Mental Health Among Children During COVID-19 Affected by Family Financial Status

Financial disruptions related to COVID-19 containment policies resulted in adverse mental health outcomes among children, according to study results published in JAMA Network Open.

Investigators from University of California, San Diego sourced data for this study from the Adolescent Brain Cognitive Development (ABCD) study which was a longitudinal study that recruited 11,878 children aged 9 to 10 years attending 21 schools in the United States from 2016 to 2018. Between 2020 and 2021, children and parents of ABCD were sent 6 online surveys about mental health outcomes. In addition, data from the ABCD study were linked with the Oxford COVID-19 Government Response Tracker (OxCGRT), county-level COVID-19 data from John Hopkins University, and county-level unemployment rates from the US Bureau of Labor Statistics. The aim of this study was to evaluate whether financial and school disruptions from the COVID-19 pandemic affected perceived stress, sadness, positive affect, worry, and sleep outcomes among children.

This study included data from 6030 to 6080 children, depending on the analysis, who had a median age of 13 (IQR, 12-13) years, 48.9% were girls, and 62.7% were White.

Children who were from a family that experienced financial disruption during the COVID-19 pandemic experienced a 205.2% (P ≤.01) increase in perceived stress, 112.1% (P ≤.01) increase in sadness, 73.9% (P ≤.05) increase in COVID-19-related worry, and a 32.9% (P ≤.05) decrease in positive affect.

School disruptions did not significantly affect stress, worry, sadness, or positive affect outcomes and neither family financial disruptions nor school disruptions significantly affected any sleep outcomes.

Predictors for changes in perceived stress during COVID-19 included female gender (coefficient, 12.473%; P ≤.001) and age (coefficient, 4.952%; P ≤.001); COVID-19 worry was related with female gender (coefficient, 8.789%; P ≤.001), age (coefficient, 1.986%; P ≤.001), and Black (coefficient, 16.916%; P ≤.001), Asian (coefficient, 16.636%; P ≤.001), and Hispanic (coefficient, 7.482%; P ≤.01) race and ethnicities; and positive affect was related with female gender (coefficient, -4.180%; P ≤.001), age (coefficient, -2.188%; P ≤.001), exposure to the media (coefficient, -0.204%; P ≤.05), and Black race (coefficient, 5.615%; P ≤.001).

Abnormal sleep latency was observed among children who were Asian (coefficient, 4.385%; P ≤.05) or Hispanic (coefficient, 4.340%; P ≤.01), abnormal sleep inertia was affected by age (coefficient, -5.721%; P ≤.001) and observed among girls (coefficient, -2.426%; P ≤.001), and abnormal sleep duration was observed among Black children (coefficient, 6.872%; P ≤.05) and associated with age (coefficient, 5.527%; P ≤.001).

The limitations of this study included the self-reported outcomes and the use of a bias correction method.

These data indicated that the financial situation of a family during the COVID-19 pandemic and not school closures had larger impacts on childhood wellbeing. The study authors concluded, “These findings suggest that COVID-19 containment policies and geographic variations in unemployment rates may have worsened child mental health, but largely through family financial disruptions and not school disruptions. Therefore, policy makers should consider policies that more effectively mitigate the financial impact of pandemic containment on families and, thereby, child mental well-being.”