Abstract
PURPOSE: In an effort to improve preparation for future pandemics, researchers continue to examine the myriad psychosocial pathways through which the COVID-19 pandemic impacted mental health. Moving beyond extant research on factors such as financial difficulties or social isolation, we present findings on two less documented pathways: (a) COVID illness and death within one's social network and (b) experiencing pandemic-related basic needs stressors, beyond financial difficulties, on the mental health of mothers and children in South Asia. METHODS: Data come from the 2021-2022 wave of the Bachpan birth cohort (6-year-old children, n = 814 mother-child dyads) in rural Pakistan. Multivariable regressions were used to estimate the association between COVID illness/death among family/friend/community members and basic needs stressors (e.g. difficulties with food, housing, medical care) with 4 outcomes: maternal anxiety (GAD-7) and depression symptoms (PHQ-9), and child emotional/behavioral problems (SDQ-TD) and anxiety (SCAS). RESULTS: Maternal mental health was independently predicted by illness within the mother's network and basic needs stressors, even after accounting for pre-pandemic socioeconomic status, depression, and pandemic-related financial stressors. Specifically, having a family member/friend who became ill was associated with 1.29 higher PHQ-9 scores (95% CI: 0.34, 2.24), compared to those who did not know anyone affected. Increased basic needs stressors were also associated with higher PHQ-9 and GAD-7 levels and children's behavioral/emotional problems and anxiety. Social network proximity to COVID illness/death was not associated with child mental health outcomes. CONCLUSION: These findings provide evidence of additional pathways through which prolonged global events, like the pandemic, can have multigenerational mental health impacts.