Recent news headlines have been dominated by acute, serious issues surrounding the COVID-19 outbreak, issues that will likely impact another, long-simmering public health crisis afflicting our children: depression. Suicide is the second leading cause of death in teenagers. The prevalence of depression among U.S. teens has increased by a staggering 30% over the last decade. We are capable of and have no choice but to simultaneously address these public health crises.
Influences on mental health are complex, but there is growing evidence that nutrition and physical activity play a key role. We are beginning to understand that “diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology.” In adults, we have strong evidence that unhealthy diets are associated with depression and that eating a healthy diet filled with fresh fruits, vegetables, fish, and lean protein is associated with a reduced risk of depression. For children and teens, the burgeoning research has also found links between unhealthy diets and depression. Research shows that the healthier a child’s diet habits were, the fewer emotional and peer problems they experienced. We also now know that allowing our kids the time and space for physical activity and exercise can improve their mental health. For example, a recent study found that the increase in sedentary behavior throughout adolescence is associated with a greater risk of depressive symptoms in teens.
These two factors that play a key role in children’s ability to manage the current upheaval related to COVID and the stress it brings to their lives - access to healthful foods and ample physical activity - are cruelly in short supply. In New York City alone, it is estimated that 2 million people will face food insecurity as a result of the economic repercussions of this pandemic. Economic downturns themselves are associated with increased mental health problems for youth, thus only compounding the risks to children’s mental health during this time.
There is no single solution to reduce the risk of depression for children and teens, but nutrition and physical activity are two essential tools. So, how can we break down the silos of nutrition, exercise, and mental health to optimize children’s health during this acute crisis and for the long-term? Through robust and well supported programs that increase access to healthy food, educate children about nutrition and physical activity, and prioritize mental health. Over the past three months, community organizations have quickly joined forces to fill the void created by school closures and supply the most vulnerable children and their families with nutritious meals and access to mental health counseling. Organizations that previously focused on providing food and nutrition education to children, such as Children’s Aid and the Sylvia Center, have redeployed to provide direct food assistance during this critical time. While the focus now is on immediate food assistance, we cannot lose sight of the urgent need to reduce food insecurity for the long-term.
As with any public health crisis, funding is essential, and the nonprofits doing the work to fill the cracks in our broken system are not immune to the adverse economic ramifications of this pandemic. Reported losses for some of these organizations are nearing $1 million, putting their ability to continue operations at great risk. Continued government funding for these organizations is critical to protecting children’s physical and mental health in the short and long-term; there is no other investment that could pay greater dividends.
The average onset for anxiety is six years old and for mood disorders is thirteen years old. We already know what needs to be done to teach our children be resilient to the inevitable stresses of life and lead healthy lives, but we are not doing enough. The public health crisis of depression in our youth has only been exacerbated by COVID. New York needs to take a comprehensive approach to addressing children’s mental health. By investing immediately in nutrition education and food security programs, we can meet our children’s acute needs while staying vigilant in our efforts to reduce their risk of developing depression in the long-term. The time for prevention is now.
Lesley Kroupa is a former corporate lawyer turned Registered Dietitian and public health advocate. She is based in San Diego, California.