eMethods. Study Variables Developed from 2019-2020 National Survey of Children’s Health (NSCH)
Data Sharing Statement
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Lanza K, Hunt ET, Mantey DS, Omega-Njemnobi O, Cristol B, Kelder SH. Volunteering, Health, and Well-being of Children and Adolescents in the United States. JAMA Netw Open. 2023;6(5):e2315980. doi:10.1001/jamanetworkopen.2023.15980
The positive effects of volunteering (ie, undertaking unpaid work to benefit others) on the health and well-being of adult volunteers are well-established.1,2 However, the effect of volunteering on youths is largely unknown, with 2 studies of limited samples of adolescent volunteers finding volunteering to reduce cardiovascular risk factors3 and to positively associate with school engagement.4 Herein, we assessed the association between volunteering and the health and well-being of children and adolescents across the United States.
This cross-sectional study’s data originated from the publicly available 2019 to 2020 National Survey of Children’s Health.5 Data were adjusted and weighted to reflect the demographic composition of youths in each state. We used parent-reported survey data for children aged 6 to 11 years (n = 22 126) and adolescents aged 12 to 17 years (n = 29 769). Institutional review board approval and informed consent were not required because we did not merge and/or enhance the data set such that individuals might be identified. This study followed the STROBE reporting guideline.
Parents answered whether, during the past 12 months, their child or adolescent participated in community service or volunteer work at school, church, or in the community. The study had 5 parent-reported, dichotomous outcomes: (1) excellent and/or very good health, (2) flourishing, (3) anxiety, (4) depression, and (5) behavioral problems (eMethods in Supplement 1). We specified logit regression (n = 15 models) in Stata version 16 (StataCorp) to test the association between volunteering and the 5 outcomes for children, adolescents, and the total sample. Significance was set at a 2-sided P < .05. Statistical analysis was performed from March to April 2022. Models were adjusted for sex, race and ethnicity, household income, parental religiosity, and urbanicity (eMethods in Supplement 1).6
Among the 51 895 youths included in the sample, 22 126 were children aged 6 to 11 years, 29 769 were adolescents aged 12 to 17 years, 26 863 (52%) were male, 3621 (7%) were Black, 6618 (13%) were Hispanic, and 35 021 (67%) were White; most youths in the study were above poverty level (88%), metropolitan (83%), in excellent or very good health (64%), flourishing (64%), and without behavioral problems (90%) (Table 1). More adolescents than children reported anxiety (19% vs 11%), depression (11% vs 3%), and volunteering (54% vs 34%). In modeling (Table 2), volunteering was associated with higher odds of parent-reported excellent or very good health in children (adjusted odds ratio [aOR], 1.25; 95% CI, 1.07-1.47; P = .006) and adolescents (aOR, 1.42; 95% CI, 1.24-1.63; P < .001). Volunteering was also associated with higher odds of flourishing in children (aOR, 1.35; 95% CI, 1.15-1.58; P < .001) and adolescents (aOR, 1.97; 95% CI, 1.72-2.26; P < .001). There was no association between volunteering and anxiety for children (aOR, 1.02; 95% CI, 0.81-1.28; P = .88), while volunteering was associated with lower odds of anxiety in adolescents (aOR, 0.74; 95% CI, 0.61-0.88; P = .001). There was no association between volunteering and depression for children (aOR, 0.74; 95% CI, 0.48-1.15; P = .18) and adolescents (aOR,0.78; 95% CI, 0.60-1.01; P = .06). Volunteering was associated with lower odds of behavioral problems in children (aOR, 0.64; 95% CI, 0.51-0.79; P < .001) and adolescents (aOR, 0.67; 95% CI, 0.54-0.83; P < .001).
Using survey data from across the United States, we found that volunteering was associated with higher odds of excellent or very good health and flourishing in children and adolescents, and with lower odds of anxiety in adolescents and behavioral problems in children and adolescents. Study limitations included lack of a diverse sample, potential response bias from parent-reported data, and the cross-sectional design not permitting determination of causality.
This study’s findings are encouraging of further investigation to assess causality, which if revealed, may provide opportunity for prescribing volunteering as a public health intervention. Furthermore, with volunteering in adolescence having been found to be associated with decreases in risky health behaviors and depressive symptoms in adulthood,6 youths who help others may be helping themselves now and later.
Accepted for Publication: April 17, 2023.
Published: May 30, 2023. doi:10.1001/jamanetworkopen.2023.15980
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2023 Lanza K et al. JAMA Network Open.
Corresponding Author: Kevin Lanza, PhD, University of Texas Health Science Center at Houston, School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, 1616 Guadalupe St, Ste 6.300, Austin, TX 78701 (email@example.com).
Author Contributions: Drs Lanza and Hunt had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Lanza, Hunt, Mantey, Omega-Njemnobi.
Acquisition, analysis, or interpretation of data: Lanza, Hunt, Cristol, Kelder.
Drafting of the manuscript: Lanza, Hunt.
Critical revision of the manuscript for important intellectual content: Lanza, Mantey, Omega-Njemnobi, Cristol, Kelder.
Statistical analysis: Lanza, Hunt, Mantey.
Administrative, technical, or material support: Omega-Njemnobi, Cristol.
Conflict of Interest Disclosures: None reported.
Data Sharing Statement: See Supplement 2.