Social determinants of mental health and adolescent anxiety and depression: Findings from the 2018 to 2019 National Survey of Children’s Health

Abstract

Background: There is a current crisis in children’s mental health. Defining social determinants of mental health (SDMH) facilitates investigations of social impact on mental health. Aims: To examine associations between nine SDMH and adolescent depression and anxiety in a U.S. nationally representative sample. Methods: Poor access to health care, caregiver underemployment, food insecurity, poorly built environment, housing insecurity, household dysfunction adverse childhood experiences (ACEs), racism, caregiver poor education, and poverty/income inequality were assessed from the 2018 to 2019 National Survey of Children’s Health (NSCH) ( N = 24,817). Results: The likelihood of reporting adolescent depression and/or anxiety was assessed for each SDMH using multinomial logistic regressions. All SDMH, besides caregiver underemployment, were associated with increased odds of reporting adolescent anxiety, depression, or anxiety and depression. Only household dysfunction ACEs and racism had statistically significant associations for all three mental health outcomes. Conclusions: Interventions targeting ACEs and racism may be more impactful in mitigating mental health challenges associated with SDMH during adolescence. The NSCH may provide an important public health tool to investigate SDMH in children.