Associations between parent-reported family economic hardship and mental health conditions in U.S. children

ABSTRACT

This study examines the association between parent-reported family economic hardship (FEH) and child mental health conditions. We hypothesized a positive association between parent perceptions of FEH and child mental health conditions that would persist after controlling for underlying demographic and socioeconomic characteristics. Cross-sectional data came from the 2016 and 2017 National Surveys of Children's Health (NSCH), nationally representative surveys of non-institutionalized children in the United States, aged 0–17 years. We conducted chi-square as well as multivariable logistic regression analyses to investigate the relationships between FEH and internalizing disorders and behavioral/conduct problems among children ages 3–17 years. Overall, one in four children experienced FEH during their lifetime. FEH was statistically significantly (p < 0.0001) and positively correlated with each mental health condition, and the association remained after adjusting for covariates. Specifically, FEH was associated with 84% increased odds of having an internalizing disorder (OR = 1.84, 95%, CI: 1.54–2.20) and 53% increased odds of having behavioral/conduct problems (OR = 1.53, 95% CI: 1.25–1.87). Findings suggest that income alone may be an insufficient predictor of the health risks of economic hardship. Further research should examine FEH as a broader measure of disadvantage and its relationship with child health.

KEYWORDS:

• Family economic hardship
• family environment
• child mental health
• child poverty
• adverse childhood experiences
• family stress

Acknowledgments

The views expressed are the authors’ and not necessarily those of the Health Resources and Services Administration or the U.S. Department of Health and Human Services, nor does mention of the department or agency names imply endorsement by the U.S. government. The authors acknowledge Romuladus E. Azuine, DrPH, MPH, RN, for his assistance with conceptualizing and editing the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes on contributors

Evva Assing-Murray, PhD, MA, is a health scientist in the Office of Epidemiology and Research, within the Maternal and Child Health Bureau at the Health Resources and Services Administration. She supports research investments related to autism transition, adolescent and young adult health, maternal and child health measurement, pregnancy, and life course health development. Her research focuses on systemic barriers to quality healthcare for underserved and marginalized MCH populations, and HIV/AIDS.

Lydie Lebrun-Harris, PhD, MPH, is a senior social scientist in the Office of Epidemiology and Research, within the Maternal and Child Health Bureau at the Health Resources and Services Administration. She supports the office's oversight and administration of the annual National Survey of Children's Health. Her current research portfolio focuses on topics related to U.S. children's health, well-being, and access to quality health care.