Self-perceived mental health among Canadian adolescents and young adults with asthma: Insights from a national cross-sectional study

BACKGROUND: Asthma is a common chronic airway disease that often begins in adolescence and can persist into adulthood. While its physical health impacts are well documented, its broader psychosocial effects in youth remain underexplored. Emerging evidence suggests that females with asthma experience a greater mental-health burden than males, likely reflecting underlying biological and psychosocial differences. Few studies have examined the association using nationally representative data. OBJECTIVE: To examine the association between asthma and poor self-perceived mental health among Canadian adolescents and young adults (AYA). METHODS: We analyzed 20, 921 respondents aged 12-34 (drawn from 21,776 eligible participants) from the 2019-2020 Canadian Community Health Survey, a nationally representative cross-sectional survey. Descriptive analyses examined demographic, socioeconomic, behavioral, and health-related characteristics. Multivariable logistic regression models estimated adjusted odds ratios (aOR) for poor self-perceived mental health, controlling for key covariates. The interaction between asthma and sex was assessed on multiplicative and additive scales. RESULTS: Poor mental health was more prevalent among those with asthma than those without. Asthma was associated with increased odds of poor mental health (aOR 1.72; 95% CI: 1.32-2.27). Sex-stratified analyses indicated a significant association in females but not in males. Measures of additive interaction indicated a synergistic effect between asthma and female sex. CONCLUSIONS: Female adolescents and young adults with asthma have higher odds of reporting poor self-perceived mental health compared to those without asthma, an association not observed in their male counterparts. The findings underscore the importance of incorporating routine mental health screening into asthma care and developing targeted psychosocial interventions for young females.