187 - Mobilizing For the Future? Civic Engagement as a Driver of Health in Households With and Without Children

Publication Number: 187.5794

Jennifer J. Lee, Johns Hopkins University, Baltimore, MD, United States; Amienne Spencer-Blume, Johns Hopkins University, Baltimore, MD, United States; Sara B. Johnson, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Eliana M. Perrin, Johns Hopkins University Schools of Medicine, Nursing, and Public Health, Baltimore, MD, United States; Andrew J. Perrin, Johns Hopkins University, Baltimore, MD, United States; Adam Sheingate, Johns Hopkins University, Baltimore, MD, United States; Michael D.M. Bader, Johns Hopkins University, Baltimore, MD, United States

Background: Civic engagement, including voting, community service, and collective action, has been proposed as a social driver of health (SDoH). Parent/caregiver civic engagement is an important predictor of children’s civic engagement. Through civic engagement, caregivers can advocate for social policies that benefit their children. However, little is known about caregiver civic engagement or its implications for physical and mental health.

Objective: To examine the relationship between civic engagement and health in caregivers vs. non-caregivers. We hypothesized that civic engagement would be related to better physical and mental health, with larger effect sizes among caregivers.

Design/Methods: The 2023 Baltimore Area Survey was a mail survey of a representative sample of 1,352 adults in Baltimore City and Baltimore County, MD. “Caregivers” were those with children < 18 in the household. Civic engagement was assessed with a measure from the Cooperative Election Survey. Respondents reported past-year involvement in activities such as volunteering, voting, or donating blood. Responses were summed; higher scores indicated more engagement (range:0-8). Self-rated physical and mental health were rated on a 5-point scale from poor to excellent. The Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 item (GAD-2) assessed depression and anxiety in the last 2 weeks, respectively. Each ranged from 0-6, with scores of 3+ indicating risk for disorder. Population-weighted multivariable linear and logistic regression models estimated the relationship of civic engagement and health outcomes, accounting for linear and quadratic age, gender, education, race/ethnicity (as a proxy for racialized experience), and county. Models were stratified by caregiving.

Results: We found no significant difference in civic engagement between caregivers and non-caregivers (Table 1). Contrary to our expectations, among non-caregivers, civic engagement was related to better self-rated physical and mental health, and lower depression risk after accounting for covariates, whereas civic engagement was unrelated to any health outcome for caregivers (Table 2).

Conclusion(s): In this sample of Baltimore City and County, civic engagement was related to health only for adults without children. Since lack of civic participation can undermine the transmission of civic engagement to the next generation and suppress critical efforts to advance child-focused policies, further research in larger samples should assess these relationships and determine why civic engagement was unrelated to health in caregivers.

Table 1: Characteristics of the overall study population and households with and without children in the Baltimore Area Survey
Table 1_demographics.pdf

Table 2: Cross-sectional relationship between civic engagement and health outcomes in the Baltimore Area Survey among caregivers and non-caregivers
Table 2_civeng+health.pdf