Children and COVID-19 Research Library

The COVID-19 pandemic is having a major impact on the mental health of populations in the Americas. Studies show high rates of depression and anxiety, among other psychological symptoms, particularly among women, young people, those with pre-existing mental health conditions, health workers, and persons living in vulnerable conditions. Mental health systems and services have also been severely disrupted. A lack of financial and human resource investments in mental health services, limited implementation of the decentralized community-based care approach and policies to address the mental health gap prior to the pandemic, have all contributed to the current crisis. Countries must urgently strengthen their mental health responses to COVID-19 by taking actions to scale up mental health and psychosocial support services for all, reach marginalized and at-risk populations, and build back better mental health systems and services for the future.

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.

The prevalence of mental health problems among children (ages 0–21) in the United States remains unacceptably high and, post-COVID-19, is expected to increase dramatically. Decades of psychological knowledge about effective treatments should inform the delivery of better services. Dissemination and implementation (D&I) science has been heralded as a solution to the persistent problem of poor quality services and has, to some extent, improved our understanding of the contexts of delivery systems that implement effective practices. However, there are few studies demonstrating clear, population-level impacts of psychological interventions on children. Momentum is growing among communities, cities, states, and some federal agencies to build “health in all policies” to address broad familial, social, and economic factors known to affect children’s healthy development and mental health.

Mathematical modeling studies have suggested that pre-emptive school closures alone have little overall impact on SARS-CoV-2 transmission, but reopening schools in the background of community contact reduction presents a unique scenario that has not been fully assessed. This study adapted a previously published model using contact information from Shanghai to model school reopening under various conditions. It investigated different strategies by combining the contact patterns observed between different age groups during both baseline and “lockdown” periods. It also tested the robustness of this strategy to the assumption of lower susceptibility to infection in children under age 15 years.

This commentary aims to examine the crucial role of dissemination and implementation (D&I) science—the study of methods to promote adoption and integration of evidence-based research in real-world policy or practice—to improve public health post–COVID-19. D&I science was created for this very situation, in which scientific knowledge is greatly needed but only if it holds practical relevance for the policy, environmental, and organizational systems that advance health. The paper discusses the application of D&I science to rapid evaluations of federal child nutrition assistance programs deployed during the COVID-19 pandemic.

Since its emergence in December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also referred to as the novel coronavirus 2019 or COVID-19, has created a global pandemic. To date, there are over 15 million confirmed cases worldwide and over 4 million confirmed cases in the United States. (1) Although many questions remain unanswered regarding children affected by the virus, the pandemic has highlighted inequities in the US health care system and has demonstrated the potential of advocacy to influence policy changes. Although the pandemic remains a tremendous challenge, we present a perspective on how lessons we have learned during this pandemic may translate to further advocacy for equity in neonatal care.

Since COVID-19 in the pediatric population is infrequently severe, the indirect costs of the pandemic, related to the measures implemented to deal with the spread of the virus, can be worse than the infection itself. To assess this issue, this study evaluates the number of children vaccinated or evaluated for the most common diseases in a poor village in Sierra Leone, showing a worrisome drop in vaccinations performed and children evaluated for acute diseases. Preliminary findings highlight that support is needed to guarantee basic services to children during the COVID-19 pandemic, particularly in poor settings where preventive measures can be lifesaving in the long term.

COVID-19 and TC Harold have severely affected Fijians’ short and long-term resilience as many are resorting to the use of detrimental coping strategies such as reduction in food intake, barter of assets, reduction of expenditure on health or education. Social protection schemes for marginalised groups exist but are limited and access was restricted by COVID-19 preventative measures, particularly for people with disabilities.

Community-based health care is an essential part of primary care at all times; in the context of the COVID-19 pandemic, the distinct capacity of trusted community members for social engagement and delivering care where it is needed is ever more critical. This joint WHO, UNICEF and IFRC guidance addresses the role of community-based health care in the pandemic context. It includes practical recommendations for decision makers to help keep communities and health workers safe, to sustain essential services at the community level, and to ensure an effective response to COVID-19. Using this comprehensive and coordinated approach will help countries strengthen the resilience of community-based health services throughout the pandemic, into early recovery and beyond.