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Abstract

The aim of this study was to understand associations between pandemic stressors and parents’ self-rated physical and mental health; symptoms of mental health problems, and at-risk substance use problems. Data were collected from February 2022 to March 2022 as part of Wave 2 of the Well-being and Experiences Study in Manitoba, Canada (n = 749). Stressors frequently identified since the onset of the pandemic included inability to spend time with family and friends, worry about getting coronavirus disease-2019 (COVID-19), and travel restrictions. In the past month, the most frequently identified stressors were worry about getting COVID-19, travel restrictions, public health restrictions, and worry about the future. The stressors with the greatest number of associations with worse health outcomes included: job loss or financial burden; feeling lonely or isolated; disrupted or poor sleep; uncertainty about the future; accessing health care for any reason; increased conflict in relationships; cancellation of surgeries, caregiving for children; and inability to spend time with family. Understanding the COVID-19 stressors that were associated with health and substance problems can inform clinical approaches to respond to pandemic-related problems, as well as public health preparedness to mitigate declines in parents’ health and well-being in the context of future pandemics.

Background

The coronavirus disease-2019 (COVID-19) pandemic and public health measures necessary to minimize risk led to unique challenges for parents. Studies have found that the impact of the pandemic on stress, mental health, and substance use was different, and often more pronounced, among parents or caregivers (hereinafter referred to as parents) than among nonparents (American Psychological Association 2020Gadermann et al. 2021Hill MacEachern et al. 2021). In two nationally representative surveys of adults in Canada conducted at the beginning of the pandemic, differences emerged between parents (of children under 18) and non-parents (Gadermann et al. 2021Hill MacEachern et al. 2021). Parents self-reported a higher prevalence of worsening mental health since the onset of the pandemic (Gadermann et al. 2021) and of significantly increased alcohol use compared to before the pandemic (Hill MacEachern et al. 2021). However, among males, parents were less likely than non-parents to report increased cannabis use (Hill MacEachern et al. 2021). Understanding parents’ stress, mental health, and substance use during the pandemic is key to preventing and/or lessening the negative consequences not only for their own health and well-being but also, intergenerationally (Daks et al. 2020Spinelli et al. 2020Roos et al. 2021).

Parents have identified a range of COVID-related stressors including (but not limited to): caring for and worrying about the impacts of the pandemic on their children; lack of supports such as childcare; balancing roles and responsibilities; anxiety and worry about COVID-19; uncertainty about the future; job or income loss; mental and physical health; health care system concerns; inability to see family or friends; and relationship challenges (Brown et al. 2020Adams et al. 2021Alonzi et al. 2021Gadermann et al. 2021Roos et al. 2021). In one study, at the beginning of the pandemic, parents of non-adult children reported experiencing an average of 3.5 COVID-related stressors (Brown et al. 2020).

In an August 2020 survey involving a representative sample of parents in Germany, higher pandemic-related stress scores were correlated with worse depression, anxiety, and self- rated health (Calvano et al. 2022). These associations are informative, but greater specificity is needed to understand what pandemic stressors were associated with health and well-being problems to thereby inform prevention strategies, as well as intervention approaches to reduce impairment. Although some studies have had greater specificity, their focus was narrow. For example, researchers investigated the impacts of school closures and time spent home schooling due to the COVID-19 pandemic and noted significant, associations between these experiences and parental mental health problems and cannabis and alcohol use (marginal association) to cope with mental health symptoms (Deacon et al. 2021Kishida et al. 2021). One U.S. study of parents conducted early in the pandemic studied the associations between a comprehensive list of pandemic-related experiences moderate-to-severe mental distress (Hart and Han 2021). Experiences associated with an increased likelihood of distress included: having been diagnosed with COVID-19; stigma or discrimination; pandemic-related income or job loss; increased anxiety, depression, loneliness; increased alcohol or substance use; and not having enough basic supplies (Hart and Han 2021). On the other hand, the same study reported that fear of COVID-19 contagion (being infected and infecting others) and worry about family members and friends were associated with a decreased likelihood of mental distress (Hart and Han 2021). A Chinese study noted that the absence of family conflict during the pandemic was associated with lowered odds of mental health problems, but two-week quarantine (personal or family member) was associated with higher odds of depression (Wu et al. 2020). Furthermore, Tsai et al. (2024) found that caregiving for children with attention deficit hyperactivity disorder (ADHD) was associated with elevated psychological distress in parents, suggesting that parents of children with psychiatric disorders may have experienced greater challenges during the pandemic.

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