Psychological Well-Being of Low-Income Mothers of One-Year-Olds during the COVID-19 Pandemic

Background and Purpose: The COVID-19 pandemic and the subsequent social restrictions created an unprecedented context for families raising young children. Prior research has documented detrimental effects of the pandemic on maternal psychological well-being, but little is known about how the pandemic specifically impacted the mental health of low-income mothers with young children. In this study, we examine self-reported measures of depression, anxiety, and sleep quality among low-income mothers of one-year-olds during the early phase of the pandemic when social distancing was at its peak in the United States.

Methods: We use survey data from the Age-1 wave of the Baby’s First Years study, collected between June 2019 and June 2020. The Baby’s First Years study is a randomized controlled trial of poverty reduction during early childhood. Launched in 2018, the study recruited 1,000 low-income mothers after they gave birth in hospitals in four metropolitan areas. Mothers were randomized to receive either a large ($333) monthly cash gift or a nominal ($20) monthly cash gift. Approximately one year after the child’s birth, 931 mothers completed the Age-1 survey.

The current study uses the control group (n=547) to estimate the associations between the COVID-19 pandemic and self-reported measures of depression, anxiety, and sleep quality. We compare mothers who were interviewed before March 14^th, 2020 (n=343) to mothers who were interviewed after March 14^th, 2020 (n=204) to determine whether the pandemic was associated with differences in maternal psychological well-being. We use three types of models to estimate associations: 1) bivariate OLS regression, 2) bivariate OLS regression with inverse-probability treatment weights, and 3) multivariate OLS regression controlling for baseline characteristics.

Results: Mothers who were interviewed during the pandemic reported lower rates of depression, fewer anxiety symptoms, and higher sleep quality compared to similar mothers interviewed before the pandemic (B=-1.15, p<0.01; B=-1.30, p<0.05; B=0.58; p<0.05; respectively). After controlling for differences in baseline characteristics using inverse-probability treatment weights and multivariate OLS regression, the pandemic continued to be associated with lower rates of depression and higher sleep quality; however, the association between the pandemic and maternal anxiety was no longer significant.

Conclusions and Implications: Inconsistent with most research on maternal mental health during the COVID-19 pandemic, we found that low-income mothers of one-year-olds reported significantly better mental health during the early phase of the pandemic. These surprising results may have important implications for understanding the unique circumstances of mothers who are raising young children while experiencing poverty. Although we cannot infer causality, it is possible that the social context of the pandemic temporarily ameliorated some of the complex life stressors this population disproportionately experiences. Prior research shows that mothers of young children are at an increased risk of experiencing mental health symptoms, and this risk is further elevated under the economic and social constraints of poverty. As we begin to enter a post-pandemic world, it is essential to design a social safety net and service delivery system that better supports maternal mental health for low-income and marginalized mothers.