Children and COVID-19 Research Library

Health disparities are defined as differences among specific populations in the ability to achieve full health potential (as measured by differences in incidence, prevalence, mortality, burden of disease, and other adverse health conditions). Among children, multiple factors contribute to these disparities, including economic stability, and access to health care. According to the Annie E. Casey Foundation, before the current pandemic, 12 million children in the United States were living in poverty in 2019, including one-third of African American and Native American children and 25% of Latinx children.8 During the same period, of the 4.4 million children without health insurance, 14% were Native American, 9% were of Hispanic descent, and 18% were immigrants. At present, owing to the impact of the pandemic on job security, more than 50% of African American, Latinx, and multiethnic adults are now without medical insurance, directly affecting the health security of their children.8 With the onset of the pandemic and the social and political upheaval felt by many disenfranchised communities, these well-documented disparities (and the importance of addressing them) have again been brought to the attention of the medical community. This overview will examine the effects of these health disparities in various populations of children in this country. We will first examine the historical context of health disparities, how they developed, and why they still exist. We will then examine how specifically the COVID-19 pandemic impacted these disparities among children and adolescents, both directly and indirectly. Finally, we hope to provide some recommendations to reduce these disparities.

In response to the COVID-19 pandemic, research institutions across the globe have modified their operations in ways that have limited or eliminated the amount of permissible in-person research interaction. In order to prevent the loss of important developmentally-timed data during the pandemic, researchers have quickly pivoted and developed innovative methods for remote assessment of research participants. This manuscript describes methods developed for remote assessment of a parent child cohort with a focus on examining the perinatal environment, behavioral and biological indicators of child neurobehavioral development, parent-child interaction, as well as parent and child mental and physical health.

The COVID-19 pandemic has impacted children and parents involved in the child welfare system and the professionals working with these families. Using survey data collected August–September of 2020, this mixed-methods study examined the perspectives of 196 child welfare-involved professionals (77 attorneys, 99 caseworkers, and 20 therapists) in the United States about the impact of COVID-19 on parents of origin, children, foster parents, and child welfare professionals. Particular attention was paid to the implications of COVID-19 and associated challenges for parent–child contact and reunification. With respect to professional stresses, more than half of participants worried about their own personal safety and health amidst COVID-19, and more than three-quarters expressed concerns about the safety and well-being of child welfare-involved families.

The present study assessed factors associated with maternal preferences for their children’s educational format (i.e., completely in-person, completely online/remote, or hybrid of in-person and online/remote) for return to school during the COVID-19 pandemic and whether these associations differed between full-time employed mothers and mothers who were not employed. Participants were 911 mothers of school-aged children from the United States (full-time employed, n = 650; not employed, n = 261). Recruitment took place online via social media during Summer 2020. Questionnaires on school modality preference, maternal work status, and demographic characteristics were filled out online through Qualtrics.

With the US Food and Drug Administration’s (FDA’s) emergency use authorization of the Pfizer-BioNTech COVID-19 vaccine for adolescents aged 12-15 years on May 10, 2021, COVID-19 vaccination is now available to all adolescents aged 12-17 years. Moderna has also applied for emergency use authorization approval for this age group.1 The Centers for Disease Control and Prevention strongly recommends vaccination of the adolescent population, which comprises approximately 25 million people in the United States. Comprehensive protection is critical to adolescent and population health and is a big step toward a return to “normal life” for young people, including in-person school. Vaccine hesitancy—the reluctance or refusal to choose vaccination—identified by the World Health Organization as a top 10 global health threat, undermines these goals. According to a June 2021 Kaiser Family Foundation COVID-19 poll, 42% of parents with adolescents aged 12-17 years said they had either already vaccinated their children or planned to vaccinate their children, 18% said they would “wait a while to see how it is working,” 25% were definitely opposed, and 10% would choose vaccination only if required for school.

This study explored the associations among perceived stress, depressive symptoms, loneliness, and social support during the COVID-19 pandemic; and differences in perceived stress, depressive symptoms, and social support prior to the pandemic and during the pandemic among pregnant Black women. A sample of 33 pregnant Black women who participated in the Biosocial Impact on Black Births (BIBB) and were still pregnant in May–June 2020 were invited to complete an online survey about their experiences during the pandemic. Fifteen women responded very much or somewhat to experiencing stress and anxiety because of the COVID-19 pandemic. Eight women had CES-D scores ≥23, which have been correlated with depression diagnosis. Women who reported higher levels of loneliness during the COVID-19 pandemic also reported higher levels of perceived stress and depressive symptoms and lower levels of social support during the pandemic. Women who reported lower levels of social support during the pandemic also reported higher levels of perceived stress and depressive symptoms during the pandemic. There were no changes in perceived stress, depressive symptoms, or social support prior to the pandemic and during the pandemic.

Using unique data from an economically and racially diverse sample of 448 caregivers with young children (ages 4–9 years) in Ohio, this study assesses multiple sources of family social and economic disruptions and their associations with parenting activities during the COVID-19 stay-at-home order. Caregivers reported extensive social and economic challenges during this time, while also increasing (on average) their time spent in play/learning activities. Time spent in discipline was less likely to increase during this period.

Studies directly comparing preterm birth rates in women with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are limited. This study's objective was to determine whether preterm birth was affected by SARS-CoV-2 infection within a large integrated health system in New York with a universal testing protocol. This retrospective cohort study evaluated data from seven hospitals in New York City and Long Island between March 2020 and June 2021, incorporating both the first and second waves of the coronavirus disease 2019 (COVID-19) pandemic in the USA. All patients with live singleton gestations who had SARS-CoV-2 polymerase chain reaction (PCR) testing at delivery were included. Deliveries before 20 weeks of gestation were excluded.

Families are navigating an unstable economy due to COVID-19. Financial stressors have the potential to strain intimate relationships and exacerbate prior inequities across lower-income families. Notably, the economic impact of COVID-19 disproportionately influenced Black and Latinx families. As a response to families' economic adversity during the pandemic, the federal government initiated the CARES Act. This type of federal response to lower-income families, however, is not new. The purpose of this paper is to contextualize and historicize previous and current efforts to mitigate the consequences of financial hardship on families by comparing the assumptions and efficacy of the Healthy Marriages Initiative and the CARES act.

Stay-at-home orders and the removal of care and domestic supports during the early days of the COVID-19 pandemic substantially disrupted US parents’ work and family lives. Although much is known about changes in US parents’ paid labor arrangements, the evidence regarding changes in unpaid domestic labor has been largely anecdotal. This study uses novel data from 1,025 US parents in different-sex partnerships to provide a descriptive overview of changes in mothers’ and fathers’ participation in, and division of, housework and childcare from March 2020 to the early days of the pandemic (late April 2020).

Children with ASD receive a multitude of educational, medical, and therapeutic services. At the onset of the COVID-19 pandemic, all of these services came to a complete halt following strict lockdowns. Many services have resumed in a hybrid format using face to face and virtual modes of delivery. This study describes findings from the COVID-19 impact survey administered at the onset of the pandemic in a subgroup of families from the SPARK cohort (N = 6393), one of the largest ASD cohorts in the US. The differential early impact of COVID-19 on various subgroups of children with ASD and their families was examined. Caregivers of children and adolescents with ASD between 19 months and 18 years completed an online survey inquiring about the impact of COVID-19 pandemic on access to services, parent concerns about the same, impact on child's ASD-related behaviors, child, and parent mental health, and the benefits/potential benefits of online/future online services.

Scalable programs for school-based SARS-CoV-2 testing and surveillance are needed to guide in-person learning practices and inform risk assessments in kindergarten through 12th grade settings. To characterize SARS-CoV-2 infections in staff and students in an urban public school setting and evaluate test-based strategies to support ongoing risk assessment and mitigation for kindergarten through 12th grade in-person learning. This pilot quality improvement program engaged 3 schools in Omaha, Nebraska, for weekly saliva polymerase chain reaction testing of staff and students participating in in-person learning over a 5-week period from November 9 to December 11, 2020. Wastewater, air, and surface samples were collected weekly and tested for SARS-CoV-2 RNA to evaluate surrogacy for case detection and interrogate transmission risk of in-building activities.

UNICEF estimates that 1.6 billion children across the world have had their education impacted by COVID-19 and have attempted to continue their learning at home. With ample evidence showing a negative impact of noise on academic achievement within schools, the current pre-registered study set out to determine what aspects of the home environment might be affecting these students. Adolescents aged 11–18 took part online, with 129 adolescents included after passing a headphone screening task. They filled out a sociodemographic questionnaire, followed by a home environment and noise questionnaire. Participants then completed three executive function tasks (the Flanker, the Backward Digit Span, and the Wisconsin Card Sorting Test) while listening to a soundtrack of either white noise or home-like environmental noise. For purposes of analysis, based on the noise questionnaire, participants were separated into quieter and noisier homes.

Growing evidence informs about the detrimental impact that COVID-19 has had on youths’ mental health and well-being. As of yet, no study has directly examined the experiences and perspectives of children and young adolescents from racial and ethnic minority groups in the U.S., despite being exposed to more adversity, which may affect coping with the many challenges posed by the pandemic. This study aimed to give voice to a mostly Hispanic/Latinx group of youth regarding the impact of COVID-19 stay-at-home measures and to identify their emotional responses and coping strategies amid the pandemic in the U.S. when restrictions were at their hardest.