PolicyLab

Mental Health Awareness Month offers an opportunity to reflect on the importance of our health and well-being—including for the littlest amongst us. The first five years of life are a critically important period of physical, social, cultural, and emotional development in the lives of children and their families that sets the foundation for young children’s future health, development, and well-being. Importantly, all events that occur in the child’s life at this early stage are likely to have a significant impact as they develop.

Over the last several decades, we have learned that social determinants of health—including where children and families live, work, and play—are crucial in understanding how contexts impact health, and in the case of incredibly young children, their development.

Additionally, the well-being of young children depends heavily on the mental and physical health of their parents and caregivers. Thus, it is crucial to prioritize the mental well-being of these adults and the environments in which children are nurtured to address the challenges impacting infants, toddlers and preschoolers.

Amid this landscape of supports and challenges for families with young children, the past 4 years have been particularly difficult for many families with the rise of the COVID-19 pandemic and simultaneous increasing national awareness and discussion of long-standing racial inequities. Racism is a known social determinant of health which affects the mental health and well-being of families, particularly pregnant and postpartum individuals and their children.

As we have continued to wrestle with the COVID-19 pandemic, there have been increased efforts to better understand the impacts of this global event with racialized components on communities that have historically lacked access, services, and care. Our team’s Prenatal to Preschool (P2P) study, described below, is one such example of a project that originated during the pandemic with the explicit goal to better understand how this global crisis differentially impacted the mental health of families in our Philadelphia community.

Prenatal to Preschool (P2P): How are we understanding the mental health of very young children and their families?

P2P evaluates the simultaneous effects of the pandemic, stressors, and multiple forms of racism on mothers and their developing children, providing important insight into risk and resilience factors in early development and the peripartum period.

In the context of a major U.S. city, Philadelphia, like many others, is marked by pronounced neighborhood disparities, such that our group found it imperative for public health and policy efforts to better understand how known inequities impact the mental well-being of the city's thousands of very young children and their families. We are doing this by examining cross-cultural differences and experiences faced by Black and non-Latinx White families.

Our team began talking to families participating in the study when they were pregnant at the very beginning of the pandemic when the world shut down in April 2020. Over the last four years, as our global and local experiences of the pandemic changed, caregivers have answered questions about their health and well-being, as well as that of their growing child’s, and their partners in child-rearing. Questions have covered topics including depression, anxiety, parenting stress, social supports, experiences of multiple forms of racism, their child’s development, and COVID-related worries.

Our initial findings underscore the importance of supporting families with very young children in a variety of ways and amongst unprecedented challenges.

We hope that this project will set the foundation for future work to continue fostering diversity and equity in research, along with promoting the well-being of children and families impacted by the pandemic.

As the P2P families continue to participate as their children turn four, we will be able to look at the past four years with an additional goal to create individualized, culturally informed preventative interventions for all families. We aim to ensure that the work we are doing joins the work of so many others in achieving mental health equity for all young children and their families in our region and across the nation.

Tiffany Tieu is a former clinical research assistant at PolicyLab.

Ayomide Popoola is a former clinical research assistant at PolicyLab.