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Association of Social Determinants of Health and Vaccinations With Child Mental Health During the COVID-19 Pandemic in the US

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
Key Points

Question  To what extent are individual and structural social determinants of health (SDoH) and vaccinations associated with child mental health during the COVID-19 pandemic?

Findings  In this cohort study of 8493 US children, pandemic-related food insecurity, parental unemployment, disrupted mental health treatment, living in neighborhoods with higher shares of adults working full-time, and living in states lagging in vaccination rates were associated with increased trajectories of perceived stress, sadness, and COVID-19–related worry. Associations between SDoH and these mental health outcomes were more common among Asian, Black, and Hispanic children more than White children.

Meaning  Supporting children’s mental health requires multifaceted policies that address SDoH and structural barriers to food, health services, employment protection, and vaccination.


Importance  The COVID-19 pandemic disproportionately affected mental health in socioeconomically disadvantaged children in the US. However, little is known about the relationship of preexisting and time-varying social determinants of health (SDoH) at individual and structural levels, vaccination eligibility/rates, and the racial and ethnic differences to trajectories of child mental health during the COVID-19 pandemic.

Objective  To estimate the association of trajectories of child mental health to multilevel SDoH and vaccination eligibility/rates.

Design, Setting, and Participants  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 (release 4.0). The ABCD study recruited 11 878 children (baseline) and conducted 6 COVID-19 rapid response surveys across 21 US sites (in 17 states) from May 16, 2020, to March 2, 2021.

Exposures  Preexisting individual (eg, household income) and structural (area deprivation) SDoH and time-varying individual (eg, food insecurity, unemployment) and structural (eg, social distancing, vaccination eligibility/rates) SDoH.

Main Outcomes and Measures  Perceived Stress Scale, the National Institutes of Health–Toolbox emotion measures, and COVID-19–related worry.

Results  The longitudinal sample included 8493 children (mean [SD] age, 9.93 [0.63] years; 5011 girls [47.89%]; 245 Asian [2.34%], 1213 Black [11.59%], 2029 Hispanic [19.39%], 5851 White [55.93%], and 1124 children of other/multiracial ethnicity [10.74%]). Trajectories of stress, sadness, and COVID-19–related worry decreased after adult vaccination rollout. Compared with younger children, boys, White children, or those living with married parents, those who reported greater perceived stress included older children aged 12 to 15 years (β = 0.26; 95% CI, 0.12-0.41; P < .001); girls (β = 0.75; 95% CI, 0.61-0.89; P < .001); Hispanic children (β = 0.24; 95% CI, 0.01-0.47; P = .04); children living with separated parents (β = 0.50; 95% CI, 0.03-0.96; P = .04); children experiencing disrupted medical health care access (β = 0.19; 95% CI, 0.01-0.36; P = .04); children living in economically deprived neighborhoods (β = 0.28; 95% CI, 0.05-0.51; P = .02); children living in areas with more full-time working-class adults who were unable to social distance (β = 1.35; 95% CI, 0.13-2.67; P = .04); and children living in states with fewer fully vaccinated adults (β = 0.59; 95% CI, 0.16-1.02; P = .007). COVID-19 pandemic–related worry was higher among Asian children (β = 0.22; 95% CI, 0.08-0.37; P = .003), Black children (β = 0.33; 95% CI, 0.22-0.43; P < .001), children of other/multiracial ethnicity (β = 0.17; 95% CI, 0.09-0.25; P < .001), and children with disrupted medical health care (β = 0.15; 95% CI, 0.09-0.21) and disrupted mental health treatment (β = 0.11; 95% CI, 0.06-0.16). Inability to afford food was associated with increased sadness (β = 1.50; 95% CI, 0.06-2.93; P = .04). States with later vaccination eligibility dates for all adults were associated with greater COVID-19–related worry (β = 0.16; 95% CI, 0.01-0.31; P = .03) and decreased positive affect (β = −1.78; 95% CI, −3.39 to −0.18; P = .03) among children.

Conclusions and Relevance  Results of this study suggest a disproportionately adverse association of the COVID-19 pandemic with child mental health among racial and ethnic minority groups, which may be improved by addressing modifiable individual (food insecurity, unemployment, health services, parental supervision) and structural (area deprivation, job protection, vaccination) SDoH.

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Article Information

Accepted for Publication: March 1, 2022.

Published Online: April 27, 2022. doi:10.1001/jamapsychiatry.2022.0818

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Xiao Y et al. JAMA Psychiatry.

Corresponding Author: Yunyu Xiao, PhD, Department of Population Health Sciences, Weill Cornell Medicine, New York–Presbyterian, Division 306, 425 E 61 St, New York, NY 10065 (yux4008@med.cornell.edu).

Author Contributions: Dr Xiao had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Xiao, Pathak, Mann.

Drafting of the manuscript: Xiao, Pathak.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Xiao, Yip.

Obtained funding: Xiao.

Administrative, technical, or material support: Xiao, Pathak.

Supervision: Pathak, Mann.

Conflict of Interest Disclosures: Dr Xiao reported receiving grants from the Bill & Melinda Gates Foundation during the conduct of the study. Dr Mann reported receiving royalties for commercial use of the Columbia Suicide Severity Rating Scale paid from the Research Foundation for Mental Hygiene. No other disclosures were reported.

Funding/Support: This research is supported by grant CORONAVIRUSHUB-D-21-00125 from the Bill & Melinda Gates Foundation and a Research Grants Council Collaborative Research Fund grant (C7151-20G) from the University Grants Committee of Hong Kong.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Abbasi  J .  Prioritizing physician mental health as COVID-19 marches on.   JAMA. 2020;323(22):2235-2236.PubMedGoogle ScholarCrossref
Berkowitz  SA , Basu  S .  Unemployment insurance, health-related social needs, health care access, and mental health during the COVID-19 pandemic.   JAMA Intern Med. 2021;181(5):699-702.PubMedGoogle ScholarCrossref
Amsalem  D , Dixon  LB , Neria  Y .  The coronavirus disease 2019 (COVID-19) outbreak and mental health: current risks and recommended actions.   JAMA Psychiatry. 2021;78(1):9-10.PubMedGoogle ScholarCrossref
Leifheit  KM , Pollack  CE , Raifman  J ,  et al.  Variation in state-level eviction moratorium protections and mental health among US adults during the COVID-19 pandemic.   JAMA Netw Open. 2021;4(12):e2139585.PubMedGoogle Scholar
The World Health Organization. A conceptual framework for action on the social determinants of health. Accessed February 25, 2022. https://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf
Newlove-Delgado  T , McManus  S , Sadler  K ,  et al; Mental Health of Children and Young People group.  Child mental health in England before and during the COVID-19 lockdown.   Lancet Psychiatry. 2021;8(5):353-354.PubMedGoogle ScholarCrossref
Pierce  M , Hope  H , Ford  T ,  et al.  Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population.   Lancet Psychiatry. 2020;7(10):883-892.PubMedGoogle ScholarCrossref
Panchal  U , Salazar de Pablo  G , Franco  M ,  et al.  The impact of COVID-19 lockdown on child and adolescent mental health: systematic review.   Eur Child Adolesc Psychiatry. 2021;1-27.PubMedGoogle Scholar
Li  W , Wang  Z , Wang  G ,  et al.  Socioeconomic inequality in child mental health during the COVID-19 pandemic: first evidence from China.   J Affect Disord. 2021;287:8-14.PubMedGoogle ScholarCrossref
Hawrilenko  M , Kroshus  E , Tandon  P , Christakis  D .  The association between school closures and child mental health during COVID-19.   JAMA Netw Open. 2021;4(9):e2124092.PubMedGoogle Scholar
Christakis  DA , Van Cleve  W , Zimmerman  FJ .  Estimation of US children’s educational attainment and years of life lost associated with primary school closures during the coronavirus disease 2019 pandemic.   JAMA Netw Open. 2020;3(11):e2028786.PubMedGoogle Scholar
Lee  J .  Mental health effects of school closures during COVID-19.   Lancet Child Adolesc Health. 2020;4(6):421.PubMedGoogle ScholarCrossref
Hillis  SD , Blenkinsop  A , Villaveces  A ,  et al.  COVID-19–associated orphanhood and caregiver death in the US.   Pediatrics. 2021;e2021053760.PubMedGoogle Scholar
Rider  EA , Ansari  E , Varrin  PH , Sparrow  J .  Mental health and well-being of children and adolescents during the Covid-19 pandemic.   BMJ. 2021;374:n1730.PubMedGoogle Scholar
Hause  AM , Baggs  J , Marquez  P ,  et al.  COVID-19 vaccine safety in children aged 5-11 years—US, November 3-December 19, 2021.   MMWR Morb Mortal Wkly Rep. 2021;70(5152):1755-1760.PubMedGoogle ScholarCrossref
Bauer  BW , Law  KC , Rogers  ML , Capron  DW , Bryan  CJ .  Editorial overview: analytic and methodological innovations for suicide-focused research.   Suicide Life Threat Behav. 2021;51(1):5-7.PubMedGoogle ScholarCrossref
Shim  RS .  Dismantling structural racism in psychiatry: a path to mental health equity.   Am J Psychiatry. 2021;178(7):592-598.PubMedGoogle ScholarCrossref
Shim  RS , Starks  SM .  COVID-19, structural racism, and mental health inequities: policy implications for an emerging syndemic.   Psychiatr Serv. 2021;72(10):1193-1198.PubMedGoogle ScholarCrossref
Bernardini  F , Attademo  L , Rotter  M , Compton  MT .  Social determinants of mental health as mediators and moderators of the mental health impacts of the COVID-19 pandemic.   Psychiatr Serv. 2021;72(5):598-601.PubMedGoogle ScholarCrossref
Lopez  L  III , Hart  LH  III , Katz  MH .  Racial and ethnic health disparities related to COVID-19.   JAMA. 2021;325(8):719-720.PubMedGoogle ScholarCrossref
Cohn  AC , Mahon  BE , Walensky  RP .  One year of COVID-19 vaccines: a shot of hope, a dose of reality.   JAMA. 2022;327(2):119-120.PubMedGoogle ScholarCrossref
Wrigley-Field  E , Garcia  S , Leider  JP , Van Riper  D .  COVID-19 mortality at the neighborhood level: racial and ethnic inequalities deepened in Minnesota in 2020.   Health Aff (Millwood). 2021;40(10):1644-1653.PubMedGoogle ScholarCrossref
Golberstein  E , Wen  H , Miller  BF .  Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents.   JAMA Pediatr. 2020;174(9):819-820.PubMedGoogle ScholarCrossref
Rosenthal  DM , Ucci  M , Heys  M , Hayward  A , Lakhanpaul  M .  Impacts of COVID-19 on vulnerable children in temporary accommodation in the UK.   Lancet Public Health. 2020;5(5):e241-e242.PubMedGoogle ScholarCrossref
Kidman  R , Margolis  R , Smith-Greenaway  E , Verdery  AM .  Estimates and projections of COVID-19 and parental death in the US.   JAMA Pediatr. 2021;175(7):745-746.PubMedGoogle ScholarCrossref
Abrams  EM , Szefler  SJ .  COVID-19 and the impact of social determinants of health.   Lancet Respir Med. 2020;8(7):659-661.PubMedGoogle ScholarCrossref
Dooley  DG , Christakis  D .  It is time to end the debate over school reopening.   JAMA Netw Open. 2021;4(4):e2111125.PubMedGoogle Scholar
Tung  EL , Peek  ME , Rivas  MA , Yang  JP , Volerman  A .  Association of neighborhood disadvantage with racial disparities in COVID-19 positivity in Chicago.   Health Aff (Millwood). 2021;40(11):1784-1791.PubMedGoogle ScholarCrossref
Anglin  DM , Ereshefsky  S , Klaunig  MJ ,  et al  From womb to neighborhood: a racial analysis of social determinants of psychosis in the US.   Am J Psychiatry. 2021;178(7):599-610.PubMedGoogle ScholarCrossref
Tandon  PS , Zhou  C , Johnson  AM , Gonzalez  ES , Kroshus  E .  Association of children’s physical activity and screen time with mental health during the COVID-19 pandemic.   JAMA Netw Open. 2021;4(10):e2127892.PubMedGoogle Scholar
Pouwels  KB , House  T , Pritchard  E ,  et al; COVID-19 Infection Survey Team.  Community prevalence of SARS-CoV-2 in England from April to November, 2020: results from the ONS Coronavirus Infection Survey.   Lancet Public Health. 2021;6(1):e30-e38.PubMedGoogle ScholarCrossref
Gao  S , Rao  J , Kang  Y ,  et al.  Association of mobile phone location data indications of travel and stay-at-home mandates with COVID-19 infection rates in the US.   JAMA Netw Open. 2020;3(9):e2020485.PubMedGoogle Scholar
ABCD Research Consortium. Home page. Accessed October 11, 2021. https://abcdstudy.org/
National Archives and Records Administration. Standards for maintaining, collecting, and presenting federal data on race and ethnicity. September 30, 2016. Accessed February 19, 2022. https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf
Heeringa  SG , Berglund  PA .  A guide for population-based analysis of the Adolescent Brain Cognitive Development (ABCD) study baseline data.   bioRxiv. Preprint posted online February 10, 2020. doi:10.1101/2020.02.10.942011Google Scholar
National Institute of Mental Health Data Archive. Adolescent Brain Cognitive Development Study (ABCD) data release: COVID Rapid Response Research (RRR) Survey second data release. Accessed January 27, 2022. https://nda.nih.gov/study.html?id=1225
The New York Times. Covid-19 vaccinations: county and state tracker. January 13, 2022. Accessed January 13, 2022. https://www.nytimes.com/interactive/2020/us/covid-19-vaccine-doses.html
US News & World Report. Who is eligible for a COVID-19 vaccine in your state? May 28, 2021. Accessed January 13, 2022. https://www.usnews.com/news/best-states/articles/covid-19-vaccine-eligibility-by-state
US Centers for Disease Control and Prevention. COVID data tracker. Updated March 20, 2022. Accessed February 27, 2022. https://covid.cdc.gov/covid-data-tracker/#datatracker-home
Rose  T , Lindsey  MA , Xiao  Y , Finigan-Carr  NM , Joe  S .  Mental health and educational experiences among Black youth: a latent class analysis.   J Youth Adolesc. 2017;46(11):2321-2340.PubMedGoogle ScholarCrossref
Cohen  S , Kamarck  T , Mermelstein  R .  A global measure of perceived stress.   J Health Soc Behav. 1983;24:385-396.Google ScholarCrossref
NIH Toolbox. NIH toolbox scoring and interpretation guide. June 16, 2021. Accessed October 11, 2021. https://nihtoolbox.force.com/s/article/nih-toolbox-scoring-and-interpretation-guide
Github. ABCD-STUDY/geocoding. Accessed January 27, 2022. https://github.com/ABCD-STUDY/geocoding/blob/master/Gen_data_proc.R
Dong  E , Du  H , Gardner  L .  An interactive web-based dashboard to track COVID-19 in real time.   Lancet Infect Dis. 2020;20(5):533-534.PubMedGoogle ScholarCrossref
SafeGraph. Social distancing metrics. Accessed October 11, 2021. https://docs.safegraph.com/docs/social-distancing-metrics
Andersen  M , Maclean  JC , Pesko  MF , Simon  KI . Paid sick-leave and physical mobility: evidence from the US during a pandemic. Accessed January 27, 2022. https://EconPapers.repec.org/RePEc:nbr:nberwo:27138
Barch  DM , Albaugh  MD , Baskin-Sommers  A ,  et al.  Demographic and mental health assessments in the adolescent brain and cognitive development study: updates and age-related trajectories.   Dev Cogn Neurosci. 2021;52:101031.PubMedGoogle Scholar
Funkhouser  CJ , Chacko  AA , Correa  KA , Kaiser  AJE , Shankman  SA .  Unique longitudinal relationships between symptoms of psychopathology in youth: a cross-lagged panel network analysis in the ABCD study.   J Child Psychol Psychiatry. 2021;62(2):184-194.PubMedGoogle ScholarCrossref
van Dijk  MT , Murphy  E , Posner  JE , Talati  A , Weissman  MM .  Association of multigenerational family history of depression with lifetime depressive and other psychiatric disorders in children: results from the Adolescent Brain Cognitive Development (ABCD) study.   JAMA Psychiatry. 2021;78(7):778-787.PubMedGoogle ScholarCrossref
Stoel  RD , van den Wittenboer  G , Hox  J .  Analyzing longitudinal data using multilevel regression and latent growth curve analysis.   Metodologia de las Ciencias del Comportamiento. 2003;5(1):21-42.Google Scholar
McNeish  D , Matta  T .  Differentiating between mixed-effects and latent-curve approaches to growth modeling.   Behav Res Methods. 2018;50(4):1398-1414.PubMedGoogle ScholarCrossref
Wu  YT , Daskalopoulou  C , Muniz Terrera  G ,  et al; ATHLOS Consortium.  Education and wealth inequalities in healthy ageing in 8 harmonised cohorts in the ATHLOS Consortium: a population-based study.   Lancet Public Health. 2020;5(7):e386-e394.PubMedGoogle ScholarCrossref
Assari  S , Boyce  S , Bazargan  M , Caldwell  CH .  African Americans’ diminished returns of parental education on adolescents’ depression and suicide in the Adolescent Brain Cognitive Development (ABCD) study.   Eur J Investig Health Psychol Educ. 2020;10(2):656-668.PubMedGoogle ScholarCrossref
Harrell  FE  Jr .  Regression Modeling Strategies: With Applications to Linear Models, Logistic and Ordinal Regression, and Survival Analysis. Springer International Publishing; 2015.
West  SG , Aiken  LS , Krull  JL .  Experimental personality designs: analyzing categorical by continuous variable interactions.   J Pers. 1996;64(1):1-48.PubMedGoogle ScholarCrossref
Dong  Y , Peng  CYJ .  Principled missing data methods for researchers.   Springerplus. 2013;2(1):222.PubMedGoogle ScholarCrossref
Raifman  J , Bor  J , Venkataramani  A .  Association between receipt of unemployment insurance and food insecurity among people who lost employment during the COVID-19 pandemic in the US.   JAMA Netw Open. 2021;4(1):e2035884.PubMedGoogle Scholar
Chakrabarti  S , Hamlet  LC , Kaminsky  J , Subramanian  SV .  Association of human mobility restrictions and race/ethnicity-based, sex-based, and income-based factors with inequities in well-being during the COVID-19 pandemic in the US.   JAMA Netw Open. 2021;4(4):e217373-e217373.PubMedGoogle ScholarCrossref
Wolfson  JA , Leung  CW .  Food insecurity during COVID-19: an acute crisis with long-term health implications.   Am J Public Health. 2020;110(12):1763-1765.PubMedGoogle ScholarCrossref
Melchior  M , Caspi  A , Howard  LM ,  et al.  Mental health context of food insecurity: a representative cohort of families with young children.   Pediatrics. 2009;124(4):e564-e572.PubMedGoogle ScholarCrossref
Mozaffarian  D , Fleischhacker  S , Andrés  JR .  Prioritizing nutrition security in the US.   JAMA. 2021;325(16):1605-1606.PubMedGoogle ScholarCrossref
Shachar  C , Engel  J , Elwyn  G .  Implications for telehealth in a postpandemic future: regulatory and privacy issues.   JAMA. 2020;323(23):2375-2376.PubMedGoogle ScholarCrossref
Raza  A , Claeson  M , Magnusson Hanson  L , Westerlund  H , Virtanen  M , Halonen  JI .  Home and workplace neighborhood socioeconomic status and behavior-related health: a within-individual analysis.   Ann Behav Med. 2021;55(8):779-790.PubMedGoogle ScholarCrossref
Chen  YH , Glymour  M , Riley  A ,  et al.  Excess mortality associated with the COVID-19 pandemic among Californians 18-65 years of age, by occupational sector and occupation: March through November 2020.   PLoS One. 2021;16(6):e0252454.PubMedGoogle Scholar
Jay  J , Bor  J , Nsoesie  EO ,  et al.  Neighbourhood income and physical distancing during the COVID-19 pandemic in the US.   Nat Hum Behav. 2020;4(12):1294-1302.PubMedGoogle ScholarCrossref
Yuan  Y , Deng  Z , Chen  M ,  et al.  Changes in mental health and preventive behaviors before and after COVID-19 vaccination: a propensity score matching (PSM) study.   Vaccines (Basel). 2021;9(9):1044.PubMedGoogle ScholarCrossref
Chen  S , Aruldass  AR , Cardinal  RN .  Mental health outcomes after SARS-CoV-2 vaccination in the US: a national cross-sectional study.   J Affect Disord. 2022;298(Pt A):396-399.PubMedGoogle Scholar
Yang  LH , Link  BG , Susser  ES .  Examining power relations to understand and address social determinants of vaccine uptake.   JAMA Psychiatry. 2021;78(12):1303-1304.PubMedGoogle ScholarCrossref
Xiao  Y , Lindsey  MA .  Racial/ethnic, sex, sexual orientation, and socioeconomic disparities in suicidal trajectories and mental health treatment among adolescents transitioning to young adulthood in the USA: a population-based cohort study.   Adm Policy Ment Health. 2021;48(5):742-756.PubMedGoogle ScholarCrossref
Xiao  Y , Lindsey  MA .  Adolescent social networks matter for suicidal trajectories: disparities across race/ethnicity, sex, sexual identity, and socioeconomic status.   Psychol Med. 2021;1-12.PubMedGoogle Scholar
Argabright  ST , Visoki  E , Moore  TM ,  et al.  Association between discrimination stress and suicidality in preadolescent children.   J Am Acad Child Adolesc Psychiatry. 2021;S0890-8567(21)01355-1.PubMedGoogle Scholar
Stinson  EA , Sullivan  RM , Peteet  BJ ,  et al.  Longitudinal impact of childhood adversity on early adolescent mental health during the COVID-19 pandemic in the ABCD study cohort: does race or ethnicity moderate findings?   Biol Psychiatry Glob Open Sci. 2021;1(4):324-335.PubMedGoogle ScholarCrossref
Office of the Surgeon General. Protecting youth mental health. Accessed January 27, 2022. https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf
Hansen  H , Braslow  J , Rohrbaugh  RM .  From cultural to structural competency—training psychiatry residents to act on social determinants of health and institutional racism.   JAMA Psychiatry. 2018;75(2):117-118.PubMedGoogle ScholarCrossref
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