Linking social determinants of health to mental health, movement behaviors, and cognitive function among US youth

Background: Few studies have focused on a comprehensive view of social determinants of health (SDOH) domains as influences on the health of young people. This study aimed to investigate the associations between the Healthy people 2030 SDOH-related domains (i.e., economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context) with mental health, movement behaviors, and cognitive function among U.S. youth. Methods: This cross-sectional study used nationally representative data from the 2020-2021 National Survey of Children's Health, covering 54,595 youth aged 6-17 years. The associations of indicators of SDOH-related domains with mental health (depression and anxiety), movement behaviors (physical activity and screen-based sedentary behavior), and cognitive function were estimated using multivariable logistic regression models, adjusting for age, sex, and race. Results: Economic stability, education access and quality, health care access and quality, and social and community context were associated with at least one outcome measure of mental health, movement behaviors, and cognitive function, while neighborhood and built environment was associated with mental health and movement behaviors. The social and community context domain stood out, with friendship difficulty and household-based adverse childhood experiences being associated with poorer outcomes on most health indicators. Conclusion: All five SDOH-related domains are related to aspects of youth health, with the social and community context domain showing the most associations, highlighting the need for interventions to improve social connection and address adverse childhood experiences, which may be more impactful in ameliorating many health-related challenges.