruptions—were linked to large increases in stress, sadness, and worry and a decrease in positive affect among children aged 10 to 13 years, finds a US study published yesterday in JAMA Network Open.
The study, led by researchers from Weill Cornell Medicine and the University of California at Berkeley, involved data from 6,030 children aged 10 to 13 years completing surveys as part of the Adolescent Brain Cognitive Development (ABCD) Study from 2016 to 2018 and its COVID Rapid Response Research Releases, which involved five online surveys from May 2020 to May 2021.
ABCD was a stratified probability sample of 11,878 children aged 9 or 10 years attending public and private schools in 21 US cities.
The researchers linked the survey responses to state-level data from the Oxford COVID-19 Government Response Tracker, county-level data on COVID-19 incidence from John Hopkins University, and county-level monthly unemployment rates from the Bureau of Labor Statistics.
Weighted median age was 13 years, 48.9% were girls, 62.7% were White, 19.4% were Hispanic, 7.6% were Black, 4.5% were Asian, and 5.7% were of mixed or other race.
The goal was to determine whether financial difficulties (eg, job or income loss) and school closures related to COVID-19 public-health policies were separately associated with negative mental-health changes.
"Pandemic-related containment policies, including school closures, social distancing, and restrictions of in-person activities, were essential to control infection before vaccination and antiviral medications became available," the researchers wrote. "However, such policies may have unintended consequences for child mental health."
Economic impacts and public policy
Pandemic-related family financial struggles were tied to increases of 205.2% [95% confidence interval [CI], 52.9% to 509.0%] in perceived stress and 112.1% [95% CI, 22.2% to 268.1%] in sadness, a 32.9% [95% CI, 3.5% to 53.4%] decrease in positive affect, and a 73.9 percentage-point [95% CI, 13.2 to 134.7] increase in moderate to extreme COVID-related worry—but not to sleep disruptions.
School disruptions weren't linked to mental-health changes or sleep problems.
"These findings suggest public policy should consider the economic impact on families due to pandemic containment measures, in part to protect child mental health until vaccines and antiviral drugs become available," the authors wrote.
In a Weill Cornell Medicine news release, lead author Yunyu Xiao, PhD, said that children's mental health and early-life exposure to stress may have long-term effects.
These findings suggest public policy should consider the economic impact on families due to pandemic containment measures, in part to protect child mental health until vaccines and antiviral drugs become available."
"We must not only take care of clinical needs but also study other factors that affect people," she said. "To conduct the best science aimed at improving lives, we need to develop holistic public health approaches that go beyond treating biological causes of illness and addressing the social determinants of health."