Factors Associated with Mental Health among Young Adults: Cross-Country Longitudinal Evidence from Ethiopia, India, and Peru

Abstract

This study investigates contingent and longitudinal predictors of mental health in early adulthood, using unique, harmonized panel data from the Young Lives study in Ethiopia, India, and Peru, spanning over two decades across diverse settings. It accounts for factors and events occurring during the most significant developmental stages, from infancy through childhood and adolescence. It focuses on self-reported symptoms of anxiety and depression, measured amid unprecedented turmoil, during and after the global COVID-19 pandemic and Ethiopia’s civil war. High rates of anxiety and depression were sustained over the whole period (2021-2024) in Peru, the country reporting the highest prevalence of mental health issues; they remained stable in India and showed post-conflict deterioration in Ethiopia. Original findings identify key life-stage predictors. In early life, poor caregiver’s mental health and higher household wealth are associated with increased adult anxiety, particularly in Peru. During adolescence, strong parent-child relationships and a sense of pride protect against adult anxiety, while academic performance shows weaker associations. In adulthood, neuroticism is a consistent risk factor across all countries, whereas grit is uniquely protective in India. Across all settings, experiences of violence and economic shocks are strong correlates of poor mental health. Significant sex disparities exist in Peru and India, where females report worse outcomes, yet no such gap was found in Ethiopia. These findings emphasize the need for gender-sensitive, context-specific mental health policies in low- and middle-income countries, highlighting the need to address risk factors throughout the life course to promote young people’s mental well-being.