Adversity and Opportunity—The Pandemic’s Paradoxical Effect on Child Health and Well-Being
In this JAMA Pediatrics commentary, Paul Wise and Lisa Chamberlain write the COVID-19 pandemic has triggered emergency policy responses that have cut through years of muddled inaction on issues critical to child health and well-being.
Like most existential threats, pandemics generate not only hardships but also hard choices. Clearly, the COVID-19 pandemic has profoundly disrupted the fabric of family and community life. However, it has also triggered emergency policy responses that have cut through years of muddled inaction on issues critical to child health and well-being. Many people are surprised to learn that now, 2 years into the pandemic, child poverty has fallen to historic lows. This is not the result of some long-term secular trend. Rather, it is the result of new, aggressive policy initiatives, initiatives that without immediate action will be abandoned in the coming months.
The disruptive power of the pandemic has rippled across the social determinants of child health. Just several months after the first cases were detected in the United States, the unemployment rate reached levels not seen since the depths of the Great Depression, with the majority of lost jobs concentrated in low-wage industries. Two-thirds of child care centers closed by April 2020, one-third remaining closed by April 2021. Recent reports estimate that more than one-third of households with children were experiencing either housing hardships or inadequate food, privations that fell disproportionately on racial and ethnic minority families. School closures have been widespread with wildly uneven capacities to respond by district. This has resulted in disparities potentially affecting children’s long-term learning and patterns of mortality over the life course.