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The Hidden US COVID-19 Pandemic: Orphaned Children

According to a study published today in the journal Pediatrics, one child in the United States loses a parent or caregiver for every four COVID-19 deaths in the country. In addition, the findings highlight orphanhood as a hidden and ongoing secondary tragedy caused by the COVID-19 pandemic, and they emphasize the importance of identifying and caring for these children throughout their development – both during the pandemic and following it.

On average, over 140,000 children under the age of 18 will lose a parent, custodial grandparent, or grandparent caregiver between April 1, 2020, and June 30, 2021 in the United States, according to estimates. These individuals provided the child with a home and basic needs such as love, security, and daily care. COVID-19 is responsible for orphanhood or the death of a grandparent caregiver in approximately 1 in every 500 children in the United States, according to the findings of the study. COVID-19-related caregiver deaths were disproportionately concentrated among people of color, ethnic minorities, and those living in rural areas. Children from racial and ethnic minorities accounted for 65% of the total number of people who lost a primary caregiver as a result of the pandemic.

Children's lives are irreversibly altered when they lose a mother, father, or grandparent who provided them with a home, basic needs, and loving care. When a parent dies, it is considered an adverse childhood experience (ACE), and it has been linked to mental health problems, reduced school attendance, low self-esteem, sexual risk behaviors, and an increased risk of substance abuse and other harmful behaviors such as suicide, violence, sexual abuse, and exploitation.

According to Susan Hillis, CDC researcher and study lead author, "Children facing orphanhood as a result of COVID is a hidden, global pandemic that, unfortunately, has not spared the United States." "For generations to come, we will all be affected by the problem's severe immediate and long-term consequences, which will be felt most acutely by our children. A top priority must be given to addressing the loss these children have suffered – and continue to suffer – in every aspect of our emergency response, both now and in the post-pandemic era."

The study was conducted in collaboration with the Centers for Disease Control and Prevention (CDC), Imperial College London, Harvard University, Oxford University, and the University of Cape Town, all of which are located in South Africa. Imperial College London and the Centers for Disease Control and Prevention's COVID Response collaborated on the study, which was partially funded by the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health (NIH), and Imperial College London, among others.

"The sheer number of young people affected serves as a sobering reminder of the devastation that has occurred over the past 18 months," said Dr Alexandra Blenkinsop, co-lead researcher at Imperial College London. It is clear from these findings which children have been left most vulnerable as a result of the pandemic, as well as where additional resources should be directed.

The data from the analysis were used to estimate COVID-19-associated orphanhood (death of one or both parents) as well as deaths of custodial and co-residing grandparents in the United States as a whole and in each state between April 1, 2020, and June 30, 2021. Those who die as a result of COVID-19-related events, such as lockdowns, restrictions on gatherings and movement, and decreased access to or quality of health-care and treatment for chronic diseases, are referred to as "COVID-19-associated deaths." The data was also separated and analyzed by race and ethnicity, with White, Black and Asian populations being separated from American Indian/Alaska Native populations, as well as Hispanic and non-Hispanic populations.

Following a COVID-19-related death, the study's authors estimate that 120,630 children in the United States lost a primary caregiver (a parent or grandparent who is responsible for providing housing, food, and other basic needs, as well as care). In addition, 22,007 children were left without a secondary caregiver (grandparents providing housing but not most basic needs). It is estimated that 142,637 children have lost at least one parent, as well as a custodial or other co-residing grandparent caregiver, in total.

"An unimaginable tragedy, the death of a parent can have a profound impact on the lives of their children. As a society, we must work together to ensure that all children have access to evidence-based prevention interventions that can assist them in dealing with this trauma while also promoting their future mental health and well-being "Nora D. Volkow, MD, Director of the National Institute on Drug Abuse (NIDA). As a result of numerous underlying inequities and health disparities, people of color are at a higher risk of contracting COVID-19 and dying from it, as well as a higher risk of losing a parent or caregiver and suffering adverse developmental consequences.

Racial and ethnic disparities in COVID-related caregiver loss.

As a result of COVID-19, there were significant racial and ethnic disparities in caregiver deaths, according to the findings. White people account for 61 percent of the total population of the United States, while people from racial and ethnic minorities account for 39 percent of the total population. The fact remains that children of non-Hispanic White parents account for 35% of those who have lost a primary caregiver (51,381), while children of racial and ethnic minorities account for 65% of those who have lost a primary caregiver (91,256 children).

Taking into account primary and secondary caregivers, the researchers discovered significant disparities by race/ethnicity: one in every 168 American Indian/Alaska Native children, one in every 310 Black children, one in every 412 Hispanic children, one in every 612 Asian children, and one in every 753 White children experienced orphanhood or caregiver death. White children were 4.5 times more likely to lose a parent or grandparent caregiver than American Indian or Alaska Native children, while Black children were 2.4 times more likely and Hispanic children were more than twice as likely as white children (1.8).

In general, the states with the largest populations – California, Texas, and New York – had the greatest number of children at risk of primary caregiver death as a result of COVID-19, according to the study. After breaking down their findings by geography and race/ethnicity, the authors could see how these deaths and disparities varied from one state to the next.

Approximately 49 percent to 67 percent of children who experienced the loss of a primary caregiver were of Hispanic ethnicity in states along the US-Mexico border in the southern United States, including New Mexico, Texas, and California. In the southeastern United States, which includes Alabama, Louisiana, and Mississippi, between 45 and 57 percent of children who lost a primary caregiver were African-American. American Indian/Alaska Native children who had lost a primary caregiver were more common in South Dakota (55 percent), New Mexico (39 percent), Montana (38 percent), Oklahoma (23 percent), and Arizona, among other states (23 percent ). (Eighteen percent)

In line with a similar study published in July 2021 in The Lancet, which discovered that more than 1.5 million children worldwide lost a primary or secondary caregiver during the first 14 months of the COVID-19 pandemic, the current study was conducted. When conducting their studies in both the global and US contexts, researchers used the UNICEF definition of orphanhood, which includes the death of one or both parents6. Children who have lost a parent are included in the definition because they are at a higher risk of developing mental health problems, being abused, living in unstable housing, and living in poverty than other children. Especially for children raised by single parents, the death of the parent associated with COVID-19 may represent the loss of the primary provider of love and security, as well as the loss of the primary provider of day-to-day care.

The study's co-author Charles A. Nelson III, PhD, a researcher at Boston Children's Hospital who studies the effects of adversity on brain and behavioral development, said: "While we frequently consider the impact of COVID-19 in terms of the number of lives lost to the disease, as this study demonstrates, it is critical to consider the broader impact – both in terms of those who have died and those who have been left behind." In addition, we must make certain that children who have lost a parent or caregiver receive the appropriate support and that the additional impact of the COVID-19 pandemic is addressed comprehensively in both our rapid response and our overall public health response, she says.

In the case of children whose caregivers die as a result of COVID, there are evidence-based interventions that can help them do better in life.

It is critical that children remain in their homes. This means that families who have been affected by the pandemic must be supported, and those who require kinship or foster care must receive services as soon as possible after becoming ill.

Children's resilience can be increased through programs and policies that promote stable, nurturing relationships and address the challenges that children face during their childhood. Among the most important strategies are the ones listed below:

Increasing the economic support of the family.

Exceptional childcare and educational support for children and adolescents.

Parents' parenting abilities and family relationships can be improved through participation in programs that have been scientifically proven.

All strategies must be tailored to the ages of the children and must take into consideration racial disparities and structural inequalities in society. Children who are most at risk must be reached by these efforts.

It concludes that "effective action to reduce health disparities and protect children from direct and secondary COVID-19 harm is both a public health and a moral imperative."

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