National Academies report reveals dire pandemic effects on at-risk kids, families

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The latest report from the National Academies of Sciences, Engineering, and Medicine highlights the outsized pandemic burdens shouldered by racial-minority and low-income communities, among them the finding that Black, Latino, and Native American children account for 65% of those who have lost a primary caregiver to COVID-19.

The Academies' Committee on Addressing the Long-Term Impacts of the COVID-19 Pandemic on Children and Families reviewed the literature, commissioned three papers, and held listening sessions with adolescents, educators, juvenile-justice and child-welfare professionals, and Native American tribal leaders.

It is well-known that racial-minority and low-income people are more vulnerable to COVID-19 infection, hospitalization, and death because of work and living conditions and a higher proportion of underlying medical conditions. But they were also more likely to face problems such as unemployment and an inability to fully participate in virtual education because of a lack of technology, a lack of a reliable internet connection, and limited English proficiency, the report, published yesterday, said.  

"In almost every outcome—across measures of social, emotional, behavioral, educational, mental, physical, and economic health and well-being—low-income and racially and ethnically minoritized children and their families have borne, and without intervention will continue to bear, the brunt of the pandemic's negative effects," the authors said.

Lower kindergarten enrollment

While the pandemic's negative effects on all children's and adolescents' physical, emotional, and educational well-being are well-documented, the effects on non-White and low-income families and children have been particularly acute, the report said. For example:

Low-income and racially and ethnically minoritized children and their families have borne, and without intervention will continue to bear, the brunt of the pandemic's negative effects.

  • Native American, Black, and Latino children were 4.5, 2.4, and 2.0 times more likely than White children to have lost a parent or other caregiver to the pandemic. Children from these groups, as well as those who don't speak English at home, were also the most likely to drop out of early-childhood programs.
  • Nine percent fewer students enrolled in kindergarten in the 2019-20 school year than in 2019, with larger declines in fully remote school districts, which enrolled more low-income students
  • Higher rates of delayed preventive care and vaccinations, with lower uptake among Black and Latino children
  • Overdose deaths, most from fentanyl, increased, with the highest rates among Native American youth
  • Pregnancy-related death rates rose 33%, with the greatest jumps in Black and Latina women (see related CIDRAP news brief today)

Efforts to lessen pandemic impact

The report also shines a light on school, agency, and community efforts to mitigate the effects of the pandemic and related public health measures, such as school closures and lockdowns. For example:

  • Tribal communities promoted physical distancing, vaccination, and masking by basing the recommendations on tribal beliefs about interconnectedness, social responsibility, and the need to protect elders
  • Schools pivoted to supporting children and families by, for example, distributing meals, connecting families to social services, and providing technology to ensure access to remote instruction.
  • Healthcare organizations implemented telemedicine programs while accommodating large numbers of COVID-19 patients

10 recommendations

To help children and families find a way forward, the committee issued 10 recommendations, asking that:

  • Federal agencies, states, Native American tribes, local organizations, and the nonprofit and profit sectors establish a task force on mitigating the effects of the pandemic on children and families, with a focus on Black, Latino, Native American, and low-income families
  • State and federal agencies involved in COVID-19 pandemic-relief planning and preparedness for future pandemics address the needs of pregnant women, children, and at-risk communities, including children in the foster-care and juvenile-justice systems
  • The US Department of Education renew pandemic funding of high-poverty schools and early-childhood programs, expand the education workforce, prepare for future pandemics, and support children's academic, emotional, and social recovery
  • The US Department of Health and Human Services (HHS) strengthen and expand Medicaid coverage to ensure steady access to physical and mental health services
  • HHS further invest in policies and funding to ensure access to quality mental health treatment and behavioral health services in clinical settings, communities, and schools
  • The US government incentivize states to expand key safety-net programs, such as Temporary Assistance for Needy Families and child care subsidies
  • The federal government support federal paid family leave and sick leave policies or incentivize states to establish their own
  • The government reissue and continue the expansion of the Child Tax Credit and distribute it monthly rather than yearly
  • Public and private agencies eliminate barriers to collecting child and family data across health, education, social services, juvenile justice, child welfare, and federal and state administrative agencies to optimize services, policies, programs, and research
  • Federal agencies prioritize and fund research on the effects of the pandemic on families and children, including adding COVID-related questions to ongoing national studies such as the Youth Risk Behavior Survey and the Head Start Family and Child Experiences Survey

"The effects of the COVID-19 pandemic on children and families may be felt for years to come: for example, research on the 1918 influenza pandemic found long-term physical and mental effects for those who were children or in utero during it," the authors wrote.

"Understanding and responding to the long-term impact of the pandemic is needed in order to support the health, development, and well-being of children, benefiting not only children and their families, but also society at large."

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