2016 to 2020 Saw Anxiety, Depression Increase among Children

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From 2016 to 2020, increases were seen in anxiety and depression among children, while decreases were observed in parent or caregiver mental health and coping with parenting demands, according to a study published in JAMA Pediatrics.

The recent release of the 2020 National Survey of Children’s Health (NSCH) offers an opportunity to examine 5-year trends in children’s well-being, including an exploration of potential effects of the COVID-19 pandemic. The purpose of this study was to assess changes over time in several domains: children’s health conditions, positive health behaviors, access to and utilization of health care services, and family well-being and stressors.

Study sought to answer

(1) What are the recent trends across various children’s health-related measures?

(2) Were there significant changes between 2019 and 2020, which might be attributed to the COVID-19 pandemic?

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Key Points

Question: What are the recent trends in children’s health, including significant changes that might be attributed to the COVID-19 pandemic?

Findings: Between 2016 and 2020, there were significant increases in children’s diagnosed anxiety and depression, decreases in physical activity, and decreases in caregiver mental and emotional well-being and coping with parenting demands.

After the onset of the pandemic specifically, there were significant year-over-year increases in children’s diagnosed behavioral or conduct problems, decreases in preventive medical care visits, increases in unmet health care needs, and increases in the proportion of young children whose parents quit, declined, or changed jobs because of child care problems.

Meaning: Study findings point to several areas of concern that can inform future research, clinical care, policy decision making, and programmatic investments to improve the health and well-being of children and their families.

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Abstract

Objective To examine recent trends in children’s health-related measures, including significant changes between 2019 and 2020 that might be attributed to the COVID-19 pandemic.

Design, Setting, and Participants Annual data were examined from the National Survey of Children’s Health (2016-2020), a population-based, nationally representative survey of randomly selected children. Participants were children from birth to age 17 years living in noninstitution settings in all 50 states and the District of Columbia whose parent or caregiver responded to an address-based survey by mail or web. Weighted prevalence estimates account for probability of selection and nonresponse. Adjusted logistic regression models tested for significant trends over time.

Main Outcomes and Measures Diverse measures pertaining to children’s current health conditions, positive health behaviors, health care access and utilization, and family well-being and stressors.

Results A total of 174 551 children were included. Between 2016 and 2020, there were increases in anxiety (7.1% to 9.2%) and depression (3.1% to 4.0%). There were also decreases in daily physical activity (24.2% to 19.8%), parent or caregiver mental health (69.8% to 66.3%), and coping with parenting demands (67.2% to 59.9%). In addition, from 2019 to 2020, there were increases in behavior or conduct problems (6.7% to 8.1%) and child care disruptions affecting parental employment (9.4% to 12.6%) as well as decreases in preventive medical visits (81.0% to 74.1%).

Conclusions and Relevance Recent trends point to several areas of concern that can inform future research, clinical care, policy decision making, and programmatic investments to improve the health and well-being of children and their families. More analyses are needed to elucidate varying patterns within subpopulations of interest.

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