Pediatric health care disrupted by COVID-19 pandemic, compounded by existing barriers such as systemic racism

(Press-News.org) This study explores the extent to which pediatric health care was interrupted during and as a result of the COVID-19 pandemic. This was measured based on three primary outcomes of interest: foregone care, foregone well-child or vaccination-related visits, and complete absence of well-child or vaccination-related visits. Researchers extracted data from a nationwide longitudinal survey known as CovEx (COVID Experiences Survey) that had been administered in two “waves'' to a cohort of parents of children between five and 12 years of age. Wave 1 took place October 8-November 13, 2020, and Wave 2 took place March 24-May 7, 2021, with an 82% retention rate of participants. Data was examined through the lens of four categories: child-level, parent-level, household-level, and county-level.

Almost one-third (30.1%) of children in the cohort had not had a well-child or vaccination-related visit in over one year, making up the largest percentage among the three primary outcomes of interest. Among the other two measured gaps, 16.3% of children in the cohort had foregone care and 10.9% had foregone well-child or vaccination-related visits. Non-Hispanic White children were at a much lower risk of experiencing any of the three gaps, with the greatest difference seen in their being less than half as likely to have a foregone well-child or vaccination-related visit in comparison to their non-White counterparts. Children who were in school using a completely virtual platform were 1.43 times as likely to forgo care than kids who were in a part-virtual/part-in-person (i.e., hybrid) format or only in-person.

What We Know: Health care barriers such as racism and low socioeconomic status continue to disproportionately affect specific populations. The COVID-19 pandemic only compounded these issues, once again affecting the same populations to disproportionate heights and making access to health care even more difficult. 

What This Study Adds: 

This study reiterates how, due to the COVID-19 pandemic, pediatric patients missed routine appointments, with racial disparities increasing this risk. Children in counties with fewer primary care doctors per capita were more likely to miss their well-child or vaccination-related visits. Additionally, children with an existing emotional, mental, or developmental behavioral condition had more than twice the risk of foregone care.

Disparities in Unmet Health Care Needs Among US Children During the COVID-19 Pandemic

Sanjana Pampati, MPH, et al

Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, Georgia, and Emory University, Rollins School of Public Health, Atlanta, Georgia

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