An examination of multiple illness and social related stressors during the COVID-19 pandemic on maternal and child mental health; findings from a birth cohort in rural Pakistan.

PURPOSE: In an effort to improve preparation for future pandemics, researchers continue to examine the myriad psychosocial pathways through which the COVID-19 pandemic impacted mental health. Moving beyond extant research on factors such as financial difficulties or social isolation, we present findings on two less documented pathways: (a) COVID illness and death within one's social network and (b) experiencing pandemic-related basic needs stressors, beyond financial difficulties, on the mental health of mothers and children in South Asia.

METHODS

Data come from the 2021-2022 wave of the Bachpan birth cohort (6-year-old children, n = 814 mother-child dyads) in rural Pakistan. Multivariable regressions were used to estimate the association between COVID illness/death among family/friend/community members and basic needs stressors (e.g. difficulties with food, housing, medical care) with 4 outcomes: maternal anxiety (GAD-7) and depression symptoms (PHQ-9), and child emotional/behavioral problems (SDQ-TD) and anxiety (SCAS).

RESULTS

Maternal mental health was independently predicted by illness within the mother's network and basic needs stressors, even after accounting for pre-pandemic socioeconomic status, depression, and pandemic-related financial stressors. Specifically, having a family member/friend who became ill was associated with 1.29 higher PHQ-9 scores (95% CI: 0.34, 2.24), compared to those who did not know anyone affected. Increased basic needs stressors were also associated with higher PHQ-9 and GAD-7 levels and children's behavioral/emotional problems and anxiety. Social network proximity to COVID illness/death was not associated with child mental health outcomes.

CONCLUSION

These findings provide evidence of additional pathways through which prolonged global events, like the pandemic, can have multigenerational mental health impacts.