Sex, ethnic and socioeconomic inequalities and trajectories in child and adolescent mental health in Australia and the UK: findings from national prospective longitudinal studies

Abstract

Background: This study investigates the sex, ethnic and socioeconomic inequalities in emotional difficulties over childhood and adolescence using longitudinal cohort studies in the UK and Australia. Estimating cross-national differences contributes to understanding of the consistency of inequalities in mental health across contexts. Methods: Data from 19,748 participants in two contemporary representative samples in Australia (Growing Up in Australia: The Longitudinal Study of Australian Children, n = 4,975) and UK (Millennium Cohort Study, n = 14,773) were used. Emotional difficulties were assessed using the parent-reported Strengths and Difficulties Questionnaire at ages 4/5, 6/7, 11/12 and 14/15 years and the self-reported Short Moods and Feelings Questionnaire at age 14/ 15. Latent Growth Curve Modelling was used to examine mental health over time. Results: There were significant increases in emotional difficulties in both countries over time. Emotional difficulties were higher in Australian children at all ages. The gender gap in self-reported depressive symptoms at age 14/15 was larger in the UK (8% of UK and 13% of Australian boys were above the depression cut-off, compared with 23% of girls). Ethnic minority children had higher emotional difficulties at age 4/5 years in both countries, but over time this difference was no longer observed in Australia. In the UK, this reversed whereby at ages 11/12 and 14/15 ethnic minority children had lower symptoms than their White majority peers. Socioeconomic differences were more marked based on parent education and employment status in Australia and by parent income in the UK. UK children, children from White majority ethnicity and girls evidenced steeper worsening of symptoms from age 4/5 to 14/15 years. Conclusions: Even in two fairly similar countries (i.e. English-speaking, high-income, industrialised), the observed patterns of inequalities in mental health symptoms based on sociodemographics are not the same. Understanding country and context-specific drivers of different inequalities provides important insights to help reduce disparities in child and adolescent mental health.

Understanding changes to children's connection to nature during the COVID‐19 pandemic and implications for child well‐being

“…Harvey et al, 2020;Richardson et al, 2017;Sobko et al, 2018) Undoubtedly, the COVID-19 pandemic has led to widespread devastation and loss and has significantly impacted millions of people's well-being and livelihood. However, this upheaval has also provided many with an opportunity to reflect and to recognise the importance of nature, and children's connection to nature, as a means of addressing increasing mental health problems in young people (Deighton et al, 2019;Terhaag et al, 2021;Waite et al, 2021). It remains to be seen if the increase in children's connection to nature noted in this study will be sustained as lockdown restrictions are eased.…”

“…Conversely, given the increasing mental health problems experienced by children and young people (Deighton et al, 2019;Terhaag et al, 2021;Waite et al, 2021), it is notable that several lines of evidence indicate a growing disconnection between humans, specifically children, and the natural world (Balmford et al, 2002;Bragg et al, 2013;Moss, 2012;Natural England, 2009). This disconnection is particularly important when considered alongside stress recovery theory (Ulrich et al, 1991), which suggests that exposure to natural settings accelerates recovery from stressful stimuli.…”

Longitudinal impact of the COVID19 pandemic on mental health in a general population sample in France: Evidence from the COMET Study

“…However, in some countries such as UK and Australia where the restrictions were very strict ( “Oxford COVID-19 Government Response Tracker”, n.d. ), symptoms of depression and anxiety in the general population gradually decreased over time during the lockdown periods ( Fancourt et al, 2021 ; Pierce et al, 2021 , Pierce et al, 2020a , Pierce et al, 2020b ; Robinson et al, 2022 ; Terhaag et al, 2021 ; Daly et al, 2020 ). Observed increases were larger and persistent for depressive symptoms, as opposed to smaller changes in anxiety disorder symptoms and measures of overall mental health functioning ( Fancourt et al, 2021 ; Pierce et al, 2021 , Pierce et al, 2020a , Pierce et al, 2020b ; Robinson et al, 2022 ; Terhaag et al, 2021 ; Daly et al, 2020 ). Of note, few other studies ( Batterham et al, 2021 ; Hyland et al, 2021 ; Lu et al, 2022 ) have reported the different trajectories of mental health status across distinct lockdown phases.…”

Longitudinal impact of psychosocial status on children’s mental health in the context of COVID-19 pandemic restrictions

“…First, most studies are cross-sectional and the impact of a pre-existing socioeconomic disadvantage on children's mental health during the COVID-19 has hardly been studied within a longitudinal framework [ 21 ]. Second, interactions between socioeconomic difficulties and risk factors, including sex of the child and parental separation, which have been shown to be linked with SES before the pandemic [ 14 , 22 ] have not been considered. Understanding the consequences of the COVID-19 crisis on those vulnerable children already at risk of mental health problems is essential for rapidly developing policies and interventions to mitigate the mental health problems of vulnerable groups of children already living in a deprived socioeconomic environment [ 23 ].…”