Young in pandemic times: a scoping review of COVID-19 social impacts on youth

ABSTRACT This scoping review article concerns COVID-19 social impacts on youth between 15 and 24 years old. The article charts 108 scientific journal articles, published between 1 March 2020 and 1 November 2021, encompassing 27 different countries but primarily concerning the USA (30%) and Canada (12%). The reviewed studies tell the overall hardship of being young in pandemic times; they report collective experiences of isolation, constraint, loss of formative life moments, and reverberation of structural inequalities. But they also show that the pandemic is not just passively consumed by the youth of today; young people are likewise at the forefront of collective mitigation strategies and community support organizing. Based on these scoping review findings, the article concludes that further agency-oriented research on youth responses is vital for a deeper understanding of what it can mean to be young in pandemic times.


Introduction
What does it mean to be young in pandemic times? What social impacts of COVID-19 on youth have so far been documented? With the outbreak of the COVID-19 pandemic, researchers around the world immediately began documenting and analysing the situation's social effects. The scattered studies soon morphed into a fast-growing research field that swiftly produced a plethora of research in various areas and subfields. In this very particular context -an acceleration hitherto unfamiliar to the slow publication practice of the humanities and critical social sciences -literature reviews are helpful; they provide maps to orient ourselves, overview existing knowledge, and then venture further into uncharted territory.
The objective of this review article is to contribute to this mapping with particular attention to the pandemic's social impacts on youth. People between the age of 15 and 24 -the UN definition of Youthaccounts for 16% of the world's population (UN, 2021). In the borderlands between childhood and early adulthood, youth occupy a peculiar position of dependency on caregivers while developing independence as a route towards adulthood. Youth is, in other words, a social group located in a complex nexus of relations to parents and other family members, teachers and other adults, and peers of their age. While this dependable and interlinked sociality is arguably the fuel of the youth, it also means vulnerability to impaired physical or mental health , unequal outcomes of accelerated digitalization and youth unemployment (Lisney, 2021), and then also to the COVID-19 pandemic's manifold social impacts.
In this review article, I map and thematize the existing literature on youth and COVID-19 to chart what it has meant to be young in pandemic times. The article outlines the main findings of the hitherto international research on the COVID-19 pandemic's social impacts on youth, here organized into the themes of living conditions, lifestyles, mental health, and also the responses to these impacts. Whereas this particular branch of research has not yet been systematically overviewed, a few review studies have set out to synthesize the pandemic's psychological effects on children and adolescent populations. A systematic review of mental health among children in previous pandemics indicates that people living in families are particularly exposed to psychological distress since negative emotions tend to affect all family members (Lateef et al., 2021). With regards to COVID-19, a systematic review performed early on in the pandemic demonstrates that adolescents ≤ 18 years old have suffered from depression and anxiety during the societal lockdowns (Nearchou et al., 2020). These psychological impacts have more recently been verified by a systematic review of mental health outcomes for people ≤ 19 years old (Samji et al., 2021), and by a review study of impacts on young adults, aged 18-30, which also synthesized documented experiences of depression, anxiety, and an overall decrease in psychological wellbeing (Cielo et al., 2021).
Yet these systematic reviews do not address the liminal coming of age -youth between 15 and 24 years old -and they focus on psychological conditions rather than accounting for the broader range of social impacts arising in the wake of the pandemic. The aim of my literature review is to address that sociological lacuna; I set out to overview how the COVID-19 pandemic has impacted the living conditions, lifestyles, as well as mental health of youth, and I also scope some of the responses from youth on these social impacts. Before I elaborate upon these themes, I present the method used to identify, select, and analyse the existing literature.

The scoping review
Scoping review is a method that combines the transparent rigour of the systematic review and quantitative meta-analysis with the thematic foci and qualitative appraisal offered by the narrative review (Arksey & O'Malley, 2005, p. 20;Booth et al., 2016, pp. 17-29). It has become an increasingly used method to systematically map and thematize available research on a given topic (Munn et al., 2018, p. 2;Sargeant & O'Connor, 2020, pp. 2, 6). For optimized reliability and replicability, scoping reviews are typically performed by a team of researchers to compare and validate the parallel work procedures of each reviewer (Levac et al., 2010, pp. 5-6;Peters et al., 2015, p. 142). When time and resources prohibit a cooperative scenario (Arksey & O'Malley, 2005, pp. 29-31), a scoping review can also be performed single-handedly if it entails methodological transparency that would enable others to assess the analysis (cf., Bastian, 2014). My way to enhance transparency is to follow the PRISMA guidelines for systematic scoping reviews. The standards of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) are most commonly used to synthesize quantitative studies within the medical disciplines, but social scientists have increasingly come to follow these guidelines of methodological compatibility and enhanced transparency (A. C. Tricco et al., 2016). Based on the latest updated guidelines, (Page, Mckenzie et al., 2021;, along with the PRISMA extension for scoping reviews (A. Tricco et al., 2018), I here present my eligibility criteria, database searches, selection process, and analysis.
The eligibility criteria for inclusion stemmed from reviewing scientific publications concerning the social impacts of the COVID-19 pandemic on youth. As research took off after WHO's official recognition of the COVID-19 virus transmission as a pandemic (WHO, 2020), my performed database searches included publications between 1 March 2020 and 1 November 2021, to finalize the review and analysis in the ensuing month.
Another eligibility criterion was that of science, which meant that I only included peer-reviewed, primary research published in the form of journal articles, books, or book chapters. I excluded editorial introductions to special issues, reports from panel discussions and conferences, articles published as commentaries/debates, and texts based solely on secondary literature. I also excluded mere methodological articles and evaluations of different therapeutic, social work, or public health interventions. As I wanted to review studies that specifically engaged with the social conditions of the COVID-19 pandemic, I excluded studies that merely used the pandemic as an episodic backdrop, that is, when this particular social situation was not the primary contextual focus of the investigation, or when the period of the empirical study predated the pandemic outbreak.
The perhaps most important eligibility criterion was that of social impacts. This social focus led me to exclude studies in the broader fields of medicine and epidemiology: investigations about the actual virus, its spreading, and its physical consequences. Studies in the academic disciplines of psychiatry and psychology were included since these mental health symptoms arguably entangle with the pandemic living conditions and changed lifestyle patterns of youth. Another scientific genre I had to exclude, to meet my eligibility criterion of social impacts, was intervention studies: research reports on mitigation strategies, vaccination schemes, clinical interventions, social work approaches, sports activities, and policy measures.
Finally, my scoping review only included studies with a primary focus on youth. Here I subscribed to the statistical category used by the United Nations, which classifies youth as people between the age of 15 and 24 years (UN, 2021). Since the studies I found did not fit so neatly into this classification, I had to evaluate inclusion in almost every singular case to identify the mean age of the population in question. I included studies that did not specify an age-span of their population but referred to it in terms of youth, such as studies about college and university students, while I excluded reports about various social groups that did not engage specifically with youth, such as broad-brushing studies based on national and international statistics.
The database searches combined two keywords: 'youth' and 'COVID-19', which I entered into the search engines of Web of Science, Scopus, PsycINFO, and ProQuest (Social Science Premium Collection). The search was limited to English titles, abstracts, and keywords (which unfortunately meant exclusion of research findings published in other languages). Following my eligibility criteria, I filtered the search to published peer-reviewed journal articles and books/book chapters. In the multidisciplinary databases Web of Science and Scopus, I included psychology and psychiatry but excluded physical health and medicine disciplines such as paediatrics and neurology. In PsycINFO, I filtered the search to include only studies of people in the age categories 13-17 and 18-29.
The selection process followed the steps of the PRISMA guidelines, as presented in Figure 1. First, I identified through my database searches over one thousand records (titles and abstracts) for further screening and assessment. I exported these records into the reference managing software EndNote20, and then went through the list to remove nearly four hundred duplicates. This left me with seven hundred records. I screened these records' abstracts to exclude an additional four hundred studies that did not meet my eligibility criteria. After this exclusion, full-text versions of the remaining reports were sought for retrieval, primarily via Uppsala University Library and Google Scholar but also via personal requests on the academic networking site ResearchGate. I succeeded to track down all but seven reports. In the last step, I assessed full-text versions of more than three hundred journal articles and found two-thirds to not meet my eligibility criteria. After this exclusion, I had identified a total of 108 studies eligible for inclusion.
The analysis was performed with the aid of computer-assisted qualitative data analysis software MAXQDA2020. After importing the 108 full-texts into the software, I registered meta-data by coding each study's research method and geographical focus. To outline the overarching themes of social impacts, I performed a thematic analysis in two steps; first I assigned open codes to each study to capture the main contents and results, then I merged and reorganized them into axial codes (Qureshi & Ünlü, 2020). These were then complemented by a second coding round, in which I performed a lexical search, in the entire studies' corpus, for keywords connected with my axial codes. In the final instance, I sorted my axial codes into the four themes of COVID-19 social impacts on youth: living conditions, lifestyle changes, mental health, and responses.

COVID-19 social impacts on youth
Among the 108 studies analysed in my scoping review, the most frequently used research method (76%) was to conduct surveys such as online questionnaires, self-assessment formulas, and occasionally also official statistics, to quantitatively analyse patterns of social impacts due to the pandemic. The qualitative studies were built primarily on in-depth interviews and focus groups (17%), but also involved methods of digital ethnography (4%) and autoethnography (3%). As illustrated in the Table 1 below, the dominating geographical focus of the studies -which reflected the limitation of my database searches to English titles -was the USA (30%) and Canada (12%), followed by India, Italy, China, and Australia, whereas most countries were only represented in one study each. Some studies had a multiple country focus (9%). In the following pages, I organize the content of these studies based on the four analytical themes produced by my scoping review.

Living conditions
The studies indicated that the living conditions of youth have changed dramatically under the COVID-19 pandemic. One aspect was the impact of income opportunities. Several studies documented how the youth of working age suffered from economic fallout (Churchill, 2021;Cook et al., 2021;Karijo et al., 2021;Vehkalahti et al., 2021), which was reported to cause financial stress (Feurer et al., 2021), augmented by reduced income opportunities for parents and other family members (Miconi et al., 2021). Studies also reported stress regarding delays in academic activities (Sreeram & Mundada, 2021;Wang et al., 2021). Another prevalent aspect was that youth experienced a lack of access to health and social support services under the pandemic (Dyer et al., 2021;Hawke et al., 2020;Jones et al., 2021). Blocked access to public services was particularly felt by youth that were already structurally marginalized, such as Roma people and Middle Eastern immigrants in Northern Europe (Miconi et al., 2021) as well as negatively racialized groups in North America (Ash et al., 2021). Studies also reported that LGBTQ youth had more trouble accessing psychiatric services during the pandemic compared to their heterosexual and cisgender peers (Abramovich et al., 2021;Hawke et al., 2021). The social restrictions and subsequent isolation -the lockdowns -were reported to have a particularly strong impact on youth Cheng et al., 2021;. The shelter-at-home order has led to exhausting interactions with family members (Fish et al., 2020;Salerno et al., 2021), and in many cases to augmented family conflicts (Carmen Cano-Lozano et al., 2021;Suhail et al., 2021). At the same time, studies reported that loneliness characterized the living conditions of youth under the pandemic. Loneliness has been manifested in the loss of important life moments and age-specific celebrations associated with the era of youth (Bjørknes et al., 2021;Branquinho et al., 2020;Sarkadi et al., 2021), but also more directly by isolation from youth peers; an autoethnographic article, written by young university students in the UK (Rosalie Jones et al., 2020, p. 290), stated that 'we are lonely, because we are not in responsive rhythm with one another's bodies.' Such pandemic-invoked alteration in the rhythms of life was in turn connected to notable lifestyle changes among youth.

Lifestyle changes
The economic vulnerability and social isolation, characterizing the living conditions of the COVID-19 pandemic, have entangled with notable lifestyle changes in the wake of this disruption of social life (Mohler-Kuo et al., 2021). Several studies reported increased substance use among youth (Abramovich et al., 2021;Branquinho et al., 2020;Hawke et al., 2020), and eating disorders were more frequently reported during the COVID-19 pandemic (Kim et al., 2021;Spigel et al., 2021;Vitagliano et al., 2021). Other studies also documented how the shelter-at-home order led to physical inactivity (Chaturvedi et al., 2021;Elliott et al., 2021;Shepherd et al., 2021;Zago et al., 2021), lost motivation for training (Bazett-Jones et al., 2020, and overall sedentary behaviour (Appelhans et al., 2021;Branquinho et al., 2021;Fillon et al., 2021). Increased exposure to social media has also resulted in enhanced weight stigmatizing and body dissatisfaction (Lessard & Puhl, 2021), as well as direct cyberbullying (Mkhize & Gopal, 2021). Extensive screen time was documented to cause gaming addiction and other forms of problematic internet use (Fernandes et al., 2020;Islam et al., 2020;Mohler-Kuo et al., 2021;Muzi et al., 2021), as well as requirements for digital literacy (Luthfia et al., 2021). Studies also documented a correlation between depression and time spent in virtual environments (Sikorska et al., 2021), which was propelled by increased exposure to racial discrimination (Tao & Fisher, 2021).
Worrying was also a prevalent theme in the studies; youth were reported to be worried about the virus' impact on themselves or their relatives (Germani et al., 2020;Lehmann et al., 2021;Ranta et al., 2020), but studies also reported overall worry of the pandemic situation (Timonen et al., 2021), about their future (Bjørknes et al., 2021), and about the state of democracy and world economy (Sarkadi et al., 2021). Several studies also documented how the pandemic situation resulted in parental stress due to changed working conditions and psychological pressure (Cusinato et al., 2020), leading to affect dysregulation , and overall lack of support from parents (Fish et al., 2020;Salerno et al., 2021). Conversely, youth with greater attachment security to parents were better protected against depression and anxiety (Laurier et al., 2021). At the same time, negative mental health was also reported to be more prevalent among females , LGBTQ-youth (O'Brien et al., 2021;Platero & López-Sáez, 2020;Turner et al., 2021), and among Black and Asiandescendent youth living in the United States (Cheah et al., 2020;Parker et al., 2021;Tao & Fisher, 2021).

Responses
The social impacts of the COVID-19 pandemic have not been passively consumed by the youth of today. Studies documented resilience to mental health problems (Ridout et al., 2021;Truskauskaite-Kuneviciene et al., 2021). Youth have adopted several coping strategies: improved dietary intake (Suhail et al., 2021), exercising (Cielo et al., 2021;O'Brien et al., 2021), relaxation Timonen et al., 2021), spirituality (Parker et al., 2021), critical thinking (Bjørknes et al., 2021;Maker Castro et al., 2021), positive reframing (Cheng et al., 2021;Waselewski et al., 2020), and engagement in pleasant and personal development activities (Branquinho et al., 2020). One study reported that the social movement Fridays for Future expanded its narrative to link the Climate Crisis to the Corona Crisis (Sorce & Dumitrica, 2021). Studies furthermore documented how youth have been at the forefront in mitigating the pandemic social impacts, setting up organizational networks to support their peer communities (Calabrese Barton et al., 2021;Wu et al., 2021), to facilitate poverty relief (Barbhuiya & Mazmuder, 2021), to enable food distribution (Andrew, 2020;Mohd Najmi, 2021), and to shelter stray animals (Rai & Maheshwari, 2021). Here studies reported that peer networks of supportive family and friends were particularly important for black as well as for sexual minority adolescents (O'Brien et al., 2021;Parker et al., 2021).

Conclusion
This scoping review of 108 scientific articles has offered a macroscopic view of what it can mean to be young in pandemic times. I have condensed the findings into four themes: living conditions, lifestyle changes, mental health, and responses. The living conditions for young people (aged 15-24) under the pandemic include declined income opportunities for working youth and their families, impeded educational development, lack of adequate access to healthcare and social support services, exhausting interactions with family members, magnified experiences of loneliness and social disconnection, as well as loss of important life moments associated with youth-time. These pandemic living conditions have prompted notable lifestyle changes among youth, such as increased substance use, physical inactivity, as well as disturbed sleeping and eating habits. Extensive screen time also has caused gaming addiction and other forms of problematic internet use, cyberbullying, dependence on digital literacy, and increased exposure to weight stigmatizing and racial discrimination. The hardship of new living conditions and lifestyle changes has placed additional burdens on youth mental health, with documentations of depression and anxiety, worrying, sleeping problems, post-traumatic stress, obsessive-compulsive disorder, deliberate self-harm, and suicidal ideation.
The reviewed studies tell the hardship of being young in pandemic times. The youth of today has collective experiences of social isolation, constraints, and loss of formative moments. To further explore the long-term outcomes of this particular cohort, future research could deploy longitudinal studies, quantitative as well as qualitative, in documenting the generational developments throughout the prolonged COVID-19 pandemic. But the collective experiences of youth are also differentiated. My scoping review reveals that the social impacts of COVID-19 have been particularly hard on sexual minorities, negatively racialized youth, and other social groups that are structurally disadvantaged in society. More research is therefore needed to fully uncover the pandemic-specific patterns of unequal impact distribution; we need deeper inquiries into why some remained resilient while others became increasingly vulnerable. Intersectional analyses of class, gender, race, sexuality, and disability -and additional axis of structural inequality -are thus key in unearthing the uneven social impacts on different youth populations. Here research could venture much further into the various ways youth have responded to the COVID-19 pandemic. Existing studies have already documented individual coping strategies as well as collective efforts of youth self-organization, but more research is needed to outline how these individual and/or collective responses entangle with overarching structures of social stratification. Thicker descriptions of youth responses would likely gain from more participatory and community research, knowledge production that learns from and with youth. In any case, future studies of COVID-19 social impacts would need to analyse pandemic-specific patterns of structural inequalities -while at the same time allowing for analytical agency with regard to youth responses -in order to think beyond the social confinements of being young in pandemic times.

Disclosure statement
No potential conflict of interest was reported by the author(s).

Notes on contributor
Markus Lundström is affiliated to the Department of Sociology, and the Centre for Multidisciplinary Studies on Racism, and the Department of Sociology, at Uppsala University. His research is focused on social movements and inequality.