Contextualizing the Indirect Consequences of COVID-19 on Families and Youth Experiencing Structural Marginalization for Future Pandemic Preparedness: A POPCORN Qualitative Study
1
Faculty of Medicine, University of British Columbia, Vancouver, Canada
2
BC Children’s Hospital Research Institute, BC Children's Hospital, Vancouver, Canada
3
Department of Pediatrics, University of British Columbia, Vancouver, Canada
4
Social Pediatrics Program, BC Children's Hospital, Vancouver, Canada
5
CHU Sainte-Justine, Montréal, Canada
6
Department of Global and Public Health, McGill University, Montréal, Canada
7
Department of Pediatrics, McGill University, Montréal, Canada
8
Department of Pediatrics, McMaster University, Hamilton, Canada
9
School of Public Health, Université de Montréal, Montréal, Canada
10
Department of Microbiology, infectious Diseases, and Immunology, Université de Montréal, Montréal, Canada
11
Department of Pediatrics, Université de Montréal, Montréal, Canada
12
Multiple Institutions, Country-wide, Canada
Popul. Med. 2026;8(Supplement Supplement 1):A3153
ABSTRACT
INTRODUCTION:
Beyond direct health impacts of COVID-19, public health measures had indirect consequences for children and families1,2. Quantitative data suggest associations with poorer mental health but are limited as to why3-8. Few investigations have focused on equity-seeking groups despite disproportionate pandemic-related impacts on these communities9,10. The objective of this qualitative study was to understand how pandemic-response measures contributed to mental health experiences of youth and families experiencing structural-marginalization, for future pandemic preparedness.
METHODS:
Youth 12-24 years old and caregivers aged 19+ were recruited from an inner-city clinic in Vancouver, Canada that preferentially serves families experiencing intersecting forms of structural marginalization. Following informed consent, participants completed a semi-structured interview and demographic questionnaire. Interviews were transcribed and analyzed using reflexive thematic analysis. To improve appropriateness and validity, an existing Community Guidance Circle supported interview guide creation and results interpretation.
RESULTS:
Twenty-three interviews were conducted with n=10 youth (15±3 years) and n=13 caregivers (38±13 years). Youth identified with diverse gender identities; caregivers were primarily cis-gender women. Over three-quarters of participants reported at least one chronic health condition/disability, almost half identified as Indigenous, and one quarter were born outside Canada. Personal and social assistance accounted for most income sources. Social isolation, social media and virtual schooling with limited resources contributed to declining youth mental health, whereas positive relationships with adult mentors and online communities were described as supportive. Misinformation, inconsistent financial aid, and inaccessible community supports contributed to increased caregiver stress, family conflict and poorer caregiver mental health, including persistent anxiety, paranoia and depressive symptoms.
CONCLUSIONS:
These indirect impacts of COVID-19 highlight the importance of accessible health information and strengthening social connectedness to mitigate unintended consequences of necessary public health measures. These findings contribute to a much-needed body of literature that centres diverse perspectives to inform equitable public health decisions and future pandemic preparedness.
Beyond direct health impacts of COVID-19, public health measures had indirect consequences for children and families1,2. Quantitative data suggest associations with poorer mental health but are limited as to why3-8. Few investigations have focused on equity-seeking groups despite disproportionate pandemic-related impacts on these communities9,10. The objective of this qualitative study was to understand how pandemic-response measures contributed to mental health experiences of youth and families experiencing structural-marginalization, for future pandemic preparedness.
METHODS:
Youth 12-24 years old and caregivers aged 19+ were recruited from an inner-city clinic in Vancouver, Canada that preferentially serves families experiencing intersecting forms of structural marginalization. Following informed consent, participants completed a semi-structured interview and demographic questionnaire. Interviews were transcribed and analyzed using reflexive thematic analysis. To improve appropriateness and validity, an existing Community Guidance Circle supported interview guide creation and results interpretation.
RESULTS:
Twenty-three interviews were conducted with n=10 youth (15±3 years) and n=13 caregivers (38±13 years). Youth identified with diverse gender identities; caregivers were primarily cis-gender women. Over three-quarters of participants reported at least one chronic health condition/disability, almost half identified as Indigenous, and one quarter were born outside Canada. Personal and social assistance accounted for most income sources. Social isolation, social media and virtual schooling with limited resources contributed to declining youth mental health, whereas positive relationships with adult mentors and online communities were described as supportive. Misinformation, inconsistent financial aid, and inaccessible community supports contributed to increased caregiver stress, family conflict and poorer caregiver mental health, including persistent anxiety, paranoia and depressive symptoms.
CONCLUSIONS:
These indirect impacts of COVID-19 highlight the importance of accessible health information and strengthening social connectedness to mitigate unintended consequences of necessary public health measures. These findings contribute to a much-needed body of literature that centres diverse perspectives to inform equitable public health decisions and future pandemic preparedness.
| eISSN: | 2654-1459 |
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