Prevalence of mental health problems among US youth has increased in recent years, and there is a dearth of epidemiological research at the state level that integrates risk and protective factors into population-based surveillance. We utilized the developmental assets framework to measure protective factors; we assessed (1) prevalence of depressive symptoms, high adverse childhood experiences (ACEs; ≥ 4 ACEs), and few developmental assets (≤ 2 assets) over time, and (2) associations among these three phenomena. Using 2016 and 2019 Minnesota Student Survey data, we utilized descriptive statistics, multivariable logistic regression, and post-estimation analyses (adjusting for school clustering and demographics). Using pooled data, we examined how high ACEs and few assets predicted depressive symptoms and we tested three-way interactions for high ACEs, few assets, and survey year. There were statistically significant increases in prevalence of depressive symptoms, high ACEs, and few assets between 2016 and 2019. High ACEs (AOR = 2.74; 95% CI = 2.61, 2.89) and few assets (AOR = 3.13; 95% CI = 3.00, 3.26) were positively related to depressive symptoms; interactions were statistically significant. Additive interactions showed that, compared to their counterparts, adolescents with high ACEs
and
few assets had the highest prevalence of depressive symptoms, and this group exhibited the largest increase in prevalence between 2016 and 2019. Depressive symptoms are highest among adolescents with high risk and few protective factors, and recent increases in the prevalence of depressive symptoms appear to have disproportionately occurred among these adolescents. We offer a potential roadmap for following the Centers for Disease Control and Prevention recommendations to integrate ACEs and protective factors into local public health efforts.
Supplementary Information
The online version contains supplementary material available at 10.1007/s42844-022-00052-2.
The Minnesota Department of Health (MDH) Safe Harbor Program promotes Love146’s Not a Number (NAN) human trafficking for youth. This collaboration reaches youth in a variety of settings through a multidirectional format that integrates issues familiar to young people while increasing their knowledge and skill for navigating situations where trafficking or exploitation is a risk or occurring. Safe Harbor prefers NAN’s curriculum because it is tailored to youth of all genders, is updated to reflect the lived experiences of youth, allows for cultural specificity, includes labor trafficking, and requires program fidelity. The partnership supports Minnesota’s public health, population-level strategies for preventing human trafficking and exploitation (sex and labor). NAN is also a means for responding to youth needs identified by the Minnesota Student Survey and other data to improve health, safety, and identification of protective factors.
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