107 - Impact of Household COVID Diagnosis and Social Determinants of Health on Behavioral and Mental Health of Children

Poster Number: 107
Publication Number: 107.409

Benjamin Fogel, Pennsylvania State University College of Medicine, Hershey, PA, United States; Steven Hicks, Pennsylvania State University College of Medicine, Hershey, PA, United States

Background: Social isolation associated with the COVID pandemic has affected children’s behavioral and mental health. A household COVID diagnosis leads to further isolation, and could exacerbate behavioral/mental health. These effects may be impacted by social determinants of health (SDOH).

Objective: The goal of this study was to examine the relationship between household COVID diagnoses, SDOH, and child behavioral/mental health.

Design/Methods: This cohort study included 379 children in 3 age groups: toddlers (2 years; n = 96), school age (5-7 years; n =181), and teens (12-14 years; n = 102). Child mental/behavioral health was assessed with age-appropriate, standardized surveys: toddlers (Child Behavioral Checklist; emotional reactivity, anxiety and depression subscales); school age (Survey of Wellbeing in Young Children; behavioral concerns); and teens (Screen for Child Anxiety Related Disorders (SCARED), and Patient Health Questionnaire (PHQ)-9 for depression). History of household COVID diagnosis was self-reported. SDOH were collected via survey: child race, parent education, health insurance, family income, number of people in the household, and percent of school spent in-person (teens only). For each age group, mental/behavioral health scores were compared between children with/without prior household COVID diagnosis. Then, regression analyses were used to evaluate the relative contributions of COVID and SDOH to child mental/behavioral scores.

Results: Toddlers with a prior household COVID diagnosis (n=21) had higher emotional reactivity (p=0.035) compared to toddlers without household COVID (n=75). Anxiety (p=0.18) and depression scores (p=0.56) did not differ. Public insurance status contributed to higher emotional reactivity (p=0.038). School-aged children with (n=26) and without (n=155) prior household COVID had no difference in behavioral concerns (p=0.75). Non-Asian race and low family income were risk factors for behavioral concerns (both p < 0.001). Teens with prior household COVID (n=26) had higher SCARED scores (p=0.032) than those without (n=76). There was no difference in PHQ9 scores (p=0.35). Number of people in the household (p=0.004) significantly contributed to higher SCARED scores.Conclusion(s): SDOH contributes to mental/behavioral health concerns in children of all ages. The specific SDOH impacting mental/behavioral health differ across age groups. In toddlers and teens, mental health difficulties are also exacerbated by a household COVID diagnosis. Further research is needed to determine if household COVID diagnosis (and related quarantines) have sustained impacts on child mental health.