Due to the COVID-19 pandemic, Chicago youth have dealt with new mental and physical health challenges over the past 18 months. Children and adolescents in Chicago continue to face many health challenges that existed before the pandemic, and that may be worsened by the pandemic. To learn what health issues besides COVID-19 Chicago adults were most concerned about for youth in the city, we teamed up with the Chicago Department of Public Health (CDPH) on the 2020 Healthy Chicago Survey, Jr. We asked adults from all 77 community areas in Chicago which non-COVID-19-related health problems they considered to be “big problems” for all children and adolescents in Chicago — not just for their own kids.
In this report, we share the top 10 health problems facing youth in Chicago identified by Chicago adults.
Drug use, tobacco and e-cigarettes (e.g., vaping), and stress were the top health problems facing Chicago youth identified by Chicago adults.
Mental health issues represented many of the top concerns for youth, similar to findings in 2018 and 2019.
Women and men had similar rankings for the top 10 problems, but overall, women were more likely to be concerned about each issue than men.
Drug use was the top non-COVID-19 health concern identified for Chicago youth this year. Both parents and non-parents were similarly likely to consider this a big problem (65% of both groups considered drug use a problem). Adults with a household income below the federal poverty level (FPL; the FPL is $26,500 for a family of four in 2021) and those with middle income (100–399% FPL) were more likely to consider drug use a big problem than adults with high household income (400% FPL) (69–71% vs. 53%). Women (71%) were also more likely to consider this a big problem compared with men (59%).
The 2019 Youth Risk Behavior Survey found that in Chicago, 27% of 9th grade students, 30% of 10th grade students, 37% of 11th grade students and 24% of 12th grade students reported being offered, sold or given an illegal drug on school property. Results from the 2020 Monitoring the Future Study showed that marijuana use among youth remained at similar levels during the pandemic compared with before, even though youth reported lower access to marijuana during the pandemic.
The second most frequent health concern was tobacco and e-cigarettes. White adults were less likely to consider this a big problem (55%) compared to adults of all other races/ethnicities (67–71%). Adults with lower household income were more likely to consider this a big problem (67–68%) than adults with high household income (57%).
Although rates of vaping declined among adolescents during the pandemic1, vaping-related lung disease was a major concern before the pandemic and this may contribute to increased concern about tobacco and e-cigarettes.
The Illinois Tobacco Quitline is a toll-free number to support those trying to quit smoking or tobacco use: 1-888-QUIT-YES (quityes.org). Individuals outside of Illinois can call the toll-free quitline operated by the National Cancer Institute: 1-800-QUIT-NOW.
Stress was the third most frequent health concern. Parents and non-parents were concerned about this issue to a similar degree (61% and 62%, respectively); however, women (67%) were more likely to be concerned about this issue compared with men (56%).
In a national survey, 43% of teens 13–17 years old said the level of stress in their life increased over the last year, 51% said the pandemic makes planning for their future feel impossible and 81% said they have been negatively impacted by school closures. As many students return to in-person learning this fall, parents and educators can work together to help students adjust to in-person learning again and help students find extra support if needed.
Depression was number four on the list of top health concerns. Younger adults (18–29 years old, 66%) were more likely to consider this a big problem for youth compared to older adults (45 years or older, 57%). Women (67%) were also more likely to consider this a big problem than men (55%).
Even before the COVID-19 pandemic, the rate of hospitalizations for mood and depressive disorders among 5–14-year-olds in Chicago increased from 26 per 10,000 in 2000 to 61 per 10,000 in 2017; the COVID-19 pandemic has further strained youth mental health and the pediatric mental health care system across the United States.
The critical role that schools play in delivering mental healthcare services was emphasized in a recent study that found that among all adolescents who used any mental health services from 2012 to 2015, 58% received some school-based mental health services with 35% of adolescents receiving mental health support exclusively in a school setting. School closures and remote learning also affected the mode of access to school-based mental healthcare.
Child abuse and neglect was the fifth top youth health problem concern. Women (64%) were more concerned about this compared with men (56%). Adults with middle income were also more likely to be concerned about this (65%) than adults with high income (55%).
In FY20, there were 39,027 child victims of abuse or neglect in Illinois, compared with 36,354 in FY19. In FY21, which ended on June 30, 2021, there were 35,122 child victims in Illinois, although there are still cases pending investigation.
Call the Child Helpline at 1.800.422.4453 to report a suspected case of child abuse and neglect.
The sixth most commonly-identified health problem for kids in Chicago was suicide. Young adults were more likely to consider this a big problem (63%) compared with older adults (52%), and women were more likely (63%) to be concerned about this compared with men (50%). This supports the idea that overall, women and younger adults tend to be more concerned about mental health issues compared with men and older adults. Additionally, less than half of white adults considered this a big problem (48%) compared with 61% of Black adults and 64% of Latinx adults.
Suicide and other mental health concerns may be worsened by the pandemic. The mental health consequences of the COVID-19 pandemic may persist for months and years to come. Youth who are at disproportionately high risk for suicidal ideation, suicide, self-harming behavior and depression include LGBTQ, maltreated, runaway and unhoused youth. The Illinois Department of Public Health lists warning signs for suicide, including withdrawing from friends, family and society and experiencing dramatic mood changes.
Call the National Suicide Prevention Lifeline at 1.800.273.8255 for 24/7 help available to anyone facing emotional distress or experiencing suicidal crisis.
Childhood obesity was the seventh most common health concern for Chicago youth. Latinx adults were more likely to consider this a big problem (62%) than white adults (53%). In a previous report, we found that children were spending less time outside (73%) and had less physical activity (50%) during the COVID-19 pandemic than before.9 We also noted that 26% of children were eating more than before the pandemic. These trends are a cause for concern for youth health issues such as childhood obesity.
Clinicians also have expressed concern that the COVID-19 pandemic has fueled a rise in disordered eating among youth, including binge eating disorder. Due to the changed circumstances, youth are at a high risk of forming new or maintaining disordered eating behaviors, especially with lack of exercise from staying at home. This could potentially contribute to prevalence in obesity in youth.
The eighth top health problem was teen pregnancy. Concerns regarding teen pregnancy varied significantly by race and ethnicity. Black adults were most likely to be concerned about this issue (63%), followed by Latinx adults and Asian/other adults (51% and 50%, respectively), and lastly white adults (33%). Parents were more likely to consider this a big problem (56%) compared with non-parents (47%).
Teen birth rates in Chicago have been decreasing over the past two decades. In 2000 there were 7,958 teen births in the city compared with 1,963 in 2017.
Alcohol use was listed as the ninth top problem for Chicago youth. Adults who were in worse health themselves were more likely to consider this a big problem (60%) compared with adults who were in better health (44%). Older adults (45 years +) were more likely to consider this a big problem (52%) than younger adults (18-29 years, 40%). Parents were more likely to consider this a big problem (53%) than non-parents (44%).
The CDC’s 2019 Chicago Youth Risk Behavior Survey found that for adolescents in grades nine through 12, 17% had their first alcoholic drink before age 13, 26% currently drank one or more alcoholic drinks at least one day within 30 days of taking the survey, and 39% indicated that they usually obtained the alcohol they drank by someone giving it to them. Results from the 2020 Monitoring the Future Study showed that binge drinking among youth remained at similar levels during the pandemic compared with before.
The tenth most common health concern that adults identified for youth in Chicago was unintentional injuries. Women were more likely (45%) to be concerned about this compared to men (32%). Adults with low and middle household income were more concerned about this issue (47% and 41%, respectively) compared with adults with high household income (26%).
To reduce unintentional injuries for children, parents can learn about safe car seat and booster seat practices, prevent falls by ensuring windows are only open a maximum of four inches, and require that their children wear helmets for activities such as riding bikes and roller skating.