Sociodemographic Differences in COVID-19 Pandemic Experiences Among Families in the United States

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  • LeWinn, Kaja Z.
    • Other Affiliation: University of California San Francisco
  • Trasande, Leonardo
    • Other Affiliation: New York University Grossman School of Medicine
  • Law, Andrew
    • Other Affiliation: Johns Hopkins Bloomberg School of Public Health
  • Blackwell, Courtney K.
    • Other Affiliation: Northwestern University
  • Bekelman, Traci A.
    • Other Affiliation: University of Colorado Anschutz Medical Campus
  • Arizaga, Jessica A.
    • Other Affiliation: University of California San Francisco
  • Sullivan, Alexis A.
    • Other Affiliation: University of California San Francisco
  • Bastain, Theresa M.
    • Other Affiliation: University of Southern California
  • Breton, Carrie V.
    • Other Affiliation: University of Southern California
  • Karagas, Margaret R.
    • Other Affiliation: Dartmouth Geisel School of Medicine
  • Elliott, Amy J.
    • Other Affiliation: Avera Health Institute
  • Karr, Catherine J.
    • Other Affiliation: University of Washington
  • Carroll, Kecia N.
    • Other Affiliation: Icahn School of Medicine at Mount Sinai
  • Dunlop, Anne L.
    • Other Affiliation: Emory University
  • Croen, Lisa A.
    • Other Affiliation: Kaiser Permanente Northern California
  • Margolis, Amy E.
    • Other Affiliation: New York State Psychiatric Institute
  • Alshawabkeh, Akram N.
    • Other Affiliation: Northeastern University
  • Cordero, Jose F.
    • Other Affiliation: University of Georgia
  • Singh, Anne Marie
    • Other Affiliation: University of Wisconsin School of Medicine and Public Health
  • Seroogy, Christine M.
    • Other Affiliation: University of Wisconsin School of Medicine and Public Health
  • Jackson, Daniel J.
    • Other Affiliation: University of Wisconsin School of Medicine and Public Health
  • Wood, Robert A.
    • Other Affiliation: Johns Hopkins Bloomberg School of Public Health
  • Hartert, Tina V.
    • Other Affiliation: Vanderbilt University Medical Center
  • Kim, Young Shin
    • Other Affiliation: University of California San Francisco
  • Duarte, Cristiane S.
    • Other Affiliation: New York State Psychiatric Institute
  • Schweitzer, Julie B.
    • Other Affiliation: University of California, Davis
  • Lester, Barry M.
    • Other Affiliation: Brown Alpert Medical School andWomen & Infants Hospital
  • McEvoy, Cynthia T.
    • Other Affiliation: Oregon Health and Science University School of Medicine
  • O’Connor, Thomas G.
    • Other Affiliation: University of Rochester Medical Center
  • Oken, Emily
    • Other Affiliation: Harvard Pilgrim Health Care Institute
  • Bornkamp, Nicole
    • Other Affiliation: Harvard Pilgrim Health Care Institute
  • Brown, Eric D., Jr
    • Affiliation: Gillings School of Global Public Health, Department of Environmental Sciences and Engineering
  • Porucznik, Christina A.
    • Other Affiliation: University of Utah School of Medicine
  • Ferrara, Assiamira
    • Other Affiliation: Kaiser Permanente Northern California
  • Camargo, Carlos A., Jr
    • Other Affiliation: Harvard Medical School
  • Zhao, Qi
    • Other Affiliation: University of Tennessee Health Science Center
  • Ganiban, Jody M.
    • Other Affiliation: GeorgeWashington University
  • Jacobson, Lisa P.
    • Other Affiliation: Johns Hopkins Bloomberg School of Public Health
  • Environmental influences on Child Health Outcomes Consortium
Abstract
  • Few population-based studies in the US collected individual-level data from families during the COVID-19 pandemic.To examine differences in COVID-19 pandemic–related experiences in a large sociodemographically diverse sample of children and caregivers.The Environmental influences on Child Health Outcomes (ECHO) multi-cohort consortium is an ongoing study that brings together 64 individual cohorts with participants (24 757 children and 31 700 caregivers in this study) in all 50 US states and Puerto Rico. Participants who completed the ECHO COVID-19 survey between April 2020 and March 2022 were included in this cross-sectional analysis. Data were analyzed from July 2021 to September 2022.Exposures of interest were caregiver education level, child life stage (infant, preschool, middle childhood, and adolescent), and urban or rural (population <50 000) residence. Dependent variables included COVID-19 infection status and testing; disruptions to school, child care, and health care; financial hardships; and remote work. Outcomes were examined separately in logistic regression models mutually adjusted for exposures of interest and race, ethnicity, US Census division, sex, and survey administration date.Analyses included 14 646 children (mean [SD] age, 7.1 [4.4] years; 7120 [49%] female) and 13 644 caregivers (mean [SD] age, 37.6 [7.2] years; 13 381 [98%] female). Caregivers were racially (3% Asian; 16% Black; 12% multiple race; 63% White) and ethnically (19% Hispanic) diverse and comparable with the US population. Less than high school education (vs master’s degree or more) was associated with more challenges accessing COVID-19 tests (adjusted odds ratio [aOR], 1.88; 95% CI, 1.06-1.58), lower odds of working remotely (aOR, 0.04; 95% CI, 0.03-0.07), and more food access concerns (aOR, 4.14; 95% CI, 3.20-5.36). Compared with other age groups, young children (age 1 to 5 years) were least likely to receive support from schools during school closures, and their caregivers were most likely to have challenges arranging childcare and concerns about work impacts. Rural caregivers were less likely to rank health concerns (aOR, 0.77; 95% CI, 0.69-0.86) and social distancing (aOR, 0.82; 95% CI, 0.73-0.91) as top stressors compared with urban caregivers.Findings in this cohort study of US families highlighted pandemic-related burdens faced by families with lower socioeconomic status and young children. Populations more vulnerable to public health crises should be prioritized in recovery efforts and future planning.
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  • Article
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  • Attribution 4.0 International
Journal title
  • JAMA Network Open
Page start
  • izad176
Language
  • English
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  • Publisher
ISSN
  • 2574-3805

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