Chavez Laura J, Teferra Andreas A, Hardy Rose, Yilmazer Tansel, Cooper Jennifer
Center for Child Health Equity and Outcomes Research at the Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
College of Medicine, Department of Pediatrics, The Ohio State University, 370 W 9th Ave, Columbus, OH 43210, USA.
Prev Med Rep. 2024 Jul 15;46:102811. doi: 10.1016/j.pmedr.2024.102811. eCollection 2024 Oct.
Child poverty is associated with poor adolescent mental health. Changes to the Child Tax Credit (CTC) in 2021 in the U.S. were historic and introduced a new model of distributing the credit in advance of tax filing, providing families with stable, supplemental monthly income. This policy shift offers a unique opportunity to examine the mental health effects for adolescents.
We use electronic health record data from a large pediatric primary care network in Columbus, Ohio, which collected adolescent depression screening scores in real time as the CTC advance payments were introduced. We utilized differences in age of eligibility for the CTC to examine the changes in the probability of depression screening outcomes (positive depression screen, any depression symptom, any suicidal ideation), for adolescents eligible for the credit (turned 18 first quarter of 2022), relative to those not eligible (turned 18 last quarter of 2021) (n = 1,423).
We did not observe a significant association between the policy change and study outcomes in the overall sample. However, the percentage of adolescents with a positive depression screen significantly declined for Non-Hispanic Black (13.4 percentage point reduction, p = 0.01) and publicly insured (9.7 percentage point reduction, p = 0.04) adolescents.
Our findings suggest reductions in depression symptoms for subgroups of adolescents who were age-eligible for the CTC compared to their counterparts who were not eligible. The CTC advance payments were a brief experiment in universal basic income and may offer a policy solution for addressing both poverty and a growing adolescent mental health crisis.
儿童贫困与青少年心理健康不佳有关。2021年美国儿童税收抵免（CTC）的变化具有历史性意义，并引入了一种在报税前提早发放抵免的新模式，为家庭提供稳定的每月补充收入。这一政策转变为研究对青少年心理健康的影响提供了独特机会。
我们使用了俄亥俄州哥伦布市一个大型儿科初级保健网络的电子健康记录数据，该网络在引入CTC预付款时实时收集了青少年抑郁筛查分数。我们利用CTC资格年龄的差异，研究了符合抵免资格的青少年（2022年第一季度满18岁）相对于不符合资格的青少年（2021年最后一个季度满18岁）抑郁筛查结果（抑郁筛查呈阳性、有任何抑郁症状、有任何自杀意念）概率的变化（n = 1423）。
在总体样本中，我们未观察到政策变化与研究结果之间存在显著关联。然而，非西班牙裔黑人青少年（下降13.4个百分点，p = 0.01）和参加公共保险的青少年（下降9.7个百分点，p = 0.04）抑郁筛查呈阳性的比例显著下降。
我们的研究结果表明，与不符合CTC年龄资格的青少年相比，符合该资格的青少年亚组的抑郁症状有所减轻。CTC预付款是普遍基本收入方面的一次短期试验，可能为解决贫困问题和日益严重的青少年心理健康危机提供一种政策解决方案。
