Understanding Whether Economic Instability and Food Insecurity During COVID-19 Moderate the Change in Emotional Abuse and Emotional Neglect Over Time: A Longitudinal Pre- and During COVID-19 Analysis From China, Democratic Republic of Congo, Indonesia, and Malawi

Abstract

PurposeThis study explores whether economic instability or food insecurity moderates the changes in emotional abuse and neglect over time. MethodsWe used data from the Global Early Adolescent Study, a longitudinal study among adolescents ages 13–18 years (10–14 during pre–COVID-19 round) from poor urban communities in China (n = 387), the Democratic Republic of Congo (DRC) (n = 285), Indonesia (n = 400), and Malawi (n = 320). Data were collected before (2017 to March 2020) and during the pandemic (June to November 2020). Generalized estimating equations, using inverse probability weights evaluated changes in emotional abuse and neglect pre- and during COVID-19 and tested whether these changes varied by economic instability and food insecurity experiences during COVID-19. ResultsPre–COVID-19, emotional abuse ranged from 37.2% in DRC to 65.3% in Indonesia, and emotional neglect from 10.9% in DRC to 50.3% in Indonesia. The odds of emotional neglect increased in all sites during COVID-19 except Indonesia (adjusted odds ratio (aOR) ranging from 1.7 in China to 4.1 in Malawi). In Indonesia, odds of abuse and neglect decreased significantly during COVID-19 (aOR ranging from 0.4 to 0.7); however, emotional abuse and/or neglect declines was less pronounced for those who experienced economic instability and/or food insecurity. In Malawi, adolescents who experienced food insecurity had a significant increase in odds of emotional neglect during COVID-19. DiscussionThe COVID-19 pandemic exacerbated emotional neglect and emotional abuse among adolescents living in low- and middle-income countries, although this effect varies by place and population. In Malawi and Indonesia, adolescents who experienced economic instability and/or food insecurity had more unfavorable outcomes during COVID-19, highlighting the importance of social programs correcting inequities during pandemics.