Modifiable and Non-Modifiable Risk Factors of Child Mental Health During the COVID-19 Pandemic

To examine modifiable and non-modifiable risk factors for child mental health during the COVID-19 pandemic.

Data were collected through the Voices of Child Health in Chicago Parent Panel Survey, administered between October and November 2021 in English and Spanish. Eligible caregivers had a child between 0 and 17 years old and lived in Chicago. Caregivers reported on their pandemic experiences and their child's mental health. Logistic regression identified associations between modifiable risk factors and worsening mental health during the COVID-19 pandemic. Rao-Scott chi-squared tests were used to test differences in child mental health across demographic groups.

A total of 1115 Chicago caregivers reported on 1895 children. Worse family functioning (OR = 3.53, 95%CI: 1.89-6.62), seeking extra support (OR = 5.99, 95% CI: 3.60-9.96), and missed milestones (OR = 6.32, 95%CI: 2.37-16.84) were significantly associated with worsening mental health in children. The proportion of children with worsening mental health differed across child race and ethnicity and survey language (P<.05 and P<.001, respectively). A higher proportion of Asian/other-race children had worsening mental health compared with other race and ethnicities (20% vs 9%-10%, P<.05).

Worse family functioning and missed milestones contributed significantly to worsening child mental health during the COVID-19 pandemic. Caregivers who sought extra support for their child had higher odds of having a child with worsening mental health, which may indicate that caregivers recognized their child's deteriorating mental health and took steps to address it. Worsening mental health among Asian/other-race children may be due to exposure to racism. These findings may help inform interventions in future times of stress.