Prevalence of Emotional and Behavioral Problems among Children in New York City and Association with Household Poverty

Background: Research indicates that socioeconomic conditions of the family are associated with mental health conditions among children. Using preliminary results from a population-based survey conducted by the NYC Department of Health and Mental Hygiene, this analysis examines the prevalence of  emotional and behavioral problems among children in NYC and the association between mental health  difficulties and household poverty. 

Methods: NYC Child Health, Emotional Wellness and Development Survey (CHEWDS) is a cross-sectional random-digit-dialed telephone survey conducted in 2015 that sampled parents and guardians of children ages 12 and younger living in NYC. The Strengths and Difficulties (SDQ) questionnaire was used to measure mental health problems among children ages 3-12 years and included one overall and four domain-specific scores (hyperactivity and emotional, conduct and peer problems). Household income was calculated relative to the federal poverty level (FPL). Descriptive analyses of preliminary unweighted data included prevalence of emotional and behavioral problems indicated by SDQ scores. Logistic regression was used to model variation in the relation between household poverty level and mental health difficulties. Analyses with weighted data are forthcoming.

Results: Of the 2,061 children with complete SDQ data, 11.2% had a borderline (5.7%) or abnormal (5.5%) SDQ score indicating emotional and behavioral concerns and problems. Among boys prevalence was 14.7% and among girls, 7.1% (p<.0001).  Domain-specific scores varied and ranged from 11.8% for emotional problems to 22.1% for peer problems.  Boys were significantly more likely than girls to have conduct problems, hyperactivity, and peer problems.

Mental health difficulties of children varied by poverty. Children in households under 100% FPL had 3.37 times the odds of having a mental health condition relative to children in households 200% FPL and greater (95% Confidence Interval (CI), 2.28—4.99), after adjusting for child’s age, gender, and race/ethnicity; children in households between 100-199% FPL had 1.97 times the odds relative to children in households 200% FPL and greater (95% CI, 1.28—3.02).

Conclusions: This analysis provides needed population estimates describing mental health status among children living in NYC. There was a strong association between poverty and emotional and behavioral problems in children living in NYC.