Sex-specific estimates of positive mental health among youth before and during the COVID-19 pandemic in Canada.

Introduction: Positive mental health (PMH) is an essential component of mental health and well-being. While population-level data show a decrease in youth PMH during the COVID-19 pandemic, there are sex differences that have not been examined.

Methods: Data from the 2017, 2019 and 2021 Canadian Community Health Survey were used to examine youth (12-17 years) PMH before and during the COVID-19 pandemic. Sex-specific prevalence of high self-rated mental health (SRMH) and average life satisfaction (LS) for each year were calculated and disaggregated by sociodemographic characteristics. Differences between years were quantified, and statistical significance was determined using t tests (p value < 0.004 after Bonferroni correction).

Results: From 2019 to 2021, there were significant decreases in the prevalence of high SRMH (from 66.4% to 52.3%) and average LS (8.7 to 8.2) among female youth, at the overall level and across the majority of sociodemographic groups. As for males, no significant decreases were seen at the overall level. After disaggregation, a significant decrease in prevalence of high SRMH was observed from 2019 to 2021 among male youth living in Quebec and nonimmigrant male youth. There were no significant changes in the prevalence of high SRMH or average LS from 2017 to 2019. The sex-specific differences in PMH varied across sociodemographic characteristics.

Conclusion: The PMH of female youth appears to have been affected during the COVID-19 pandemic more than that of male youth. There were sex-specific differences in PMH across sociodemographic groups, suggesting that not all youth were equally affected. Ongoing surveillance with an intersectional lens is needed to better inform public health strategies.