Social inequalities in youth mental health in Canada, 2007-2022: a population-based repeated cross-sectional study

Abstract

AbstractBackgroundRising concern surrounds youth mental health in Canada, with growing disparities between females and males. However, less is known about recent trends by other sociodemographic factors, including sexual orientation, ethnocultural background, and socioeconomic status.MethodsThis study analyzed data from 96 683 youths aged 15-24 who participated in the nationally representative Canadian Community Health Survey (CCHS) between 2007 and 2022. Trends in absolute and relative inequalities in poor/fair self-rated mental health (SRMH) by sex, sexual orientation, racialized and Indigenous identity, and socioeconomic conditions were assessed.ResultsThe percent of youths reporting poor/fair SRMH quadrupled from 4.3% in 2007-08 to 20.1% in 2021-22. During the same period, absolute inequalities in SRMH increased by 9.9 percentage points (95% CI: 6.6, 12.9) for females compared to males, 11.4 percentage points (95% CI: 4.6, 18.2) for Indigenous versus non-racialized youth, and 15.4 percentage points (95% CI: 5.7, 25.1) for youth (aged 18-24) identifying as lesbian, gay, or bisexual (LGB) compared to heterosexual.ConclusionThe sustained deterioration in youth SRMH over the past decade and a half has been accompanied by widening inequalities across several dimensions important for health equity in Canada. Action is needed to identify and implement effective programs and policies to support youth mental health and address disparities.What is already known on this topic-Youth mental health has been declining in many countries, including Canada, especially among females-Trends by other sociodemographic factors, including sexual orientation, ethnocultural background, and socioeconomic status, are less clearWhat this study adds-To our knowledge, this is the first study to examine long-term trends in youth mental health inequalities in Canada over a period marked by significant global events including the 2008 financial crisis and the COVID-19 pandemic.-Findings show disproportionate declines in mental health among certain youth populations, including those from structurally marginalized backgrounds such as those identifying as lesbian, gay or bisexual (LGB) and Indigenous.How this study might affect research, practice or policy-These findings should encourage further research and action to identify and implement evidence-based programs and policies to support youth mental health and reduce disparities.