Mixed Signals in Child and Adolescent Mental Health and Well-Being Indicators in the United States: A Call for Improvements to Population Health Monitoring.

Policy Points Social indicators of young peoples' conditions and circumstances, such as high school graduation, food insecurity, and smoking, are improving even as subjective indicators of mental health and well-being have been worsening. This divergence suggests policies targeting the social indicators may not have improved overall mental health and well-being. There are several plausible reasons for this seeming contradiction. Available data suggest the culpability of one or several common exposures poorly captured by existing social indicators. Resolving this disconnect requires significant investments in population-level data systems to support a more holistic, child-centric, and up-to-date understanding of young people's lives.

The Child and Adolescent Thriving Index 1.0: Developing a Measure of the Outcome Indicators of Well-Being for Population Health Assessment.

The well-being of children and adolescents is emerging as an area of interest for population health measurement. Previous approaches assessing national and state trends in well-being have relied on composite indices. However, these methodologies suffer from several weaknesses. This paper develops an improved index for the United States that is measurable with existing population-data resources. It derives the appropriate weights for items in this index using a longitudinal panel of 2,942 children in the Panel Study of Income Dynamics. Candidate component measures are selected for the index based on their demonstrated association with several subjective scales assessed during young adulthood. The final index demonstrates that a broad range of measures indicate higher levels of population-level well-being. The predictive validity of the index for outcomes during young adulthood is also assessed: a one-standard-deviation increase in the index score is associated with a 7.9-percentage-point decrease [95% CI: 5.9 - 9.8] in ever reporting fair or poor health, a 6.3-percentage-point decrease [95% CI: 4.6 - 8.0] in ever reporting depression, and a 17.2% [95% CI: 13.7% - 20.5%] increase in peak earnings. These values for predictive validity are slightly higher than those of existing methodologies. We also find that incorporating contextual indicators from childhood and adolescence does not substantively improve predictive validity. Policy-makers and government agencies interested in population-level well-being of children and adolescents can continue to use existing indices as reasonable proxies, but should also commit to upgrading data systems to make them more child-centric in the future. Supplementary Information: The online version contains supplementary material available at 10.1007/s12187-022-09962-0.

Food Insecurity and Family Well-Being Outcomes among Households with Young Children.

OBJECTIVES: To investigate associations between household food insecurity and multiple family well-being variables in an effort to illuminate previously understudied, policy-amenable mechanisms through which food insecurity threatens healthy development. STUDY DESIGN: Data are drawn from the nationally representative Early Childhood Longitudinal Study-Birth Cohort. The Early Childhood Longitudinal Study-Birth Cohort contains longitudinal data on household food insecurity and several family well-being factors including maternal physical and mental health, positive parenting practices and disciplinary strategies, and frequency and severity of spousal conflict. We use regression models with lagged dependent variables to estimate associations between food insecurity and family well-being outcomes, on a subsample of low-income families (N ≈ 2100-4700). RESULTS: Household food insecurity was significantly associated with poorer maternal physical health; increased depressive symptoms and use of harsh discipline strategies; and greater frequency and negativity of conflict between parents. Associations were strongest and most consistent when children were preschool aged. Transitions into food insecurity between toddlerhood and preschool were also associated with significantly worse parental physical and mental health outcomes, and more family conflict, with similar though slightly weaker and less consistent associations for transitioning into food insecurity between infancy and toddlerhood. CONCLUSIONS: Food insecurity is associated with significant decreases in family health and well-being. Clinicians and other public health officials play a critical role in assessing risk for children and families, and linking families with supportive services. Screening families experiencing or at risk for food insecurity and connecting them with resources is an avenue through which public health practitioners can support family health.

Associations Between Household Food Insecurity in Early Childhood and Children's Kindergarten Skills.

Using nationally representative data on a recent birth cohort of U.S.-born children in low-income households (n = 2,800-3,700), this study investigates associations between the timing and intensity of early childhood food insecurity and children's kindergarten reading, math, and social-emotional outcomes. Descriptive patterns reveal that approximately 20% of low-income 0- to 5-year-old children reside in food-insecure households. Food insecurity experienced during early childhood is unfavorably associated with social-emotional outcomes in kindergarten, controlling for household income and prior assessments of child social-emotional skills. Results are less consistent for cognitive outcomes but similar in magnitude. If replicated, findings may inform policy efforts to reduce disparities in early skills for approximately 15 million U.S. children in food-insecure households.

Associations Between School Connection and Depressive Symptoms From Adolescence Through Early Adulthood: Moderation by Early Adversity.

Depressive symptomatology is one of the most common and costly threats to American mental health, making the elucidation of environmental influences on depressive symptoms particularly important. Using the National Longitudinal Study of Adolescent Health, this study explores the interaction between environmental risk and protective factors in the etiology of depressive symptoms by asking whether school connection is associated with lower levels of depressive symptoms through early adulthood, and whether connection serves as a protective or promotive factor for youth who experienced early adversity. Findings highlight the importance of school connection in promoting long-term mental health for all youth and suggest that policies and practice supporting school connection may be effective intervention strategies for youth at risk for depressive symptomatology.

Variation in impacts of Tulsa pre-K on cognitive development in kindergarten: The role of instructional support.

Public prekindergarten (pre-K) programs have been a recent focus of policy and research attention, in part because of their empirically documented, positive short-term impacts on child cognitive development and school readiness. However, no studies have explored factors that might explain variation across schools in public pre-K impacts. The current study examines the Tulsa Public School pre-K program's impacts on children's letter-word identification, spelling, and applied problem-solving skills at kindergarten entry. Findings reveal substantial across-school variation in treatment impacts, associated with variation in instructional support. Results are robust to sensitivity checks and are discussed alongside implications for policy and future research. (PsycINFO Database Record

Father Absence and Adolescent Depression and Delinquency: A Comparison of Siblings Approach.

Associations between having a nonresident father and increased internalizing and externalizing behaviors in adolescence have been well established, however, research has yet to establish the plausible causality of these links or identify the mechanisms that may underlie them. Using data from the National Longitudinal Survey of Youth 1979 - the Young Adult survey (CNLSY-YA), the present study addresses these questions by comparing the behavior of siblings discordant for age at father departure across two outcomes, depressive symptoms (N= 5108) and delinquent behavior (N= 4882). Findings indicate that father departure later in childhood is associated with increased delinquency in adolescence but not with greater depressive symptoms. Moreover, father departure in early childhood was not associated with problematic behavior in adolescence. Both findings suggest that parental monitoring rather than disrupted socialization or emotional distress may account for links between having a nonresident father and adolescent delinquency.

Early Childhood Maltreatment and Girls' Sexual Behavior: The Mediating Role of Pubertal Timing.

PURPOSE: Although links between early childhood maltreatment and girls' sexual behavior in adolescence have been well established, it is unclear whether different forms of maltreatment are differentially associated with sexual outcomes and whether distinct mechanisms explain associations across maltreatment types. METHODS: Using data from National Longitudinal Study of Adolescent Health (Add Health), the present study examines whether physical abuse, sexual abuse, and physical neglect in early childhood differentially predict girls' age at first intercourse and number of sexual partners in early adulthood. The study also tests whether early pubertal timing mediates the link between early maltreatment and sexual behavior (N = 6,364). RESULTS: Findings indicate that early sexual and physical abuse were equally predictive of earlier age at first intercourse and a greater number of sexual partners, but that only the sexual abuse-age at first intercourse link was mediated by early puberty. CONCLUSIONS: These results suggest that sexual abuse and physical abuse are associated with earlier and riskier sexual behavior in girls relative to no maltreatment and to similar degrees. However, only the link between sexual abuse and sexual behavior involves a biological mechanism manifested in early pubertal timing.

Associations between family structure change and child behavior problems: the moderating effect of family income.

This study investigated conditions under which family structure matters most for child well-being. Using data from the Children of the National Longitudinal Survey of Youth (n = 3,936), a national sample of U.S. families, it was estimated how changes in family structure related to changes in children's behavior between age 3 and 12 separately by household income level to determine whether associations depended on families' resources. Early changes in family structure, particularly from a two-biological-parent to single-parent family, predicted increases in behavior problems more than later changes, and movements into single and stepparent families mattered more for children of higher versus lower income parents. Results suggest that for children of higher income parents, moving into a stepfamily may improve, not undermine, behavior.

Changes in health risk behaviors for males and females from early adolescence through early adulthood.

OBJECTIVE: We sought to identify (a) the course of changes in smoking, alcohol and marijuana use, violence, and sexual behavior from early adolescence through young adulthood for males and females, (b) points of divergence and convergence for 5 health risk behaviors between males and females, and (c) whether the trajectories of change in health risk behaviors differed for males and females. METHOD: Data from four waves of the nationally representative National Longitudinal Study of Adolescent Health (Add Health) followed 18,911 youth from early adolescence through the transition to adulthood (ages 13 through 31 years) and were analyzed using zero-inflated negative binomial growth models and logistic growth models. RESULTS: Generally, health risk behaviors steadily increased through adolescence into the early 20s, subsequently leveling off or decreasing. Results indicated early adolescent females were more likely to smoke and have more sexual partners, and 14- and 18-year-old females had higher rates of increase for getting drunk. The majority of findings, however, indicated that adolescent and young adult males engaged in more risk behaviors and were increasingly likely to engage over time. Among youth engaged in health risk behaviors, males reported greater frequency and increases in rates over time for most risk behaviors. CONCLUSIONS: We identify several critical groups for health professionals to address: early adolescent females not previously identified as more engaged in health risks; adolescent females "catching up" to male health risks; early and mid-adolescent males shifting into adult patterns of heightened health risk behaviors; and the group of risk-taking males across age groups.