Measuring Disparities in the Impact of COVID‐19 on Pediatric Mental Health in Primary Care Settings
ABSTRACT The purpose of this study is to examine disparities in mental health diagnoses, depression screening, and depressive symptoms in pediatric primary care settings before and during the COVID‐19 pandemic, and to evaluate the use of electronic health records to study temporal trends in pediatri...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | Mental Health Science |
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| Online Access: | https://doi.org/10.1002/mhs2.70015 |
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| author | Cecilia Rogers Katherine Boguszewski Angela Gummadi Mark Conaway Laura Shaffer Irène Mathieu |
| author_facet | Cecilia Rogers Katherine Boguszewski Angela Gummadi Mark Conaway Laura Shaffer Irène Mathieu |
| author_sort | Cecilia Rogers |
| collection | DOAJ |
| description | ABSTRACT The purpose of this study is to examine disparities in mental health diagnoses, depression screening, and depressive symptoms in pediatric primary care settings before and during the COVID‐19 pandemic, and to evaluate the use of electronic health records to study temporal trends in pediatric mental and behavioral health (MBH). This is an IRB‐approved, retrospective study of pediatric patients (n = 11,001) who visited three primary care sites at an academic medical center before (2017–2019) and during (2020–2022) the COVID‐19 pandemic. We used logistic regression to compare prevalence of diagnoses, depression screening, and depression symptom scores among demographic groups. This study demonstrates an increase in both PHQ‐9A screening rates and average scores from 2017–2019 to 2020–2022. Despite an increase in overall PHQ‐9A scores, prevalence of mental health diagnoses is lower in 2020–2022 compared to 2017–2019. There were significant disparities in common mental health diagnoses, including higher rates of psychological distress among lower income patients, both before and during the pandemic. In both cohorts, patients classified as African American, Asian, or Other racial groups had a lower prevalence of diagnoses compared to Caucasian patients. However, patients marked as having multiple racial groups had greater levels of diagnoses. There were also lower screening rates among Hispanic patients. Gender non‐conforming patients had a significantly larger burden of psychological distress. This suggests a need for greater equity in routine MBH screening and additional research to better understand the underlying social determinants that may be driving the greater mental health burden for certain marginalized youth. This study also highlights the strengths and challenges of utilizing EHR data to characterize disparities in pediatric mental illness. Although the nature of care delivery in an academic medical center clinic and the limitations of the EHR for collecting relevant data present challenges to this measurement, the EHR is nevertheless a promising tool for measuring and tracking pediatric mental health disparities. |
| format | Article |
| id | doaj-art-ff791bb75f7c4beeae74ed5953b85619 |
| institution | OA Journals |
| issn | 2642-3588 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mental Health Science |
| spelling | doaj-art-ff791bb75f7c4beeae74ed5953b856192025-08-20T02:32:53ZengWileyMental Health Science2642-35882025-06-0132n/an/a10.1002/mhs2.70015Measuring Disparities in the Impact of COVID‐19 on Pediatric Mental Health in Primary Care SettingsCecilia Rogers0Katherine Boguszewski1Angela Gummadi2Mark Conaway3Laura Shaffer4Irène Mathieu5Department of Pediatrics University of Virginia School of Medicine Charlottesville Virginia USADepartment of Pediatrics University of Virginia School of Medicine Charlottesville Virginia USADepartment of Pediatrics University of Virginia School of Medicine Charlottesville Virginia USADepartment of Public Health Sciences University of Virginia School of Medicine Charlottesville Virginia USADepartment of Pediatrics University of Virginia School of Medicine Charlottesville Virginia USADepartment of Pediatrics University of Virginia School of Medicine Charlottesville Virginia USAABSTRACT The purpose of this study is to examine disparities in mental health diagnoses, depression screening, and depressive symptoms in pediatric primary care settings before and during the COVID‐19 pandemic, and to evaluate the use of electronic health records to study temporal trends in pediatric mental and behavioral health (MBH). This is an IRB‐approved, retrospective study of pediatric patients (n = 11,001) who visited three primary care sites at an academic medical center before (2017–2019) and during (2020–2022) the COVID‐19 pandemic. We used logistic regression to compare prevalence of diagnoses, depression screening, and depression symptom scores among demographic groups. This study demonstrates an increase in both PHQ‐9A screening rates and average scores from 2017–2019 to 2020–2022. Despite an increase in overall PHQ‐9A scores, prevalence of mental health diagnoses is lower in 2020–2022 compared to 2017–2019. There were significant disparities in common mental health diagnoses, including higher rates of psychological distress among lower income patients, both before and during the pandemic. In both cohorts, patients classified as African American, Asian, or Other racial groups had a lower prevalence of diagnoses compared to Caucasian patients. However, patients marked as having multiple racial groups had greater levels of diagnoses. There were also lower screening rates among Hispanic patients. Gender non‐conforming patients had a significantly larger burden of psychological distress. This suggests a need for greater equity in routine MBH screening and additional research to better understand the underlying social determinants that may be driving the greater mental health burden for certain marginalized youth. This study also highlights the strengths and challenges of utilizing EHR data to characterize disparities in pediatric mental illness. Although the nature of care delivery in an academic medical center clinic and the limitations of the EHR for collecting relevant data present challenges to this measurement, the EHR is nevertheless a promising tool for measuring and tracking pediatric mental health disparities.https://doi.org/10.1002/mhs2.70015adolescentsanxietychildrenCOVID‐19depressiondisparities |
| spellingShingle | Cecilia Rogers Katherine Boguszewski Angela Gummadi Mark Conaway Laura Shaffer Irène Mathieu Measuring Disparities in the Impact of COVID‐19 on Pediatric Mental Health in Primary Care Settings Mental Health Science adolescents anxiety children COVID‐19 depression disparities |
| title | Measuring Disparities in the Impact of COVID‐19 on Pediatric Mental Health in Primary Care Settings |
| title_full | Measuring Disparities in the Impact of COVID‐19 on Pediatric Mental Health in Primary Care Settings |
| title_fullStr | Measuring Disparities in the Impact of COVID‐19 on Pediatric Mental Health in Primary Care Settings |
| title_full_unstemmed | Measuring Disparities in the Impact of COVID‐19 on Pediatric Mental Health in Primary Care Settings |
| title_short | Measuring Disparities in the Impact of COVID‐19 on Pediatric Mental Health in Primary Care Settings |
| title_sort | measuring disparities in the impact of covid 19 on pediatric mental health in primary care settings |
| topic | adolescents anxiety children COVID‐19 depression disparities |
| url | https://doi.org/10.1002/mhs2.70015 |
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