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Original research
Financial strain, schooling modality and mental health of US adults living with children during the COVID-19 pandemic
  1. Catherine K Ettman1,
  2. Elena Badillo-Goicoechea2,
  3. Elizabeth A Stuart2
  1. 1 Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  2. 2 Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  1. Correspondence to Dr Catherine K Ettman, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; cettman1{at}jhu.edu

Abstract

Background The COVID-19 pandemic upended contexts for families; relatively little work has studied the influence of rapidly changing contexts on the mental health of parents. We aimed to assess the relation between financial strain and schooling modality with the mental health of adults living with school-age children across the pandemic.

Methods Using a large, national sample from the COVID-19 Trends and Impact Surveys (N=1 485 072 responses from November 2020 through June 2022), we used weighted multiple logistic regression with interactions for school semester to estimate changes in the association of frequent feelings of depression and anxiety, respectively, with financial strain and schooling modality, controlling for demographics and state, across time.

Results In all time periods, financial strain was associated with reporting frequent feelings of depression and anxiety, respectively. The association grew over time (p<0.001) from adjusted OR (aOR) 2.25 (95% CI 2.19, 2.32)/aOR 2.63 (95% CI 2.54, 2.73) in Autumn 2020 to aOR 3.11 (95% CI 3.01, 3.22)/aOR 3.79 (95% CI 3.64, 3.95) in Spring 2022. Living with children in fully online versus in-person schooling was associated with frequent feelings of anxiety and depression symptoms in all time periods, and increased from aOR 1.08 (1.05, 1.11)/aOR 1.06 (1.02, 1.10) in Autumn 2020 to aOR 1.20 (1.10, 1.32)/aOR 1.28 (1.16, 1.42) in Spring 2022.

Conclusion Associations between financial strain and online-only schooling with poor mental health increased during the COVID-19 pandemic. Policies to support parents in the face of external stressors, such as economic instability and school closures, may improve overall population mental health.

  • DEPRESSION
  • MENTAL HEALTH
  • COVID-19
  • POLICY
  • SOCIAL CLASS

Data availability statement

Data may be obtained from a third party and are not publicly available. Aggregated data from CTIS: https://dataforgood.facebook.com/dfg/tools/covid-19-trends-and-impact-survey.

https://doi.org/10.1136/jech-2023-221672

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. Aggregated data from CTIS: https://dataforgood.facebook.com/dfg/tools/covid-19-trends-and-impact-survey.

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    Footnotes

    • Contributors CKE: conceptualisation, project administration, methodology, investigation, writing- original draft; EB-G: data curation, methodology, analysis, writing-original draft; EAS: supervision, resources, methodology, writing - review and editing; funding acquisition.

    • Funding CKE’s time was supported in part by a gift from Meta (PI: EAS). EAS’s time was supported in part by Grant R01MH115487 from the National Institute of Mental Health (PI: EAS).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.