Social and Behavioral Science Research Department, Population Council, New York, New York.
Middlebury College, Department of Economics, Middlebury, Vermont.
J Adolesc Health. 2021 Nov;69(5):713-720. doi: 10.1016/j.jadohealth.2021.07.023. Epub 2021 Sep 14.
Adolescent mental health has been under-researched, particularly in Africa. COVID-19-related household economic stress and school closures will likely have adverse effects. We investigate the relationship among adolescent mental health, adult income loss, and household dynamics during the pandemic in Kenya.
A cross-sectional mobile phone-based survey was conducted with one adult and adolescent (age 10-19 years) pair from a sample of households identified through previous cohort studies in three urban Kenyan counties (Nairobi, Kilifi, Kisumu). Survey questions covered education, physical and mental health, and COVID-19-related impacts on job loss, food insecurity, and healthcare seeking. Logistic regression models were fit to explore relationships among adult income loss, household dynamics, food insecurity, and adult and adolescent depressive symptoms (defined as PHQ-2 score ≤2).
A total of 2,224 adult-adolescent pairs (Nairobi, n = 814; Kilifi, n = 914; Kisumu, n = 496) completed the survey. Over a third (36%) of adolescents reported depressive symptoms, highest among older (15-19 years) boys. Adult loss of income was associated with skipping meals, depressive symptoms, household tensions/violence, and forgoing healthcare. Adolescents had 2.5 higher odds of depressive symptoms if COVID-19 was causing them to skip meals (odds ratio 2.5, 95% confidence interval 2.0-3.1), if their adult head of household reported depressive symptoms (odds ratio 2.6, 95% confidence interval 2.1-3.2).
Income loss during the pandemic adversely affects food insecurity, household dynamics, healthcare-seeking behavior, and worsening adolescent depressive symptoms. With schools reopening, adolescent mental health should be formally addressed, potentially through cash transfers, school or community-based psychosocial programming.
青少年心理健康问题研究不足，尤其是在非洲。与新冠疫情相关的家庭经济压力和学校停课可能会产生负面影响。我们在肯尼亚调查了疫情期间青少年心理健康、成年人收入损失和家庭动态之间的关系。
通过先前在肯尼亚三个城市（内罗毕、基利菲和基苏木）的队列研究确定的样本，对一个成年人和青少年（10-19 岁）进行了基于手机的横断面调查。调查问题涵盖了教育、身心健康以及新冠疫情对失业、粮食不安全和医疗服务的影响。使用逻辑回归模型来探讨成年人收入损失、家庭动态、粮食不安全以及成年人和青少年抑郁症状（定义为 PHQ-2 得分≤2）之间的关系。
共有 2224 对成年人-青少年（内罗毕，n=814；基利菲，n=914；基苏木，n=496）完成了调查。超过三分之一（36%）的青少年报告有抑郁症状，年龄较大（15-19 岁）的男孩中这一比例最高。成年人收入损失与不吃饭、抑郁症状、家庭紧张/暴力以及放弃医疗保健有关。如果青少年因新冠疫情而不吃饭，他们患抑郁症状的可能性会增加 2.5 倍（比值比 2.5，95%置信区间 2.0-3.1），如果他们的成年家长报告有抑郁症状，他们患抑郁症状的可能性会增加 2.6 倍（比值比 2.6，95%置信区间 2.1-3.2）。
疫情期间的收入损失对粮食不安全、家庭动态、医疗保健寻求行为以及青少年抑郁症状的恶化产生了不利影响。随着学校重新开学，青少年心理健康应该得到正式关注，可能通过现金转移、学校或社区为基础的心理社会方案来实现。
