Discrimination Against Caregivers Increased During Pandemic

Change in Race/Ethnicity Discrimination Against Caregivers During the COVID-19 Pandemic, March 2021

Increased racism has been widely reported in the media during the COVID-19 pandemic, and the latest data support those reports. Children may experience racism directly or witness it against their caregivers. Direct and indirect racism impact health, blunt well-being, and undercut health equity—addressing them is fundamental to improving children’s health and well-being.

Caregivers who responded to the questionnaire, Family Experiences During the COVID-19 Pandemic, compared their experiences of racism before and during the pandemic. In March 2021, nearly one in three caregivers in California who had ever experienced race/ethnicity discrimination reported experiencing increased racism since the pandemic began, while just over half reported no change, and about one in six reported a decrease. Asian caregivers more often reported experiencing an increase in racism during the pandemic compared with all other race/ethnicities (44% compared with 31%).

On the questionnaire from November 2020, a caregiver shared, “Social challenges are the greatest challenge I have faced since [the pandemic began] and I don’t want my child to face racism or discrimination.”

Children’s Health Equity Resources

The Impact of Racism on Child and Adolescent Health,” a policy statement from the American Academy of Pediatrics, offers guidance in clinical practice, workforce development, community engagement, and public policy settings to address the effects of racism on children.

The
National Institute for Children’s Health Quality compiled resources that address maternal and child health equity.

Do No Harm Guide: Applying Equity Awareness in Data Visualization, a research report from the Urban Institute, provides in-depth guidance on centering equity in data-work and communications.

Recently Released Data

We recently released data about family structure and immigrants. See links to the latest here.

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Childhood Cancer Survival Rates Vary by Race/Ethnicity

Five-Year Cancer Survival Rate Among California Children Ages 0 to 19 by Race/Ethnicity, 2006-2016

Treatment of childhood cancer, including leukemia and lymphoma, has improved markedly in recent decades, though survivors often need continued specialized care and may have a higher risk of developing other chronic health conditions. Because of the substantial burden of their disease, children battling cancer may also face psychological challenges, low educational attainment, and long-term quality of life issues. Cancer outcomes differ by race/ethnicity as well as other factors such as socioeconomic status and geographic location. Public policy and practices can help ensure equitable access to high-quality care during treatment and beyond.

In California, 83% of children ages 0 to 19 who were diagnosed between 2006 and 2016 were expected to survive cancer for at least five years. However, five-year survival rates varied by race/ethnicity, ranging from 79% for African American/Black children to 85% for White children. Eighty-one percent of Asian/Pacific Islander and Hispanic/Latino children and 84% of American Indian/Alaska Native children battling cancer survived the disease for at least five years.

Learn more about childhood cancer in California.

 

Children’s Health Resource

The 2021 Kids Count Data Book by the Annie E. Casey Foundation features state rankings on the overall well-being of children and on specific areas such as education and health.

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New Data on Family Experiences During Pandemic

Today, KidsData released the latest data from the Family Experiences During the COVID-19 Pandemic questionnaire. These data are the second wave of findings from the multi-wave questionnaire.

As the COVID-19 pandemic passed the one-year mark, caregivers in households with children reflected on their experiences in:

The second wave of the questionnaire covers the period from March 22, 2021, to April 12, 2021. These data join the first wave of findings from Nov. 9, 2020, to Dec. 11, 2020.

Key findings from the latest data:

Education, Health Care, and Social Activities
About the same percentage of caregivers in both waves reported disruptions since the pandemic began, including closed child care centers (16% in wave 1, 17% in wave 2), canceled medical and dental appointments (29% in both waves), and canceled sports and after-school activities (36% in wave 1, 33% in wave 2).

Child and Caregiver Safety
Almost one-quarter (23%) of caregivers reported spanking, slapping, or hitting their child at least once in the last seven days. One-third (33%) of caregivers reported physical or emotional intimate partner violence during the pandemic.

Positive Childhood Experiences
A higher percentage of African American/Black caregivers reported that their child had a caring adult outside the home (94%) than White (82%) and Hispanic/Latino (79%) caregivers.

About the Data
In the Family Experiences During the COVID-19 Pandemic questionnaire, caregivers were asked to reflect on life disruptions and the emotional and behavioral consequences of the COVID-19 pandemic. The data cover California and seven regions within California. At the state level, findings are broken down by family income level, race/ethnicity, and the presence of a child with special health care needs in the household. We expect to share a third wave of findings in the coming months.

Learn more about the questionnaire and its collaborators who made it possible in About the Data Source.


Using the Data in Your Work

We hope these data are useful in your work with children and youth to address the effects of the COVID-19 pandemic. If you would like to share how you are using these data, please reach out to us at kidsdata@prb.org.

 

Additional Resource on the COVID-19 Pandemic

For a national perspective on the Family Experiences During the COVID-19 Pandemic questionnaire, see Family Snapshots: Life During the Pandemic from the American Academy of Pediatrics, in partnership with the Centers for Disease Control and Prevention (CDC), Prevent Child Abuse America, and Tufts Medical Center. They recently released two new snapshots on child discipline and intimate partner violence during the pandemic.

 

Children’s Health Resources

“Creating Safe, Stable, Nurturing Relationships and Environments for Children” is a new resource from the California Essentials for Childhood Initiative that elevates prevention strategies and highlights findings from the CDC’s Awareness, Commitment, and Norms Survey.

Physical Punishment: Attitudes, Behaviors, and Norms Associated with Its Use Across the US is a new report from Prevent Child Abuse America that shares findings from a survey given to U.S. adults about physical punishment and offers new insights for policy, intervention, and social norms change.

Community Safety Realized: Public Health Pathways to Preventing Violence is a new tool from Prevention Institute and Big Cities Health Coalition to advance community-driven, multi-sector approaches grounded in racial justice to prevent violence and establish pathways to safety.

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Child and Family Well-Being During the COVID-19 Pandemic

Child and Family Well-Being During the COVID-19 Pandemic provides quick access to data available on KidsData.org that describe life disruptions as well as emotional and behavioral consequences of the COVID-19 pandemic. The data help measure the pandemic’s impact on children and caregivers, builds understanding of how families are faring, and suggests where support might be most needed.

Access data on the COVID-19 pandemic and its effect on critical areas of children’s health and well-being:

Data are available for California and seven regions within California. At the state level, findings are broken down by family income level, race/ethnicity, and the presence of a child with special health care needs in the household. Visit the topic summary page for more information and links to additional research.

These data are from the first two of three waves of a questionnaire. Sign up to receive KidsData News and data alerts for all the latest updates.

Caregivers Share Their Thoughts

Caregivers responding to the Child and Family Well-Being During the COVID-19 Pandemic questionnaire reflected on caring for their children during the pandemic.

“I feel like I have become more loving, considerate, and patient with my children. The need to stay home has helped us create structure. I thought I was going to get irritated by having my kids home with me all the time, but it’s really been the opposite.”

“I’ve had to let go of a lot of expectations and have really learned what is important.”

“The biggest issue is protecting my child from my own anxiety and worries. She’s young enough that her daily life isn’t too disrupted but old enough to know the grownups are upset.”

 

About the Data Source

The data come from a national questionnaire covering a wide range of content areas to help inform on the impact of the pandemic. The questionnaire, Family Experiences During the COVID-19 Pandemic, was designed by the American Academy of Pediatrics (AAP), in collaboration with the Centers for Disease Control and Prevention (CDC), Prevent Child Abuse America (PCAA), and Tufts Medical Center, Healthy Outcomes from Positive Experiences (HOPE). Findings from the questionnaire are intended to inform experts at AAP, CDC, PCAA, and HOPE on the pandemic’s effects on families and help them produce resources for medical practitioners, caregivers, and others.

In California, the Lucile Packard Foundation for Children’s Health (LPFCH) and the California Department of Public Health Essentials for Childhood Initiative (EfC) led by the California Department of Public Health, Injury and Violence Prevention Branch and the California Department of Social Services, Office of Child Abuse Prevention, funded an oversample of the questionnaire to produce findings at the sub-state level and about children with special health care needs. Findings will inform policy makers, program leaders, advocates, and others about how experiences varied within California and to what extent families with children with special health care needs faced greater challenges.

The first wave of the questionnaire was administered in California from Nov. 9, 2020, to Dec. 11, 2020. The second wave was administered from March 22, 2021, to April 12, 2021. It will be administered one more time in the coming months.

To learn more about the development of the questionnaire and to see national-level findings, see Family Snapshots: Life During the Pandemic on the American Academy of Pediatrics website.

Questionnaire Sample

In California, wave one includes 1,526 parents and caregivers who had at least one child under age 18 in the household, and wave two includes 1,520 parents and caregivers. In wave one, 29% of respondents had at least one child with a special health care need in the household, and in wave 2, it was 35%. Children with special health care needs have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and require health and related services of a type or amount beyond that required by children generally.

Demographics are similar in each wave. In wave 1, just over half of respondents were female (54%) and most were married or in a domestic partnership (69%). Nearly half of respondents were Hispanic (49%), while 28% were white, 9% were Asian, 5% were Black, and 2% were Native American. About the same percentage of respondents had a high school diploma (30%), attended some college or had a two-year degree (29%), or had a four-year or post-graduate degree (30%), while 12% of respondents did not have a high school diploma. About equal shares of respondents reported family incomes under $30,000 (28%) and incomes $100,000 and above (25%). In each wave, all data were weighted to reflect caregivers for children under age 18 in California.

 

Related Webinar

The webinar, “Family Experiences During COVID-19 Pandemic Data,” features an overview of the questionnaire and covers national and California-level findings from presenters, Drs. Robert Sege from the HOPE Project at Tufts Medical Center and Lori Turk-Bicakci from the KidsData program. The webinar was sponsored by the California Department of Public Health, Injury and Violence Prevention Branch and the California Department of Social Services, Office of Child Abuse Prevention’s Essentials for Childhood Initiative. The recording and slides are available.

Data on Family Experiences During the COVID-19 Pandemic

Education, Health Care, and Social Activities

Economic Security

Supportive Services

Emotional and Behavioral Health

Child and Caregiver Safety

Adverse Childhood Experiences

Positive Childhood Experiences

Caring for Children with Special Health Care Needs (CSHCN)

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Air Quality and Lead Exposure Endanger California Children’s Health

Children in the Inland Empire Suffered Months of Poor Air Quality in 2019

Days With Unhealthy Ground-Level Ozone Concentrations in California Counties, 2019

Air pollution is a serious threat to children’s health, with links to adverse birth outcomes, obesity, cardiovascular and respiratory diseases, and cancer. It can also be associated with deficits in cognitive and behavioral development.

Counties in the Inland Empire recorded the most days with
unhealthy ground-level ozone concentrations in 2019, followed by neighboring counties in Southern California and the Central Valley. Children in San Bernardino County spent nearly three out of every 10 days in 2019 with unhealthy air (109 days). Riverside County had 64 days with unhealthy air, and Tulare County had 59 days. By contrast, 15 counties did not record any unhealthy air days, and nine counties lacked data.

Learn more about air quality.

At Least 7,000 California Children Had Elevated Blood Lead Levels in 2018; Undercounts Obscure Magnitude of the Problem


California Children Ages 0 to 5 With Elevated Blood Lead Levels, 2018

Childhood exposure to any level of lead is linked to lifelong adverse effects on physical, neurological, cognitive, academic, and economic outcomes. No amount of lead in the blood is considered safe.

In 2018, 7,141 California children ages 0 to 5 were reported to have
elevated blood levels, including 1,291 children with blood levels at 9.5 micrograms or higher. These numbers are substantial undercounts. Though state regulations require lead screening for every child enrolled in Medi-Cal, the state’s Medicaid Program, many children are not screened. Between fiscal years 2009-10 and 2017-18, fewer than 27% of Medi-Cal enrollees ages 1 to 2 received all of their required lead screenings, according to a report by the California State Auditor.

Learn more about lead poisoning.

 

Additional Resource

U.S. children exposed to air pollution and household lead face a higher risk of incarceration and lower incomes in adulthood, according to a new study by Robert Manduca of the University of Michigan and Robert J. Sampson of Harvard University. This research is a part of a special issue in the journal, Population and Environment, summarized
here.

Conference

Be a part of the conversation on using public data to understand our communities during this period of immense challenges arising from COVID-19 and political polarization. The conference, “Public Data: Making Sense of the New Normal,” is organized by the Association of Public Data Users and takes place July 26-29, 2021. Register here.

Recently Released Data

We recently released data about asthma and teen sexual health. See links to the latest here.

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Nearly 10,000 Homeless Youth in California Lack Shelter

Number of Sheltered and Unsheltered Homeless Youth Ages 0 to 24 in California, 2020

Almost 10,000 youth and young adults who are experiencing homelessness in California are unsheltered. During the January 2020 annual homelessness Point-in-Time Count, 9,510 youth ages 0 to 24 were unsheltered while an additional 2,662 youth were homeless but sheltered. These 12,000+ youth were also without a parent or guardian while homeless. Sheltered youth were counted in emergency shelters, transitional housing programs, or safe havens; unsheltered youth were staying in a place not ordinarily used for sleeping.

Los Angeles, Santa Clara, and San Francisco counties found the highest number of youth ages 0 to 24 who were homeless and unsheltered in California in January 2020.

Youth who experience homelessness are more likely than other young people to face hunger and malnutrition, physical and mental health issues, developmental delays, and academic problems.

Learn more about homelessness.


Job Posting

PRB is hiring! Support data and administrative work on KidsData and other projects at PRB. We are looking for a full-time research assistant located in California or Washington, DC.
Read more.


Children’s Health Resources

Mapping Child Opportunity is a new, interactive map from diversitydatakids to give community leaders and policymakers tools to create conditions for all children to thrive.

Transforming Practice with HOPE (Healthy Outcomes from Positive Experiences), a new journal article in Maternal and Child Health, translates research findings about the effects of positive childhood experiences for clinical and organizational settings.


Recently Released Data

We recently released data about air quality. See links to the latest here.

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The Pandemic’s Impact on Caregivers of Children With Special Health Care Needs

Frequency of California Caregivers Feeling Overwhelmed While Providing Medical and Therapeutic Care for Children With Special Health Care Needs, March to November 2020


Families who have a child with a special health care need (CSHCN) have experienced substantial challenges during the coronavirus pandemic. CSHCN have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition. They require health and related services of a type or amount beyond that required by children generally. These requirements may add strain to daily family functioning.

The questionnaire, Family Experiences During the COVID-19 Pandemic, offers a look at how families coped with caring for their CSHCN during the pandemic. To collect and share information about these children and their needs, a section of the questionnaire is dedicated to asking about experiences specifically among families with CSHCN. In addition, all questionnaire findings on KidsData compare responses of caregivers with at least one CSHCN to those without.

Between March and November 2020, more than half of caregivers sometimes, fairly often, or very often felt overwhelmed by the day-to-day demands of providing medical or therapeutic care for their CSHCN between March and November 2020. Notably, in the week prior to responding to the questionnaire, 14% of caregivers had to provide medical care that would normally be provided by others.

The Lucile Packard Foundation for Children’s Health invests in creating a more efficient system that ensures high-quality, coordinated, family-centered care to improve health outcomes for children and enhance quality of life for families. A series of webinars and publications supported by the foundation share strategies that state Medicaid agencies have implemented during the pandemic, including expanded access to services for CSHCN. Additional resources for families, caregivers, state agency staff, and advocates offer information about caring for CSHCN during the pandemic.

Webinar Posted

The webinar and slide deck for “Family Experiences During COVID-19 Pandemic Data” are now posted! On April 29, the California Essentials for Childhood (EfC) Initiative hosted a webinar that featured findings from wave one of the Family Experiences During COVID-19 Pandemic questionnaire. Drs. Robert Sege from the HOPE Project at Tufts Medical Center and Lori Turk-Bicakci from the KidsData program at PRB shared both national and California-level findings about child and caregiver experiences.


Recently Released Data

We recently released data on homelessness and lead poisoning. See links to the latest here.

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Hospitalizations for Mental Health Issues Were Rising Before Pandemic

Rate of Hospitalizations for Mental Health Issues in California From 2002 to 2019, by Age Group


Hospitalization rates for mental health issues were rising in the years prior to the COVID-19 pandemic. In 2019, the rate of hospital discharges for mental health issues in California among teens ages 15 to 19 was 9.8 per 1,000 teens, a 46% increase from 2007 and more than triple the rate for children ages 5 to 14. Positive emotional health is critical to equipping young people for the challenges of growing up and living as healthy adults, yet the pandemic led to many new stressors for children, including disruptions and socioeconomic shifts These added strains have only heightened the need for funding and training to expand programs of mental wellness.

Webinars

Much of the data on KidsData.org come from U.S. Census Bureau products as well as other federal data sources. Two upcoming webinars provide insight on these important data sources that underly our understanding of children’s health and well-being.

Learn from data users of the American Community Survey (ACS) and U.S. Census Bureau staff about key ACS data issues and applications at the “ACS Data Users Conference,” organized by the U.S. Census Bureau and PRB. This virtual event will take place May 18-20, 2021. Register here.

Learn about changes in public data and best practices in using data at “Public Data: Making Sense of the New Normal,” organized by the Association of Public Data Users. This virtual event will take place July 26-29, 2021. Register here.

Join Prevent Child Abuse America for “Transforming Our Tomorrow: 2021 Prevent Child Abuse America Virtual Conference” to explore community needs and the impacts of our work. This virtual event will take place August 10-12, 2021. Register here.

Recently Released Data

All data from the first wave of the Family Experiences During the COVID-19 Pandemic questionnaire are now on KidsData.org! See links to the latest here.


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Four in Ten Families Report Pandemic Negatively Impacted Finances


Many families with children have seen their economic security directly impacted by the COVID-19 pandemic. Even before the pandemic, child poverty was a deep concern among many researchers, practitioners, and advocates because it can alter children’s developmental trajectories in cognitive, socio-emotional, and physical health.

As the pandemic unfolded, some caregivers were forced to cut back on work or lost their jobs, threatening their families’ economic security. Though some families offset income losses by increasing their involvement in social service programs and receiving other aid, we have yet to fully understand the new economic reality for families and its impact on children, but we have some early indications.

The questionnaire, Family Experiences During the COVID-19 Pandemic, offers a look at how the events of the past year shaped family economic security. In California, 43% of caregivers reported that their household’s financial situation had been negatively impacted from March to November 2020. Related, as of November 2020, 33% of caregivers were unemployed, had left the workforce, or reduced their employment.

Some caregivers accessed social safety net resources such as food banks and public health insurance. Notably, 11% of California families used at least one of eight services for the first time between March and November 2020. This first-time use is seen across income levels as caregivers started utilizing social safety net resources for the first time to safeguard their family’s economic security.

A national perspective from this questionnaire is now available! Family snapshots of life during the pandemic in the United States have just been released by the American Academy of Pediatrics (AAP), in collaboration with the Centers for Disease Control and Prevention, Prevent Child Abuse America, and Tufts Medical Center. Visit this new webpage to find an overview of the questionnaire and AAP recommendations based on their findings. It currently includes two snapshots describing financial impact on families and family closeness despite stress. More snapshots are to come!

The Financial Impact of the Pandemic on Families With Children in the United States notes that findings from the questionnaire are concerning: “Higher family economic stress is associated with more family conflicts and higher rates of child abuse and neglect. The Family Stress Model describes how economic hardship contributes to parent psychological distress. This distress can aggravate relationship problems between parents and disrupt parenting practices. These changes often result in increased problematic child behavior and can lead to a vicious cycle with harsher parenting and more difficult child behavioral problems. Policy makers should be advised about the possible consequences for children when household finances can threaten family stability.” Read more.

Latest Data on Child Well-Being During Pandemic

In addition to data about child and caregiver safety, we have additional data on the COVID-19 pandemic and its effect on critical areas of children’s health and well-being.

*Data coming soon.

 

Webinar

Register for the “Family Experiences During COVID-19 Pandemic Data Webinar”

Thursday, April 29, 2021, from 1:00 p.m. – 2:30 p.m. (PST)

Learn more about the questionnaire, Family Experiences During the COVID-19 Pandemic. Drs. Robert Sege from the Healthy Outcomes from Positive Experiences (HOPE) Project at Tufts Medical Center and Lori Turk-Bicakci from the KidsData program at PRB will provide an overview of the questionnaire, summarize California and national findings, share where to access California data and national snapshots, and offer highlights from the HOPE perspective. The webinar is hosted by the Essentials for Childhood Initiative. Register here.

 

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One in Four Caregivers of Special Needs Children Report Physical Discipline in Household

Physical Discipline of Children in California, by Special Health Care Needs Status

Child abuse can cause lifelong physical, emotional, and behavioral problems and may perpetuate intergenerational cycles of family violence. During the COVID-19 pandemic, the strain that families experience can be immense and may affect how children are disciplined and risk their safety. Having a child with a special health care need (CSHCN) in the household may further increase that risk.

The questionnaire, Family Experiences During the COVID-19 Pandemic, sheds light on the extent of child safety and abuse in households in November 2020. In California, 17% of caregivers reported that they spanked, slapped, or hit a child in their household in the previous week. In households including CSHCN, one in four caregivers reported these forms of punishment compared with one in seven caregivers in other households.

Similar patterns emerge in the prevalence of intimate partner violence (IPV) in the household. Since the start of the pandemic, 12% of caregivers reported that they experienced physical IPV. One in five caregivers who had a CSHCN in the household reported physical IPV compared with about one in twelve caregivers in other households.

Prevent Child Abuse America notes that multiple and interacting factors contribute to abuse, including substance abuse in the household, caregivers’ poor emotional health, and economic stress. By focusing on prevention, all children can grow and thrive in safe, stable, and nurturing relationships and environments. The organization shares that National Child Abuse Prevention Month is “a time to plant the seeds of a better tomorrow for all children and families.”

Latest Data on Child Well-Being During Pandemic

In addition to data about child and caregiver safety, we have additional data on the COVID-19 pandemic and its effect on critical areas of children’s health and well-being.

*Data coming soon.

Webinar

Register for the “Family Experiences During COVID-19 Pandemic Data Webinar”

Thursday, April 29, 2021, from 1:00 p.m. – 2:30 p.m. (PST)

Learn more about the questionnaire, Family Experiences During the COVID-19 Pandemic. Drs. Robert Sege from the Healthy Outcomes from Positive Experiences (HOPE) Project at Tufts Medical Center and Lori Turk-Bicakci from the KidsData program at PRB will provide an overview of the questionnaire, summarize California and national findings, share where to access California data and national snapshots, and offer highlights from the HOPE perspective. The webinar is hosted by the Essentials for Childhood Initiative. Register here.

April Is Child Abuse Prevention Month

Best Practice Guidelines for California’s Child Abuse Prevention Councils (CAPCs) offers a comprehensive approach to addressing child abuse and promoting prevention, shared by the California Office of Child Abuse Prevention and Strategies 2.0. CAPCs’ role is to be the catalyst, convener, and coordinator of prevention efforts at the county level.

Reframing Childhood Adversity: Promoting Upstream Approaches helps professionals communicate about child well-being and adversity, shared by the FrameWorks Institute, Prevent Child Abuse America, and the newly merged Alliance for Strong Families and Communities and Council on Accreditation.

Recently Released Data

We recently released data about emotional health and the COVID-19 pandemic. In 2019, there were more than 27,000 hospital discharges for mental health issues among California youth ages 15 to 19. See links to the latest here.

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