An Overload of stressors resulting from COVID-19

The COVID-19 pandemic has placed increased stress on America’s 73 million children, their families, and the child welfare system. An October 2020 data analysis by the Center on Poverty & Social Policy (CPSP) at Columbia University monitored monthly poverty estimates, which showed that an additional eight million Americans—including 2.5 million children—have fallen into poverty since May 2020. Families that were already in a precarious position before the pandemic began are facing stressors with regard to job loss and economic security, housing, food insecurity, school and childcare closures, and decreased access to services and support systems. An overload of stressors without sufficient support may have contributed to today’s all too common child anxiety, depression, and maltreatment and challenged the formal child welfare system.

Problems U.S. Children Face

The problems of U.S. children and youth fall into three general categories: poverty, victimization by abuse and neglect, and those resulting from their own risky behaviors.

Poverty

Children are the poorest members of our society. At the end of 2021, an estimated 25% of minority children and 17% of white children in the U.S. lived in poverty, and 1 in 2 was near to being poor. In 2019, a family of four was considered poor if their annual income fell below $26,172, which amounts to $2,181 a month, $503 a week. Although, thanks to programs like social security expansion and Medicare, only 9% of seniors are poor today, we have not adequately addressed child poverty.¹

The effects of poverty on children’s health and well-being include increased infant mortality, higher rates of low birth weight and subsequent health and developmental problems, increased frequency and severity of chronic diseases such as asthma, greater food insecurity with poorer nutrition and growth, poorer access to quality health care, increased unintentional injury and mortality, poorer oral health, lower immunization rates, and increased rates of obesity and its complications.² More than 1 in 7 children—10.7 million—were food insecure, meaning they lived in households where not everyone had enough to eat. Black and Hispanic children were twice as likely to live in food-insecure households as white children.

Children growing up in poverty have poorer educational outcomes with poorer academic achievement and lower rates of high school graduation; they have less positive social and emotional development, which, in turn, often leads to life "trajectory altering events" such as early unprotected sex with increased teen pregnancy, drug and alcohol abuse, and increased criminal behavior as adolescents and adults; and they are more likely to be poor adults with low productivity and low earnings.

Victimization, abuse, and neglect

Too many children, especially those raised in poor families, single-parent households, and those with teenage parents, are subjected to neglect and abuse. Physical abuse may be apparent, but not all signs of child abuse are as obvious. Ignoring a child’s needs, putting them in unsupervised, dangerous situations, exposing them to inappropriate sexual situations, or making them feel worthless or stupid are also forms of child abuse and neglect—and they can leave deep, lasting scars.

Social support from relatives or the child welfare system, including foster care placement, is often inadequate to compensate for parental deficiencies. Additional stressors such as bullying, cyberbullying, and gang activities, together with family neglect and abuse, can result in anxiety and depression.

The pandemic that has orphaned an estimated 200,000 children has revealed the fact that too many families were in a precarious position before the pandemic began. Clearly, greater investment in strong families and communities is needed to keep children safe and allow them to fulfill their educational, occupational, and social potential.

 Risky behaviors

According to the Centers for Disease Control and Prevention (CDC), health-risk behaviors established during youth are often continued into adulthood. Furthermore, the CDC concluded that these behaviors were interrelated and preventable by educational initiatives.

The CDCs Youth Risk Behavior Surveillance System (YRBSS) monitors categories of health-related behaviors that contribute to the leading causes of death and disability among youth and adults, including:³

• Behaviors that contribute to unintentional injuries and violence. Youth and young adults frequently engage in behaviors that increase their likelihood of death from one of the four causes of almost three-quarters of all youth deaths: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Fighting and carrying weapons increase the risk of unintentional injuries and homicides among students. Gun violence was the leading cause of death for children and teens ages 1-19 in 2018, surpassing motor vehicle accidents for the first time.

  Nearly 9% of students responding to the 2009-2019 Youth Risk Behavior Survey⁴ reported that they did not go to school because of safety concerns. An increasing percentage (36.7%) of American youth felt sad or hopeless for at least two weeks to the degree that they could not engage in their usual activities. And almost 19% seriously considered suicide.

  The survey found that during the past year, a high proportion of students experienced bullying (19.5%), electronic bullying (15.7%), experienced physical violence (8.2%) or sexual dating violence (8.2%) during the past year, or had ever been physically forced to have sex (7.5%).

  These data show that adolescents critically need adult support in addressing safety and mental health issues, problems that are largely beyond an adolescent's control.

• Sexual behaviors relate to unintended pregnancy and sexually transmitted diseases, including HIV infection. According to the 2019 National Youth Risk Behavior Survey (YRBS), 38% of heterosexual high school students have ever had intercourse, and 27% of high school students are currently sexually active. Thanks to better sexuality education and the many effective methods of contraception now available, teen pregnancy has declined over the past twenty years. Being born to older parents in a committed relationship with parents who want to have a family gives children a better start in life. 

• Alcohol and other drug use. Although alcohol use among youth has declined, by 12th grade, about two-thirds of students have tried alcohol. About half of 9th through 12th-grade students reported ever having used marijuana. Although habitual use is lower than ever use, about 15% of high school students have reported having ever used select illicit or injection drugs (i.e., cocaine, inhalants, heroin, methamphetamines, hallucinogens, or ecstasy), and 14% of students reported misusing prescription opioids.

• Tobacco use. According to the CDC, in 2021, only 1.9% of high school students reported that they had smoked cigarettes in the past 30 days, and about 1 of every 9 high school students (11.3%) reported that they had used electronic cigarettes in the past 30 days. In 2021, about 4% of middle school students and about 13% of high school students reported current use of any tobacco product. The percentage of students who report current cigarette smoking has dropped from a high of 36% in 1997 to 22% in 2003 and 1.9% in 2021.

• Unhealthy dietary behaviors. Too much processed high fat, high salt, high sugar junk food is in children's diets and extreme dieting, including anorexia, are common, especially among females.

• Inadequate physical activity and overweight. According to the Centers for Disease Control and Prevention (CDC), for children and adolescents aged 2-19 years in 2017-2018 the prevalence of obesity was 19.3% and affected about 14.4 million children and adolescents. This is more than triple the level of those overweight among children and adolescents in the late 1970s. Poor diet and physical inactivity are the main contributors to the obesity epidemic. Lockdowns and Zoom instruction are part of the problem, and even when schools are open, fewer children walk to school than in the past. Television, video games, and computers offered popular but sedentary after-school entertainment. Children often have less freedom to play outside without supervision due to parents' fears about child safety.

Prevention of risky behaviors should include health education and health services tailored to address health outcomes relating to sexual behaviors, high-risk substance use, violence, and mental health. Establishing safe and supportive school environments and engaging parents can impact all of these health outcomes.

Connectedness to family, peers and important adults in schools and community organizations is also key to protecting adolescent health. Families can provide an essential source of connectedness and support by staying engaged with what is going on in their adolescents' daily lives and talking to them about their family values. Students are more likely to thrive if they know they matter and that they have adults, teachers, and friends who care about their safety and success.

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