Associations between parent-reported family economic hardship and mental health conditions in U.S. children

Abstract

This study examines the association between parent-reported family economic hardship (FEH) and child mental health conditions. We hypothesized a positive association between parent perceptions of FEH and child mental health conditions that would persist after controlling for underlying demographic and socioeconomic characteristics. Cross-sectional data came from the 2016 and 2017 National Surveys of Children's Health (NSCH), nationally representative surveys of non-institutionalized children in the United States, aged 0–17 years. We conducted chi-square as well as multivariable logistic regression analyses to investigate the relationships between FEH and internalizing disorders and behavioral/conduct problems among children ages 3–17 years. Overall, one in four children experienced FEH during their lifetime. FEH was statistically significantly (p < 0.0001) and positively correlated with each mental health condition, and the association remained after adjusting for covariates. Specifically, FEH was associated with 84% increased odds of having an internalizing disorder (OR = 1.84, 95%, CI: 1.54–2.20) and 53% increased odds of having behavioral/conduct problems (OR = 1.53, 95% CI: 1.25–1.87). Findings suggest that income alone may be an insufficient predictor of the health risks of economic hardship. Further research should examine FEH as a broader measure of disadvantage and its relationship with child health.