Residence with a Person Who Used Substances and Childhood Anxiety and Depression: A Cross-Sectional Analysis of the 2019 National Health Interview Survey

Background: Children who live with a parent with a substance use disorder (SUD) are more likely to experience adverse health outcomes, including mental health disorders. We assessed whether residing with anyone who used substances was associated with children's anxiety and/or depression, and whether these associations differed by the children's age or sex. Methods: We analyzed nationally representative cross-sectional data from the 2019 National Health Interview Survey (n = 6642). The associations between ever residing with someone who used substances and caregiver-reported children's anxiety and depression frequency (never/a few times a year/monthly/weekly/daily) were estimated using multinomial logistic regression models, adjusted for children's age, children's sex, children's race/ethnicity, annual household income, and highest educational attainment by an adult in the household. We assessed whether the associations differed based on the children's age (5-11/12-17 years) or sex. Results: Children who had resided with someone who used substances were more likely to be reported by their caregiver as having daily anxiety (risk ratio (RR) = 2.84; 95% confidence interval (CI) = 2.04, 3.95; referent = never anxious) and daily depression (RR = 3.35; 95% CI = 1.98, 5.67; referent = never depressed). Associations with more frequent anxiety were stronger among adolescents than younger children. Associations between residing with someone who used substances and depression frequency differed based on children's age and sex. Conclusions: Our results suggest that residing with someone who used substances is associated with children's anxiety and depression. Our findings can help inform screening and treatment efforts for anxiety and depression among children, as well as for the person using substances.