Sage Journals: Discover world-class research

Abstract

Adolescents are experiencing unprecedented mental health challenges in the United States. This study investigated the relationships between social and environmental determinants of occupation (SEDO) and adolescent mental health at the population level. We quantitatively analyzed the National Cancer Institute’s Family Life, Activity, Sun, Health, and Eating (FLASHE) specialty cohort study sample (aged 12–17 years, n = 1,737, April-October 2014). Ordinal logistic regression models tested associations between SEDO factors and adolescent mental health. Analyses showed significant associations between SEDO (insufficient sleep, food insecurity, and access to social support) and mental health proxies (eating without hunger due to feeling anxious/nervous, eating without hunger due to feeling sad/depressed). This study provides an understanding of adolescents as a population experiencing mental health disparities related to SEDO. More research is needed to identify additional occupational therapy intervention targets and strategies for addressing SEDO at the population level.

Plain Language Summary

How Sleep, Food, and Social Support Affect Teen Mental Health

Teenagers in the United States are facing more mental health struggles than ever before. This study looked at how certain social and environmental factors affect teens’ mental health. Researchers analyzed data from a national survey of 12- to 17-year-olds and found that lack of sleep, not having enough food, and limited social support were linked to signs of poor mental health. Specifically, teens who experienced these challenges were more likely to eat even when they weren’t hungry due to feeling anxious, nervous, sad, or depressed. The study highlights the need for more research on how these factors impact teens and how occupational therapy can help improve their well-being.

Keywords

social and environmental determinants of health adolescent mental health population level perspectives urban rural

Get full access to this article

View all access options for this article.

References

Adams

Atkin

Lee

Hackett

S. S.

Hackett

K. L.

(2022). Exploring potential for occupational therapy practice models within areas of social deprivation: A qualitative inquiry within a community-centred food cooperative. British Journal of Occupational Therapy, 85, 828–836. https://doi.org/10.1177/03080226221092689

Badura

Geckova

A. M.

Sigmundova

Van Dijk

J. P.

Reijneveld

S. A.

(2015). When Children play, and they feel better: Organized activity participation and health in adolescents. BMC Public Health, 15, 1–8. https://doi.org/10.1186/s12889-015-2427-5

Bailliard

(2024). Occupational justice. In Schell

B. A. B.

Gillen

(Eds.), Willard and Spackman’s occupational therapy (pp. 643–659). Wolters Kluwer.

Bailliard

A. L.

Carroll

D’Agostino

E. M.

(2024). Predictors of population mental health in Montana: An occupational justice perspective. OTJR Occupational Therapy Journal of Research, 44(4), 617–624. https://doi.org/10.1177/15394492241230906

Beagan

Chapman

Power

(2018). The visible and invisible occupations of food provisioning in low income families,. Journal of Occupational Science, 25(1), 100–111. https://doi.org/10.1080/14427591.2017.1338192

Bridge

J. A.

Ruch

D. A.

Sheftall

A. H.

Hahm

H. C.

O’Keefe

V. M.

Fontanella

C. A.

Brock

Campo

J. V.

Horowitz

L. M.

(2023). Youth suicide during the first year of the COVID-19 pandemic. Pediatrics, 151(3), Article e2022058375. https://doi.org/10.1542/peds.2022-058375

Boers

Afzali

M. H.

Newton

Conrod

(2019). Association of screen time and depression in adolescence. JAMA Pediatrics, 173(9), 853. https://doi.org/10.1001/jamapediatrics.2019.175

Donnelly

Jessup

Miller

(2022). Occupational challenges during adolescence: A scoping review of barriers and facilitators. Canadian Journal of Occupational Therapy, 89(2), 172–183. https://doi.org/10.1177/00084174221089024

Dush

J. L.

(2020). Adolescent food insecurity: A review of contextual and behavioral factors. Public Health Nursing, 37(3), 327–338. https://doi.org/10.1111/phn.12708

10.

Halliwell

Podvey

Smith

J. D.

Harris

Sylvester

DeGrace

B. W.

(2021). Experience of sleep for families of young adults with autism spectrum disorder. American Journal of Occupational Therapy, 75, Article 7505205120. https://doi.org/10.5014/ajot.2021.043364

11.

Health Resources and Services Administration. (2020). Rural/Urban differences in children’s health, 2017-2018. National Survey of Children’s Health Data Briefs—NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK603014/

12.

Hingst

Alvarado

D. C.

Bardin

Farmer

(2023). Occupational therapy and cooking: A scoping review and future directions. Scandinavian Journal of Occupational Therapy, 31(1). https://doi.org/10.1080/11038128.2023.2267081

13.

Jaworska

MacQueen

(2015). Adolescence as a unique developmental period. Journal of Psychiatry and Neuroscience, 40(5), 291–293. https://doi.org/10.1111/j.1532-7795.2010.00728.x

14.

Keleş

B. Y.

McCrae

Grealish

(2019). A systematic review: The influence of social media on depression, anxiety and psychological distress in adolescents. International Journal of Adolescence and Youth, 25(1), 79–93. https://doi.org/10.1080/02673843.2019.1590851

15.

Kidwell

K. M.

Milligan

M. A.

Deyo

Lasker

Vrabec

(2024). Emotional eating prevalence and correlates in adolescents in the United States. Childhood Obesity, 20, 590–597. https://doi.org/10.1089/chi.2023.0184

16.

Kirkbride

J. B.

Anglin

D. M.

Colman

Dykxhoorn

Jones

P. B.

Patalay

Pitman

Soneson

Steare

Wright

Griffiths

S. L.

(2024). The social determinants of mental health and disorder: Evidence, prevention and recommendations. World Psychiatry, 23(1), 58–90. https://doi.org/10.1002/wps.21160

17.

Mason

T. B.

(2023). Interactions of parental feeding characteristics and adolescent emotional eating in relation to unhealthful food and sugar-sweetened beverage intake among adolescents. Appetite, 193, Article 107125. https://doi.org/10.1016/j.appet.2023.107125

18.

McLaughlin

K. A.

Costello

E. J.

Leblanc

Sampson

N. A.

Kessler

R. C.

(2012a). Socioeconomic status and adolescent mental disorders. American Journal of Public Health, 102(9), 1742–1750. https://doi.org/10.2105/AJPH.2011.300477

19.

McLaughlin

K. A.

Green

AlegríA

Costello

E. J.

Gruber

M. J.

Sampson

N. A.

Kessler

R. C.

(2012b). Food insecurity and mental disorders in a national sample of U.S. adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 51(12), 1293–1303. https://doi.org/10.1016/j.jaac.2012.09.009

20.

Moroney

Lee

S. S.

Ebbert

A. M.

Luthar

S. S.

(2022). Digital media use frequency, online behaviors, and risk for negative mental health in adolescents in high-achieving schools. Clinical Child Psychology and Psychiatry, 28(1), 237–254. https://doi.org/10.1177/13591045221108834

21.

Mui Lim

Jones

. (2017). Occupational transitions for children and young people. In Rodger

Kennedy-Behr

(Eds.), Occupation-centred practice with children: A practical guide for occupational therapists (pp. 111–132). John Wiley & Sons

22.

Murphy

L. E.

Jack

H. E.

Concepcion

T. L.

Collins

P. Y.

(2020). Integrating urban adolescent mental health into urban sustainability collective action: An application of Shiffman & Smith’s framework for global health prioritization. Frontiers in Psychiatry, 11, Article 44. https://doi.org/10.3389/fpsyt.2020.00044

23.

National Academies Press (US). (2019, May 16). Adolescent development. The Promise of Adolescence—NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK545476/

24.

National Academies Press (US). (2023). Social media and adolescent health. https://nap.nationalacademies.org/read/27396/chapter/1

25.

National Cancer Institute (NCI). (2014). Family life, activity, sun, health and eating (FLASHE) survey data. U.S. Department of Health and Human Services, National Cancer Institute. http://cancercontrol.cancer.gov/brp/hbrb/flashe.html

26.

National Institute of Mental Health (NIMH). (2022). Suicide rates by age. NIMH Data & Statistics. https://www.nimh.nih.gov/health/statistics/suicide

27.

National Institute of Mental Health (NIMH). (2023, May 22). Youth suicide rates increased during the COVID-19 pandemic. https://www.nimh.nih.gov/news/science-news/2023/youth-suicide-rates-increased-during-the-covid-19-pandemic

28.

Nebeling

Hennessy

Dwyer

L. A.

Patrick

Blanck

H. M.

Perna

F. M.

Ferrer

R. A.

Yaroch

A. L.

(2017). The FLASHE Study: Survey development, dyadic perspectives, and participant characteristics. American Journal of Preventive Medicine, 52(6), 839–848. https://doi.org/10.1016/j.amepre.2017.01.028

29.

Odgers

C. L.

Jensen

M. R.

(2020). Annual research review: Adolescent mental health in the digital age: Facts, fears, and future directions. Journal of Child Psychology and Psychiatry, 61(3), 336–348. https://doi.org/10.1111/jcpp.13190

30.

Odoms-Young

Brown

A. G.

Agurs-Collins

Glanz

(2024). Food insecurity, neighborhood food environment, and health disparities: State of the science, research gaps and opportunities. American Journal of Clinical Nutrition, 119, 850–861. https://doi.org/10.1016/j.ajcnut.2023.12.019

31.

Pascoe

M. C.

Hetrick

S. E.

Parker

A. G.

(2020). The impact of stress on students in secondary school and higher education. International Journal of Adolescence and Youth, 25(1), 104–112. https://doi.org/10.1080/02673843.2019.1596823

32.

Peters

Galvaan

(2020). A scoping review exploring “opportunity” in occupational science: Possibilities for conceptual development. Journal of Occupational Science, 28(2), 249–267. https://doi.org/10.1080/14427591.2020.1832906

33.

Pfeifer

J. H.

Berkman

E. T.

(2018). The development of self and identity in adolescence: Neural evidence and implications. Child Development Perspectives, 12(3), 158–164. https://doi.org/10.1111/cdep.12279

34.

Poole-Di Salvo

E. P.

Silver

E. J.

Stein

R. E

. (2016). Household food insecurity and mental health problems among adolescents: What do parents report? Academic Pediatrics, 16(1), 90–96. https://doi.org/10.1016/j.acap.2015.08.005

35.

Racine

McArthur

B. A.

Cooke

J. E.

Eirich

Zhu

Madigan

(2021). Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19. JAMA Pediatrics, 175(11), Article 1142.

36.

Reiss

(2013). Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review. Social Science & Medicine, 90, 24–31. https://doi.org/10.1016/j.socscimed.2013.04.026

37.

Shochat

Cohen-Zion

Tzischinsky

(2014). Functional consequences of inadequate sleep in adolescents: A systematic review. Sleep Medicine Reviews, 18(1), 75–87. https://doi.org/10.1016/j.smrv.2013.03.005

38.

Skinner

Jebeile

Burrows

(2021). Food addiction and mental health in adolescents: A systematic review. The Lancet Child & Adolescent Health, 5(10), 751–766. https://doi.org/10.1016/s2352-4642(21)00126-7

39.

Smith

D. M.

(2024). Social and environmental determinants of occupation: An intersectional concept focused on occupational justice and participation. Journal of Occupational Science, 31, 209–215. https://doi.org/10.1080/14427591.2023.2212676

40.

Suldo

S. M.

Shaunessy-Dedrick

(2013). Changes in stress and psychological adjustment during the transition to high school among freshmen in an accelerated curriculum. Journal of Advanced Academics, 24(3), 195–218. https://doi.org/10.1177/1932202X13496090

41.

Twenge

J. M.

Cooper

A. B.

Joiner

T. E.

Duffy

M. E.

Binau

S. G.

(2019). Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017. Journal of Abnormal Psychology, 128(3), 185–199. https://doi.org/10.1037/abn0000410

42.

Twenge

J. M.

Spitzberg

B. H.

Campbell

W. K.

(2019). Less in-person social interaction with peers among U.S. adolescents in the 21st century and links to loneliness. Journal of Social and Personal Relationships, 36(6), 1892–1913. https://doi.org/10.1177/0265407519836170

43.

United States Census Bureau. (2014). Current population survey. https://www.census.gov/

44.

United States Department of Agriculture. (2023). Definitions of food security. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/definitions-of-food-security/

45.

United States Department of Health and Human Services. (2023). Social determinants of health. https://health.gov/healthypeople/priority-areas/social-determinants-health

46.

U.S. Senate Committee on the Judiciary (2023). Social media and the teen mental health crisis. https://www.judiciary.senate.gov/committee-activity/hearings/social-media-and-the-teen-mental-health-crisis

47.

Victoria-Montesinos

Jiménez-López

Mesas

A. E.

López-Bueno

Garrido-Miguel

Gutiérrez-Espinoza

Smith

López-Gil

J. F.

(2023). Are family meals and social eating behaviour associated with depression, anxiety, and stress in adolescents? The EHDLA study. Clinical Nutrition, 42(4), 505–510. https://doi.org/10.1016/j.clnu.2023.01.020

48.

Wight

Kaushal

Waldfogel

Garfinkel

(2014). Understanding the link between poverty and food insecurity among children: Does the definition of poverty matter? Journal of Children and Poverty, 20(1), 1–20. https://doi.org/10.1080/10796126.2014.891973

49.

Wilcock

Hocking

(2024). An occupational perspective of health. Taylor & Francis.

50.

World Health Organization: WHO. (2019, May 30). Social determinants of health. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

51.

World Health Organization (WHO). (2020). Guidelines on mental health promotive and preventive interventions for adolescents: Helping adolescents thrive. https://www.who.int/publications/i/item/9789240011854

52.

Whiteford

Jones

Rahal

Suleman

(2018). The Participatory Occupational Justice Framework as a tool for change: Three contrasting case narratives. Journal of Occupational Science, 27(s1), 497–508. https://doi.org/10.1080/14427591.2018.1504607@rocc20.2020.27.issue-s1

53.

Xiao

Mann

J. J.

Chow

J. C.

Brown

T. T.

Snowden

L. R.

Yip

Tsai

A. C.

Hou

Pathak

Wang

F. S.

. (2023). Patterns of social determinants of health and child mental health, cognition, and physical health. JAMA Pediatrics, 177(12), Article 1294. https://doi.org/10.1001/jamapediatrics.2023.4218

54.

Zhang

Paksarian

Lamers

Hickie

I. B.

Merikangas

K. R.

(2017). Sleep patterns and mental health correlates in US adolescents. The Journal of Pediatrics, 182, 137–143. https://doi.org/10.1016/j.jpeds.2016.11.00

Social and Environmental Determinants of Occupation: Population-Level Analysis of Adolescent Mental Health

Abstract

Plain Language Summary

Keywords

Get full access to this article

References