Abstract
Adolescents and young adults have been particularly vulnerable to disruptions caused by the COVID-19 pandemic. The objectives were to identify youth's self-reported pandemic-related stressors and examine how these stressors were related to six negative health outcomes: self-perceived, fair-to-poor physical, and mental health, depression, anxiety, and at-risk alcohol and cannabis use. Data were from the Well-Being and Experiences Study (The WE Study) from Manitoba, Canada (17–22 years old; n = 587; collected from November 2021 to January 2022). The COVID-19 stressors reported most frequently since pandemic onset included: (1) not being able to spend time with friends (78.5%); (2) feeling lonely or isolated (69.9%); and (3) remote learning for school, college, or university (68.4%). In reference to the “past month”, frequently reported stressors were (1) remote learning (42.6%); (2) feeling lonely or isolated (41.2%); and (3) uncertainty about the future (41.1%). Overall, 26.1% of the sample perceived their physical health as fair-to-poor and 59.1% perceive their mental health as fair-to-poor. A number of stressors were related to fair-to-poor mental health, depression, and anxiety; fewer were related to fair-to-poor physical health and at-risk alcohol and cannabis use. These findings can inform future pandemics and recovery efforts to improve pandemic-related health risks among youth.
Introduction
The stress experienced by individuals and families during COVID-19 was prolonged as successive waves of the pandemic were met by government measures imposed to reduce transmission of the virus (Holmes et al. 2020). In Canada, public health strategies were implemented in March 2020 and continued in varying forms for more than 2 years. These unprecedented public health measures included: physical distancing; mandatory masking in public; quarantines; lock downs; travel restrictions; childcare and business closures; remote learning; and limited provision of community-based social programming and healthcare services. In Manitoba, the first lock down, referred to as the first wave, occurred in March 2020 with many restrictions lifted in June 2020. The second wave occurred in September 2020 corresponding with the second lock down with restrictions being reduced in January 2021. The third wave and lock down occurred in April 2021. Vaccines became available in the spring of 2021. The fourth wave and final lock down occurred in November 2021 with restrictions not fully lifting until May 2022.
The disruptions of the COVID-19 pandemic may have been particularly difficult for adolescents and young adults who encountered the pandemic at a pivotal point in their lives, typically marked by milestones and life course decisions about education, employment, friendships, relationships, and family formation. Although many important studies were conducted in the early months and first year of the COVID-19 pandemic (Glowacz and Schmits 2020; Essau and de la Torre-Luque 2021; Jones et al. 2021; Meherali et al. 2021; Minhas et al. 2021; Mohler-Kuo et al. 2021a; Segre et al. 2021; Villanti et al. 2022), more research is needed to better understand the stressors that youth experienced during the second year of pandemic restrictions, when circumstances such as frequency and length of lock downs changed. Little is known as to whether stressors for youth were only experienced at the start of the pandemic, or if they continued into year two. Chronic stressors over a prolonged period can illicit biological responses and have negative effects on health (Schneiderman et al. 2005). More specifically, it has been noted that the prolonged COVID-19 pandemic may have especially impacted youth when considering stress resilience and mental health (Manchia et al. 2022). A better understanding of stressors that affected youth later in the COVID-19 pandemic in year two is needed to address knowledge gaps on how those experiences were related to their physical and mental well-being and to inform policy and practice.
Research on the pandemic effects indicates that among youth, COVID-19 was related to an increased likelihood of stress, distress, substance use, anxiety, and depression symptoms (Glowacz and Schmits 2020; Essau and de la Torre-Luque 2021; Jones et al. 2021; Meherali et al. 2021; Minhas et al. 2021; Mohler-Kuo et al. 2021b; Segre et al. 2021;Villanti et al. 2022; Craig et al. 2023; Foster et al. 2023). It should be noted that many of the COVID-19 studies do not allow for causal inferences in relationships by nature of design. However, a systematic review and meta-analysis of 53 longitudinal child and adolescent cohort studies from 12 countries conducted before and during the COVID-19 pandemic found evidence indicating that depression and anxiety symptoms increased during the pandemic (Madigan et al. 2023). Some studies observed an increase in substance use among youth, while other found a decrease (Dumas et al. 2020; Papp and Kouros 2021; Sarvey and Welsh 2021). Reasons for inconsistencies in the substance use literature are unclear. Importantly, research has reported that young adults may use substances to cope with COVID-19-related stress (Arterberry et al. 2023). Additionally, less research has examined specific COVID-19-related experiences that were regarded as stressors by adolescents and young adults and whether those stressors were associated with their physical health, mental health, and substance use. Such data are needed to inform future pandemics and pandemic recovery intervention efforts for those still perceiving a need for help.
