Youth stress, happiness, and life satisfaction across morbidity status: a gender-stratified analysis

We investigated gender-stratified associations between morbidity status and psychosocial well-being (life stress, happiness, and satisfaction) in a nationally representative sample of Canadian youth. Data come from the Statistics Canada 2019 Canadian Health Survey on Children and Youth. The analytic sample comprised n = 13,580 youth aged 12–17 years. Morbidity status was categorized as: no morbidity (n = 5,208), physical illness (PI; n = 5,410) only, mental disorder (MD; n = 367) only, neurodevelopmental disorder (ND; n = 911) only, and multimorbidity (MM; ≥1 PI and ≥ 1 MD or ND; n = 1,684). Multinomial and linear regression models were stratified by youth gender (boys, girls) and adjusted for relevant sociodemographic characteristics. Youth were, on average, 14.4 years of age and 48.7% were girls. Youth with MD only or multimorbidity reported the highest levels of stress and lowest levels of happiness and life satisfaction (p < 0.01 for all). For boys and girls, MD only and MM were consistently associated with higher life stress (boys: ORMD=5.1 [2.9, 9.0], ORMM=3.5 [2.6, 4.7]; girls: ORMD=5.9 [3.3, 10.3], ORMM=5.9 [4.3, 8.0]), lower happiness (boys: ORMD=5.0 [2.6, 9.6], ORMM=4.9 [3.4, 7.3]; girls: ORMD=5.5 [3.4, 9.1], ORMM=7.0 [5.0, 9.7]), and lower life satisfaction (boys: βMD=-0.7 [-1.0, -0.4], βMM=-0.6 [-0.8, -0.4]; girls: βMD=-0.9 [-1.2, -0.6], βMM=-1.0 [-1.2, -0.8]). Few significant differences in estimates of association between boys and girls were found. Youth with MD only or MM experience compromised psychosocial well-being, which may be more pronounced among girls. Findings underscore the need for holistic health services to address the intersecting challenges faced by these vulnerable youth.