Addressing Racial and Ethnic Disparities in COVID-19 Among School-Aged Children: Are We Doing Enough?

Arica White, PhD, MPH; Leandris C. Liburd, PhD; Fátima Coronado, MD, MPH

Disclosures

Prev Chronic Dis. 2021;18(6):e55 

In This Article

Abstract and Introduction

Abstract

The disproportionate impact of COVID-19 and associated disparities among Hispanic, non-Hispanic Black, and non-Hispanic American Indian/Alaska Native children and teenagers has been documented. Reducing these disparities along with overcoming unintended negative consequences of the pandemic, such as the disruption of in-person schooling, calls for broad community-based collaborations and nuanced approaches. Based on national survey data, children from some racial and ethnic minority groups have a higher prevalence of obesity, asthma, type 2 diabetes, and hypertension; were diagnosed more frequently with COVID-19; and had more severe outcomes compared with their non-Hispanic White (NHW) counterparts. Furthermore, a higher proportion of children from some racial and ethnic minority groups lived in families with incomes less than 200% of the federal poverty level or in households lacking secure employment compared with NHW children. Children from some racial and ethnic minority groups were also more likely to attend school via online learning compared with NHW counterparts. Because the root causes of these disparities are complex and multifactorial, an organized community-based approach is needed to achieve greater proactive and sustained collaborations between local health departments, local school systems, and other public and private organizations to pursue health equity. This article provides a summary of potential community-based health promotion strategies to address racial and ethnic disparities in COVID-19 outcomes and educational inequities among children and teens, specifically in the implementation of strategic partnerships, including initial collective work, outcomes-based activities, and communication. These collaborations can facilitate policy, systems, and environmental changes in school systems that support emergency preparedness, recovery, and resilience when faced with public health crises.

Introduction

The population health impact of COVID-19 has exposed decades, if not centuries, of inequities that have systematically undermined the physical, social, material, and emotional health of racial and ethnic minority groups.[1,2] The disproportionate impact of COVID-19 and associated disparities in outcomes among some racial and ethnic minority populations is documented across age groups, including among children.[3–5] Reducing these disparities along with the inequitable economic and social impact of the pandemic on families from racial and ethnic minority groups requires broad community-based and underused collaborations, as well as innovative approaches.

In this article, we highlight health disparities and inequities among children and teenagers from racial and ethnic minority groups. We discuss education as a major social determinant of health and the impact of restricted access to in-person school, and we describe disparities in underlying chronic medical conditions and social inequities associated with poverty and systemic disadvantage. In combination, these factors exacerbate poor health outcomes in populations disproportionately affected by social conditions beyond their control, including infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. In light of documented disparities and the potential collateral damage inflicted by the COVID-19 pandemic, such as delays in health care, increases in social isolation, and decreases in vaccination rates,[6] we invoke a renewed sense of urgency in attending to the population health status of children and teens from racial and ethnic minority groups.

We argue for community-based approaches that are organized to achieve greater proactive and sustained collaborations between local health departments, local school systems, and other public and private organizations. Although these approaches are not new, the impact of the COVID-19 pandemic on school-aged children experiencing systemic disadvantage reintroduces and amplifies the need for community-based collaborations and strategic partnerships. Since the causes of health disparities are complex and multifactorial, eliminating these health disparities cannot be accomplished by a single sector or entity.[7] As trusted members of their communities, partners from the public and private sectors can play a key role in improving population health.[8] Revitalizing old partnerships and establishing new collaborations may reduce COVID-19 disparities; improve and protect the physical and mental health of children and teens from racial and ethnic minority groups experiencing systemic disadvantage; and advance health equity, which is the opportunity for everyone to be as healthy as possible.[2] We posit that these partnerships and collaborations can facilitate policy, systems, and environmental changes within school systems that support emergency preparedness and recovery and resilience when faced with public health crises.

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