JAMA Netw Open. 2026 Apr 1;9(4):e264922. doi: 10.1001/jamanetworkopen.2026.4922.
ABSTRACT
IMPORTANCE: Extreme weather disasters leave behind long-lasting mental and physical health problems. Displacement related to climate change disproportionately impacts children, whose developmental stage leaves them particularly at risk to its devastating effects.
OBJECTIVE: To compare pediatric mental health needs and care for those in need between displaced households and other households.
DESIGN, SETTING, AND PARTICIPANTS: This repeated cross-sectional analysis with multivariable logistic regression models used data from the US Census Household Pulse Survey, a nationally representative dataset, from June 1, 2023, through September 31, 2024. The study included biweekly, individual-level data reported by individual adults for all members of their household.
EXPOSURE: Experience of displacement in the past year due to a natural disaster.
MAIN OUTCOMES AND MEASURES: Mental health needs were defined based on response to a question asking whether any children in the household needed mental health treatment, such as counseling or medication, in the past 4 weeks. Then the likelihood of receiving mental health treatment was examined for those who reported mental health needs.
RESULTS: Of the 324 466 households with children identified during the study period, 277 081 respondents (mean [SD) age, 42.7 [0.05) years; 162 288 [58.6%] female) were included in the analytic sample. This sample represents approximately 35 million US households with children. Among households with children, those that experienced displacement due to natural disaster had a significantly higher chance of reporting that the children needed mental health counseling or medication (odds ratio, 1.29; 95% CI, 1.12-1.48; P < .001). Among households with reported pediatric mental health needs, displaced households were more likely to report inadequate or no treatment, even after controlling for socioeconomic hardships (odds ratio, 0.55; 95% CI, 0.38-0.66; P < .001).
CONCLUSIONS AND RELEVANCE: The cross-sectional study found that displaced children experience more unmet mental health needs after natural disasters compared with nondisplaced children, which may negatively impact their long-term development. As climate change progresses, targeted research is urgently needed to understand how best to meet these needs.
PMID:41979880 | DOI:10.1001/jamanetworkopen.2026.4922
