Linking job loss, inequality, mental health, and education

Is family social exclusion associated with child motor and socioemotional development delay? A cross-sectional exploratory study

AIM

The objective was to identify if family social exclusion is associated with child motor and social development delay in Southeastern Brazil.

DESIGN

A cross-sectional study was conducted using data from a sample of 348 children under 3 years, proportional to the number of children registered in the primary care centres of the municipality.

METHODS

Child development was measured using the "Developmental Surveillance Instrument" which was developed by the Ministry of Health in Brazil and is used for public health nurses and clinicians in their practice. An index was used to evaluate social exclusion.

RESULTS

The prevalence of child motor and socioemotional developmental delay was 27.6% and 17.2%, respectively. Children in the most social excluded group were more likely to have delayed motor development (OR = 3.4; 95% CI = 1.14; 10.55) and socioemotional developmental delay (OR = 3.9; 95% CI = 1.05; 9.02) than children in the least social excluded group.

Social media use and mental health of urban residents during China's second COVID-19 outbreak

Background

A multitude of literature has shown that during the 2019 COVID-19 outbreak, people's reliance on social media has been closely related with serious psychological problems. The "information epidemic" has sparked each country's attention. These countries including China have tried to find the solution and taken a series of measures. In January 2021, the COVID-19 broke out again in Shijiazhuang, China. Has the impact of social media on mental health changed?

Methods

Our data are based on an online survey of Chinese in January 2021, with 904 valid samples from 18 different provinces in China. We applied the methods of structural equation model analysis and the tendency value matching to conduct systematic analysis.

Results

Our research found that 38.9% of the population suffered from depression and 12.61% of the population suffered from anxiety. Chinese urban residents are more dependent on social media, with up to 80.1% of participants using social media frequently. Our research found that the relationship between social media use and residents' mental health has dramatically changed. More use of social media has been significantly associated with less depression and anxiety, especially among young people and women. Our findings are the first to reveal the relation's change between social media and mental health.

Conclusions

These findings implied that changes in the social media environment probably lead to changes in relationship between social media use and mental health since the outbreak began in 2019. Truthful and comprehensive social media information and a healthy positive social media environment can contribute to residents' mental health improvement and the fight against "information epidemic."

Group Differences: The Relationship between Social Media Use and Depression during the Outbreak of COVID-19 in China

The outbreak of COVID-19 at the end of 2019 triggered more psychological problems than usual among the public. During this epidemic, the use of social media was very high, and several studies confirmed a positive correlation between social media use and people's psychological problems. The Chinese government has subsequently implemented a series of policies concerning the social media environment to tackle this "infodemic". After the containment of the first COVID-19 outbreak, China saw a new wave of COVID-19 cases in Shijiazhuang, Hebei Province in January 2021. How the optimized social media could have impacted public mental health remained to be revealed. Our research data come from an online survey of Chinese residents during the regional epidemic in Shijiazhuang, with a total of 904 valid samples from 18 different provinces in China. The results showed that this new round of outbreaks caused a high incidence of depression (38.9%) among the public. Compared with relatively advantaged groups, disadvantaged groups have a higher depression. Attributed to the optimization of the social media environment, the prevalence of social media use during the epidemic helped to markedly mitigate anxieties from depression. This is particularly demonstrated in vulnerable groups. We found, for the first time, a change in the relationship between social media use and resident depression, and more importantly, a stronger correlation between social media use and depression in relatively disadvantaged groups. Therefore, during the epidemic, actively optimizing the social media environment has a significant and positive effect on the mental health of residents, especially vulnerable groups.

Family economic hardship and adolescent mental health during the COVID-19 pandemic

Objective

This study examined whether pandemic related family economic hardships influenced adolescents' mental health during the COVID-19 pandemic in Korea.

Methods

Data were collected from 54,948 adolescents who participated in the 2020 Korea Youth Risk Behavior Web-Based Survey. We performed a multiple logistic regression analysis to examine the association between family economic hardship and mental health (anxiety, depressive symptoms, and suicidal ideation).

Results

Among the adolescents, 39.7, 24.7, and 5.9% reported slight, moderate, and severe economic hardship, respectively. COVID-19 related family economic hardship was significantly associated with higher odds of adolescents reporting anxiety, depressive symptoms, and suicidal ideation. This association was stronger among adolescents with low to middle family economic status.

Conclusions

This study suggests that adolescents from more economically vulnerable families are likely to be at a higher risk for long-term mental health effects due to the financial consequences of the COVID-19 pandemic.

Industrial automation and intergenerational income mobility in the United States

This article examines how the automation of jobs has shaped spatial patterns of intergenerational income mobility in the United States over the past three decades. Using data on the spread of industrial robots across 722 local labor markets, we find significantly lower rates of upward mobility in areas more exposed to automation. The erosion of mobility chances is rooted in childhood environments and is particularly evident among males growing up in low-income households. These findings reveal how recent technological advances have contributed to the unequal patterns of economic opportunity in the United States today.

Prepare developed democracies for long-run economic slowdowns

Developed democracies proliferated over the past two centuries during an unprecedented era of economic growth, which may be ending. Macroeconomic forecasts predict slowing growth throughout the twenty-first century for structural reasons such as ageing populations, shifts from goods to services, slowing innovation, and debt. Long-run effects of COVID-19 and climate change could further slow growth. Some sustainability scientists assert that slower growth, stagnation or de-growth is an environmental imperative, especially in developed countries. Whether slow growth is inevitable or planned, we argue that developed democracies should prepare for additional fiscal and social stress, some of which is already apparent. We call for a 'guided civic revival', including government and civic efforts aimed at reducing inequality, socially integrating diverse populations and building shared identities, increasing economic opportunity for youth, improving return on investment in taxation and public spending, strengthening formal democratic institutions and investing to improve non-economic drivers of subjective well-being.

Increased Incidence of Stress-related Tic Habit Cough in Children During the Recent Greek Financial Crisis

BACKGROUND/AIM

Tic habit cough (THC) is not easily recognized and requires a high index of suspicion. Since there is evidence for stress-related etiology, the study presents our experience during the eight-year period of the recent Greek financial crisis.

PATIENTS AND METHODS

This is a descriptive prospective cross-sectional clinical study using a consistent approach to diagnosis, possible triggers and treatment options.

RESULTS

Fifty-one children (26 girls, age 9.5±3.1y) from a total of 3,793 new referrals for chronic cough fulfilled the criteria of THC (1.34%). Incidence rates per 1,000 person-years were 1.34 (95%CI=0.34-5.40), 3.91 (95%CI=1.86-8.19), 4.03 (95%CI=2.01-8.06) and 14.60 (95%CI=10.43-20.44) for every two years. Poisson analysis showed an increased trend during the four time periods with an incidence rate ratio equal to 2.21 (95%CI=1.58-3.09, p<0.001). THC was mainly attributed to learning difficulties, as well as stress-related impact of peer or family bullying, family financial problems and child anxiety disorders.

CONCLUSION

The incidence of THC is associated with the negative aspects of stressors during a period of financial crisis. The potential underlining psycho-physiological mechanisms are discussed as well as the fact that prompt diagnosis may result in successful interventions.

The Janus-faced effects of COVID-19 perceptions on family healthy eating behavior: Parent's negative experience as a mediator and gender as a moderator

This research examines the effects of COVID‐19 perceptions and negative experiences during the pandemic time on parental healthy eating behavior and whether these relationships interact with a parent’s gender. We ran a survey of parents who had at least one child aged 3 to 17 years old living in the United Kingdom. We received 384 valid responses, which were analysed via a variance‐based structural equation modeling approach to test our hypotheses. The results revealed that COVID‐19 perceptions effects were Janus‐faced. While they indirectly and negatively impact healthy eating behavior mediated by triggering negative experiences during the pandemic, COVID‐19 perceptions, however, directly get parents, especially fathers, more engaged into healthy eating behavior – making COVID‐19 perceptions total effects positive on healthy eating behavior. This explorative model is novel in the sense that it is the first of its kind to cast light on how parental healthy eating behavior can be shaped in pandemic time. The research is particularly timely due to the uncertain times in which the research is situated, that is, the worldwide pandemic (also termed COVID‐19); the paper highlights how family eating practices can undergo dramatic shifts during acute crises.

Opioid misuse and family structure: Changes and continuities in the role of marriage and children over two decades

BACKGROUND

The opioid crisis is widely felt in the United States. Scholarly attention to the crisis focuses on macro-level processes and largely neglects meso-level explanations such as family structure for opioid use behaviors. We hypothesize that married adults and adults with coresident children are at lower risk of misusing prescription pain relievers (PPR), using heroin, and using needles to inject heroin relative to adults from other family structures.

METHOD

We used National Survey on Drug Use and Health data from 2002-2018 to test our hypotheses with multivariable logistic regression.

RESULTS

We found that married adults have a lower predicted probability of each opioid use behavior relative to nonmarried adults across the study period. We also found that the presence of children is associated with reductions in all three outcomes especially for never married adults.

CONCLUSION

Individuals from all family structures are vulnerable to the opioid crisis, but never married adults without coresident children ("disconnected adults") are especially susceptible to temporal fluctuations and drive the temporal trends in PPR misuse and heroin use. These findings suggest that ongoing demographic trends where disconnected adults are a growing population may result in future rises in opioid use disorders and mortality because of divestment from U.S. social safety nets. Future research should examine the role of U.S. policies that make disconnected adults especially vulnerable to developing opioid use disorders.

Household economic instability: Constructs, measurement, and implications

A growing body of research demonstrates the multiple dimensions and dynamism of family income and employment. The metrics of household economic instability and their associations with household characteristics and hardship require further examination in order to compare across studies, subgroups, and historical periods. This paper empirically examines and compares commonly used measures of income and employment instability, how these measures inter-relate, vary by household characteristics, and how they predict household hardship. Using longitudinal data from the 2008 panel of the Survey of Income and Program Participation (SIPP), and focusing on households with children, this study examined a range of descriptive measures of economic instability, including in income, earnings, public assistance benefits, and employment status, and how these measures related to each other. Results indicate that overall rates of income and employment instability were high, particularly among less-educated families, those with young children, and those who did not own a home. Economic instability, particularly decreases in employment, was associated with increased household hardship three months later. Findings also show that the source of income included in the instability measure affects the patterns identified and conclusions drawn, whereas the specific type of measure used matters less. Results highlight the instability of public assistance benefits and suggest that safety net programs must take economic instability into account when designing programs and benefits.

COVID-19 and Parent-Child Psychological Well-being

BACKGROUND AND OBJECTIVES

The outbreak of coronavirus disease 2019 has changed American society in ways that are difficult to capture in a timely manner. With this study, we take advantage of daily survey data collected before and after the crisis started to investigate the hypothesis that the crisis has worsened parents' and children's psychological well-being. We also examine the extent of crisis-related hardships and evaluate the hypothesis that the accumulation of hardships will be associated with parent and child psychological well-being.

METHODS

Daily survey data were collected between February 20 and April 27, 2020, from hourly service workers with a young child (aged 2-7) in a large US city (N = 8222 person-days from 645 individuals). A subsample completed a one-time survey about the effects of the crisis fielded between March 23 and April 26 (subsample n = 561).

RESULTS

Ordered probit models revealed that the frequency of parent-reported daily negative mood increased significantly since the start of the crisis. Many families have experienced hardships during the crisis, including job loss, income loss, caregiving burden, and illness. Both parents' and children's well-being in the postcrisis period was strongly associated with the number of crisis-related hardships that the family experienced.

CONCLUSIONS

Consistent with our hypotheses, in families that have experienced multiple hardships related to the coronavirus disease 2019 crisis, both parents' and children's mental health is worse. As the crisis continues to unfold, pediatricians should screen for mental health, with particular attention to children whose families are especially vulnerable to economic and disease aspects of the crisis.

Economic influences on population health in the United States: Toward policymaking driven by data and evidence

Atheendar S. Venkataramani and colleagues discuss economic factors and population health in the United States.

Student Engagement and Disengagement as a Collective Action Problem

Isolated teachers in stand-alone American schools are expected to engage diverse students in the quest to facilitate their academic learning and achievement. This strategy assumes that all students will come to school ready and able to learn, and educators in stand-alone schools can meet the needs of all students. Student disengagement gets short shrift in this framework, and so does teacher disengagement. A growing body of research emphasizes needs for nuanced engagement frameworks, better data systems, customized interventions facilitated by intervention registries, and bridge building between schools and community health, mental health, and social service agencies. Here, engagement and disengagement challenges are reframed as opportunities for collective action, including interprofessional teams, community agency–school partnerships, cross-sector collective impact formations, cradle-to-career system building, and community development initiatives. Together these collective action forms signal new institutional designs which are fit for purpose when child/family poverty, social exclusion, and social isolation conspire against student engagement and school success.

College affirmative action bans and smoking and alcohol use among underrepresented minority adolescents in the United States: A difference-in-differences study

BACKGROUND

College affirmative action programs seek to expand socioeconomic opportunities for underrepresented minorities. Between 1996 and 2013, 9 US states-including California, Texas, and Michigan-banned race-based affirmative action in college admissions. Because economic opportunity is known to motivate health behavior, banning affirmative action policies may have important adverse spillover effects on health risk behaviors. We used a quasi-experimental research design to evaluate the association between college affirmative action bans and health risk behaviors among underrepresented minority (Black, Hispanic, and Native American) adolescents.

METHODS AND FINDINGS

We conducted a difference-in-differences analysis using data from the 1991-2015 US national Youth Risk Behavior Survey (YRBS). We compared changes in self-reported cigarette smoking and alcohol use in the 30 days prior to survey among underrepresented minority 11th and 12th graders in states implementing college affirmative action bans (Arizona, California, Florida, Michigan, Nebraska, New Hampshire, Oklahoma, Texas, and Washington) versus outcomes among those residing in states not implementing bans (n = 35 control states). We also assessed whether underrepresented minority adults surveyed in the 1992-2015 Tobacco Use Supplement to the Current Population Survey (TUS-CPS) who were exposed to affirmative action bans during their late high school years continued to smoke cigarettes between the ages of 19 and 30 years. Models adjusted for individual demographic characteristics, state and year fixed effects, and state-specific secular trends. In the YRBS (n = 34,988 to 36,268, depending on the outcome), cigarette smoking in the past 30 days among underrepresented minority 11th-12th graders increased by 3.8 percentage points after exposure to an affirmative action ban (95% CI: 2.0, 5.7; p < 0.001). In addition, there were also apparent increases in past-30-day alcohol use, by 5.9 percentage points (95% CI: 0.3, 12.2; p = 0.041), and past-30-day binge drinking, by 3.5 percentage points (95% CI: -0.1, 7.2, p = 0.058), among underrepresented minority 11th-12th graders, though in both cases adjustment for multiple comparisons resulted in failure to reject the null hypothesis (adjusted p = 0.083 for both outcomes). Underrepresented minority adults in the TUS-CPS (n = 71,575) exposed to bans during their late high school years were also 1.8 percentage points more likely to report current smoking (95% CI: 0.1, 3.6; p = 0.037). Event study analyses revealed a discrete break for all health behaviors timed with policy discussion and implementation. No substantive or statistically significant effects were found for non-Hispanic White adolescents, and the findings were robust to a number of additional specification checks. The limitations of the study include the continued potential for residual confounding from unmeasured time-varying factors and the potential for recall bias due to the self-reported nature of the health risk behavior outcomes.

CONCLUSIONS

In this study, we found evidence that some health risk behaviors increased among underrepresented minority adolescents after exposure to state-level college affirmative action bans. These findings suggest that social policies that shift socioeconomic opportunities could have meaningful population health consequences.

Acute effects of ambient particulate matter pollution on hospital admissions for mental and behavioral disorders: A time-series study in Shijiazhuang, China

Until now, few epidemiological studies have focused on the association between ambient particulate matter pollution and mental and behavioral disorders, especially in developing countries. Thus, a time-series study on the short-term association between both fine and inhalable particles (PM_2.5 and PM₁₀) and daily hospital admissions for mental and behavioral disorders in Shijiazhuang, China was conducted, from 2014 to 2016. An over-dispersed, generalized additive model was used to analyze the associations after controlling for time trend, weather conditions, day of the week, and holidays. In addition, the modification effects of age, sex, and season were estimated. A total of 9156 cases of hospital admissions for mental and behavioral disorders were identified. A 10 μg/m³ increase in a 3-day average concentration (lag02) of PM_2.5 and PM₁₀ correspond to an increase of 0.48% (95% confidence interval (CI): 0.18-0.79%) and 0.32% (95% CI: 0.03-0.62%) in daily hospital admission for mental and behavioral disorders, respectively. We found stronger associations of PM_2.5 and PM₁₀ with mental and behavioral disorders in male and elder individuals (≥45 years) than in female and younger individuals (<45 years). Further, results indicated a generally stronger association of PM_2.5 with mental and behavioral disorders in the cool season than in the warm season. This research found a significant association between ambient PM_2.5 and PM₁₀ and hospital admission for mental and behavioral disorders in Shijiazhuang, China.

Factors Associated With County-Level Differences in U.S. Drug-Related Mortality Rates

INTRODUCTION

Over the past 2 decades, drug-related deaths have grown to be a major U.S. public health problem. County-level differences in drug-related mortality rates are large. The relative contributions of social determinants of health to this variation, including the economic, social, and healthcare environments, are unknown.

METHODS

Using data from the U.S. Centers for Disease Control and Prevention Multiple-Cause of Death Files (2006-2015, analyzed in 2017); U.S. Census Bureau; U.S. Department of Agriculture Economic Research Service; Agency for Healthcare Research and Quality; and Northeast Regional Center for Rural Development, this paper modeled associations between county-level drug-related mortality rates and economic, social, and healthcare environments. Spatial autoregressive models controlled for state fixed effects and county demographic characteristics.

RESULTS

The average county-level age-adjusted drug-related mortality rate was 16.6 deaths per 100,000 population (2006-2015), but there were substantial geographic disparities in rates. Controlling for county demographic characteristics, average mortality rates were significantly higher in counties with greater economic and family distress and in counties economically dependent on mining. Average mortality rates were significantly lower in counties with a larger presence of religious establishments, a greater percentage of recent in-migrants, and counties with economies reliant on public (government) sector employment. Healthcare supply factors did not contribute to between-county disparities in mortality rates.

CONCLUSIONS

Drug-related mortality rates are not randomly distributed across the U.S. Future research should consider the specific pathways through which economic, social, and healthcare environments are associated with drug-related mortality.