Sociodemographic Differences in COVID-19 Pandemic Experiences Among Families in the United States
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Published:2023-08-23
Issue:8
Volume:6
Page:e2330495
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ISSN:2574-3805
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Container-title:JAMA Network Open
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language:en
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Short-container-title:JAMA Netw Open
Author:
LeWinn Kaja Z.1, Trasande Leonardo23, Law Andrew4, Blackwell Courtney K.5, Bekelman Traci A.6, Arizaga Jessica A.1, Sullivan Alexis A.1, Bastain Theresa M.7, Breton Carrie V.7, Karagas Margaret R.8, Elliott Amy J.9, Karr Catherine J.10, Carroll Kecia N.11, Dunlop Anne L.12, Croen Lisa A.13, Margolis Amy E.14, Alshawabkeh Akram N.15, Cordero Jose F.16, Singh Anne Marie17, Seroogy Christine M.17, Jackson Daniel J.17, Wood Robert A.18, Hartert Tina V.19, Kim Young Shin1, Duarte Cristiane S.14, Schweitzer Julie B.2021, Lester Barry M.22, McEvoy Cynthia T.23, O’Connor Thomas G.24, Oken Emily25, Bornkamp Nicole25, Brown Eric D.26, Porucznik Christina A.27, Ferrara Assiamira13, Camargo Carlos A.28, Zhao Qi29, Ganiban Jody M.30, Jacobson Lisa P.4, Smith P B31, Newby K L31, Jacobson Lisa P31, Parker C B31, Gershon Richard C31, Cella David31, Teitelbaum Susan L31, Stroustrup Annemarie31, Lampland Andrea L31, Hudak Mark L31, Washburn Lisa K31, Canino Glorisa J31, Pastyrnak Steven L31, Neal Charles31, Carter Brian S31, Helderman Jennifer B31, Simhan Hyagriv31, Kerver Jean31, Barone Charles31, Paneth Nigel31, Elliott Michael R31, Schantz Susan L31, Silver Robert M31, Wright Rosalind J31, Bosquet-Enlow Michelle31, Mason Alex31, Tylavsky Frances31, Zhao Qi31, Sathyanarayana Sheela31, Fussman Chris31, Farzan Shohreh F31, Habre Rima31, Tepper Robert S31, Gern James31, Miller Rachel L31, Nguyen Ruby HN31, Aschner Judy L31, Merhar Stephanie L31, Moore Paul E31, Pryhuber Gloria S31, Smith Lynne M31, Barrett Emily S31, Reynolds Anne Marie31, Gatzke-Kopp Lisa31, Swingler Margaret M31, Mansbach Jonathan M31, Spergel Jonathan M31, Zoratti Edward M31, Bendixsen Casper G31, Bacharier Leonard B31, O’Connor George T31, Kattan Meyer31, Rivera-Spoljaric Katherine31, Johnson Christine C31, Hertz-Picciotto Irva31, Koinis Mitchell Daphne31, D’Sa Viren31, Dabelea Dana31, Deoni Sean CL31, Hipwell Alison E31, Leve Leslie D31, Weiss Scott T31, Lyall Kristen31, Volk Heather31, Dager Stephen R31, Schultz Robert T31, Obeid Rawad31, Rollins Caitlin31, Msall Michael E31, O'Shea Michael31, Vaidya Ruben31, Meeker John31, Laham Federico31, Wu Susan31, Celedón Juan C31, Puls Henry T31, Teach Stephen J31, Porter Stephen C31, Waynik Ilana Y31, Iyer Sujit31, Samuels-Kalow Margaret E31, Thompson Amy D31, Stevenson Michelle D31, Bauer Cindy S31, Inhofe Nancy R31, Boos Markus31, Macias Charles G31, Monk Catherine31, Posner Jonathan31, Hershey Gurjit31, Keenan Kathryn31, Neiderhiser Jenae31, Litonjua Augusto31, Zeiger Robert31, Bacharier Leonard31, Landa Rebecca31, Ozonoff Sally31, Schmidt Rebecca31, Piven Joseph31, Bear Kelly31, Lenski Madeleine31, Singh Rachana31, Frazier Jean A31, Gogcu Semsa31, Montgomery Angela31, Kuban Karl C31, Douglass Laurie M31, Jara Hernan31, Joseph Robert31, Ruden Douglas31, Herbstman Julie31, Woodruff Tracey31, Giardino Angelo P31, Stanford Joseph31, Innocenti Mark31, Conradt Elizabeth31, Huddleston Kathi31, Swan Shanna31,
Affiliation:
1. Department of Psychiatry and Behavioral Sciences, University of California San Francisco 2. Department of Pediatrics, New York University Grossman School of Medicine, New York 3. Department of Population Health, New York University Grossman School of Medicine, New York 4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 5. Department of Medical Social Sciences, Northwestern University, Chicago, Illinois 6. Department of Epidemiology, Lifecourse Epidemiology of Adiposity & Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora 7. Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles 8. Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire 9. Avera Health Institute, Sioux Falls, South Dakota 10. Department of Pediatrics, University of Washington, Seattle 11. Jack and Lucy Clark Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York 12. Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, Georgia 13. Kaiser Permanente Northern California, Oakland 14. Columbia University Irving Medical Center, New York State Psychiatric Institute, New York 15. College of Engineering, Northeastern University, Boston, Massachusetts 16. Department of Epidemiology & Biostatistics, College of Public Health, University of Georgia, Athens 17. Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison 18. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 19. Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 20. Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento 21. The MIND Institute, University of California, Davis, Sacramento 22. Brown Center for the Study of Children at Risk, Brown Alpert Medical School and Women & Infants Hospital, Providence, Rhode Island 23. Department of Pediatrics, Oregon Health and Science University School of Medicine, Portland 24. Department of Psychiatry, University of Rochester Medical Center, Rochester, New York 25. Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts 26. Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill 27. Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City 28. Massachusetts General Hospital, Harvard Medical School, Boston 29. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis 30. Department of Psychological & Brain Sciences, Columbian College of Arts & Sciences, George Washington University, Washington, DC 31. for the Environmental influences on Child Health Outcomes Consortium
Abstract
ImportanceFew population-based studies in the US collected individual-level data from families during the COVID-19 pandemic.ObjectiveTo examine differences in COVID-19 pandemic–related experiences in a large sociodemographically diverse sample of children and caregivers.Design, Setting, and ParticipantsThe 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.Main Outcomes and MeasuresExposures 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.ResultsAnalyses 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.ConclusionsFindings 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.
Publisher
American Medical Association (AMA)
Cited by
1 articles.
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