Demographic, nutritional, social and environmental predictors of learning skills and depression in 20,000 Indian adolescents: Findings from the UDAYA survey

OBJECTIVES: Adolescent wellbeing is critical to breaking the intergenerational cycle of poverty and one in five of the world’s adolescents live in India. We explored predictors of learning skills and depression in Indian adolescents. METHODS: Data on adolescents aged 10–19y (three groups: 5,840 unmarried males, 8,953 unmarried females, 4,933 married females) were available from the state-representative Understanding the Lives of Adolescents and Young Adults survey in Uttar Pradesh and Bihar. Multivariable logistic regression models adjusted for cluster sampling design and state fixed effects were used to examine factors (demographic, health/nutrition, social, and environmental) associated with three outcomes: reading proficiency, math proficiency, and depressive symptoms. FINDINGS: Learning skills were poor (28–61% lacked basic reading and math skills depending on adolescent group and outcome) and depression was common (8–26%). Better learning skills were predicted by greater household wealth (AOR 1.72–2.55 depending on group) and household head education (AOR 1.03–1.07 per year), being in school (AOR 4.19–18.65), parental support (AOR 1.11–1.39), having gender equal attitudes (AOR 1.56–2.67), number of food groups consumed at least weekly (unmarried females: AOR 1.11), and having an improved latrine (AOR 1.33–1.51). Poorer learning skills were predicted by family substance use (AOR 0.68–0.74), underweight (males: AOR 0.74), witnessing parental violence (AOR 0.66–0.78). Depressive symptoms were predicted by witnessing parental violence (AOR 1.51–1.92) and experiencing sexual abuse (AOR 2.30–6.16). CONCLUSION: Factors across multiple life dimensions are associated with learning skills and depression in Indian adolescents. Adolescent-focused policies and programs should consider health/nutrition, social, and environmental aspects of life in vulnerable individuals.