ECHO Study Suggests Negative Associations Between Chronic Conditions and Positive Health May Be Primarily Attributed to a Co-Occurrence of Depression

Author(s): Julia Schuchard, Courtney K. Blackwell, Jody M. Ganiban, Angelo P. Giardino, Monica McGrath, Phillip Sherlock, Dana M. Dabelea, Sean C. L. Deoni, Catherine Karr, Cindy T. McEvoy, Barron Patterson, Sara Santarossa, Sheela Sathyanarayana, Irene Tung, Christopher B. Forrest

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, the Office of the Director, and the National Institutes of Health.

What were the study results?

Of the 16 mental and physical health conditions included in this study, only depression showed a meaningful association with lower life satisfaction among children aged 8 to 17. Ninety-five percent of children with depression also had another chronic condition.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

The study results suggest that negative associations between chronic conditions and positive health may be primarily attributed to a co-occurrence of depression. The symptoms of physical and developmental health conditions may last for years, or even a lifetime. However, interventions like regular screening for depression, particularly among children with other health conditions, could help minimize the effects these conditions have on life satisfaction.

Why was this study needed?

Although medical science has primarily focused on the negative outcomes of chronic conditions, looking at the effect of these conditions on positive health is equally important to help children thrive. Pediatric positive health refers to children's assessments of their well-being. Understanding the relationship between different types of chronic conditions and positive health outcomes may help clinicians promote children’s well-being and adaptability to health challenges.

The ECHO Program provides opportunities to study positive health—one of its five outcome areas—in large, diverse samples of children.

Who was involved?

Participants in this study included 1,764 children aged 8 to 17 in 13 cohorts across the United States. Of these children, 45% were teenagers, 50% were girls, 8% were Latinx, and 23% were Black. Also, 54% of participating children had a chronic physical or mental health condition.

What happened during the study?

Children completed questionnaires about their own physical, mental, and social health and life satisfaction. Parents reported on their children’s chronic health conditions, including a variety of physical, developmental, and mental health conditions.

What happens next?

More research is needed to understand the potential impact of mental health interventions, such as increasing the availability of mental health assessments for children and adolescents.

Where can I learn more?

Access the full journal article, titled “Influences of chronic physical and mental health conditions on child and adolescent positive health,” in Academic Pediatrics.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published: February 1, 2022

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