Abstract
This cross-sectional study examines whether there is an association between volunteering and well-being among children and adolescents across the United States.
Introduction
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.
Methods
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
Results
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).
Table 1. Summary Statistics for Children, Adolescents, and Total Sample.
| Model variable | No. (%) | ||
|---|---|---|---|
| Children (aged 6-11 y) (n = 22 126) | Adolescents (aged 12-17 y) (n = 29 769) | Total sample (aged 6-17 y) (N = 51 895) | |
| Sex | |||
| Female | 10 686 (48) | 14 346 (48) | 25 032 (48) |
| Male | 11 440 (52) | 15 423 (52) | 26 863 (52) |
| Race and ethnicity | |||
| Asian | 1162 (5) | 1591 (5) | 2753 (5) |
| Black | 1579 (7) | 2042 (7) | 3621 (7) |
| Hispanic | 2868 (13) | 3750 (13) | 6618 (13) |
| White | 14 682 (67) | 20 339 (68) | 35 021 (67) |
| Othera | 1835 (8) | 2047 (7) | 3882 (7) |
| Household income | |||
| Below federal poverty level | 2762 (12) | 3390 (11) | 6152 (12) |
| Parental religiosity | |||
| Support from place of worship/religious leader | 4857 (23) | 7006 (24) | 11 863 (23) |
| Urbanicity | |||
| Metropolitan statistical area | 13 036 (84) | 17 364 (83) | 30 400 (83) |
| Health | |||
| Excellent/very good health | 14 829 (67) | 18 552 (62) | 33 381 (64) |
| Flourishing | 13 759 (63) | 19 006 (64) | 32 765 (64) |
| Anxiety | 2372 (11) | 5476 (19) | 7848 (15) |
| Depression | 573 (3) | 3200 (11) | 3773 (7) |
| Behavioral problems | 2457 (11) | 2865 (10) | 5322 (10) |
| Volunteering | |||
| Participation in community service/volunteer work | 7453 (34) | 15 739 (54) | 23 192 (46) |
Other race and ethnicity categories included American Indian and Alaska Native, Native Hawaiian and Pacific Islander, and multiracial.
Table 2. Adjusted Regression Models Examining Odds of Excellent or Very Good Health, Flourishing, Anxiety, Depression, and Behavioral Problems Given History of Volunteeringa.
| Model outcome | Children (ages 6-11 y) | Adolescents (ages 12-17 y) | Total sample (ages 6-17 y) | |||
|---|---|---|---|---|---|---|
| aOR (95% CI) | P value | aOR (95% CI) | P value | aOR (95% CI) | P value | |
| Excellent or very good health | 1.25 (1.07-1.47) | .006 | 1.42 (1.24-1.63) | <.001 | 1.34 (1.21-1.49) | <.001 |
| Flourishing | 1.35 (1.15-1.58) | <.001 | 1.97 (1.72-2.26) | <.001 | 1.66 (1.50-1.84) | <.001 |
| Anxiety | 1.02 (0.81-1.28) | .88 | 0.74 (0.61-0.88) | .001 | 0.82 (0.71-0.95) | .01 |
| Depression | 0.74 (0.48-1.15) | .18 | 0.78 (0.60-1.01) | .06 | 0.78 (0.62-0.98) | .03 |
| Behavioral problems | 0.64 (0.51-0.79) | <.001 | 0.67 (0.54-0.83) | <.001 | 0.65 (0.56-0.76) | <.001 |
Abbreviation: aOR, adjusted odds ratio.
Independent variable of interest: participation in community service or volunteer work during the past 12 months. All models adjusted for sex, race and ethnicity, household income, parental religiosity, urbanicity (not shown). All variables were dichotomous.
Discussion
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.
eMethods. Study Variables Developed from 2019-2020 National Survey of Children’s Health (NSCH)
Data Sharing Statement
References
- 1.Burr JA, Mutchler JE, Han SH. Volunteering and Health in Later Life. Handbook of Aging and the Social Sciences. Elsevier; 2021:303-319. doi: 10.1016/B978-0-12-815970-5.00019-X [DOI] [Google Scholar]
- 2.Jenkinson CE, Dickens AP, Jones K, et al. Is volunteering a public health intervention? a systematic review and meta-analysis of the health and survival of volunteers. BMC Public Health. 2013;13(1):773. doi: 10.1186/1471-2458-13-773 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Schreier HM, Schonert-Reichl KA, Chen E. Effect of volunteering on risk factors for cardiovascular disease in adolescents: a randomized controlled trial. JAMA Pediatr. 2013;167(4):327-332. doi: 10.1001/jamapediatrics.2013.1100 [DOI] [PubMed] [Google Scholar]
- 4.Bang H, Won D, Park S. School engagement, self-esteem, and depression of adolescents: the role of sport participation and volunteering activity and gender differences. Child Youth Serv Rev. 2020;113:105012. doi: 10.1016/j.childyouth.2020.105012 [DOI] [Google Scholar]
- 5.Child and Adolescent Health Measurement Initiative . Combined 2019–2020 National Survey of Children’s Health (NSCH). Data Resource Center for Child and Adolescent Health supported by Cooperative Agreement U59MC27866 from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Accessed March 1, 2022. http://www.childhealthdata.org
- 6.Ballard PJ, Hoyt LT, Pachucki MC. Impacts of adolescent and young adult civic engagement on health and socioeconomic status in adulthood. Child Dev. 2019;90(4):1138-1154. doi: 10.1111/cdev.12998 [DOI] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
eMethods. Study Variables Developed from 2019-2020 National Survey of Children’s Health (NSCH)
Data Sharing Statement