Socio-economic conditions, mental health and quality of life of children during the COVID-19 pandemic: an intersectional analysis

Elsa Lorthe, Viviane Richard, Roxane Dumont, Andrea Loizeau, Javier Perez-Saez, Hélène Baysson, María-Eugenia Zaballa, Julien Lamour, Nick Pullen, Stephanie Schrempft, Rémy P. Barbe, Klara M. Posfay-Barbe, Idris Guessous, Silvia Stringhini for the SEROCoV-KIDS study group.
Socioeconomic conditions and children's mental health and quality of life during the COVID-19 pandemic: An intersectional analysis.. SSM - Population Health, September 2023. doi.org/10.1016/j.ssmph.2023.101472

Abstract

Background: Children and adolescents are highly vulnerable to prolonged sources of stress during sensitive periods of their development. We investigated how demographic characteristics and socioeconomic conditions intersect to shape trends in quality of life and mental health among children and adolescents two years after the onset of the COVID-19 pandemic.

Methods: We used data from the SEROCoV-KIDS prospective cohort study of children and adolescents living in Geneva (Switzerland, 2022). We conducted a multilevel intersectional analysis (MAIHDA) by grouping participants into 48 social strata defined by the intersection of gender, age, migration status, parental education and financial difficulties within the household, and using multilevel Bayesian logistic models to study poor health-related quality of life (measured with the PedsQL scale) and difficulties in terms of mental health (measured using the SDQ questionnaire).

Results: Among participants aged 2 to 17, 240 out of 2096 (11.5%, 95% CI 10.1-12.9) had poor health-related quality of life, and 105 out of 2135 (4.9%, 95% CI 4.0-5.9) had mental health difficulties. The predicted proportion of poor health-related quality of life ranged from 3.4% for Swiss girls aged 6 to 11 with a high level of parental education and no financial difficulties, to 34.6% for non-Swiss girls aged 12 to 17 with a high level of parental education and financial difficulties. The intersectional strata involving adolescents and households in financial difficulty showed a significantly poorer quality of life than their counterparts. Variations between strata in the predicted frequency of mental health difficulties were limited (between 4.4% and 6.5%).

Conclusions: We found considerable differences in adverse outcomes between social strata. Our results suggest that post-pandemic interventions to address social inequalities in quality of life should focus on specific intersectional strata involving young people and families experiencing financial difficulties, while those to improve mental health should target all children and adolescents.

Link to the article in English