On kidsdata.org, measures of how children and families in California are faring during the coronavirus disease 2019 (COVID-19) pandemic come from a national questionnaire, Family Experiences During the COVID-19 Pandemic. Caregivers with children ages 0-17 were asked a series of questions relating to the pandemic's impact on family economic security, public service use, emotional and behavioral experiences, child care, and education. Estimates based on their responses are available for California and seven sub-state regions (Los Angeles County and six county groups). At the state level, data also are broken down by household income level, caregiver's race/ethnicity, and for families with and without children with special health care needs (CSHCN).

Before the coronavirus disease 2019 (COVID-19) pandemic, millions of U.S. families already were struggling with poverty, food insecurity, housing instability, mental illness, and difficulty accessing quality health care, education, and other resources (1). The onset of the pandemic dramatically worsened these issues, leaving many parents out of work or with reduced incomes and struggling to meet their families' basic needs (2, 3, 4). At the same time, families grappled with child care and school closures, shifts to remote learning and working, and disconnection from extended family, friends, and other social supports (3, 4). Many families also experienced illness and the loss of loved ones due to the disease (5). Not surprisingly, mental health problems increased for both children and parents during 2020 (2).

Some families were particularly vulnerable to the COVID-19 crisis, including those already struggling to make ends meet, hourly workers and those with unstable employment, families of color (who faced inequities in health outcomes and access to care before the pandemic), and families with young children or children with special health care needs (2, 4, 6). The pandemic's effects on young people are of particular concern, as adverse childhood experiences (especially in early childhood) can have negative, long-term impacts on health and well being (7, 8). The more traumatic events a child experiences, the more likely the impact will be substantial and long lasting (7, 8). Every effort should be made to ensure that children and families recover from the pandemic and that their physical, emotional, educational, and material needs are met. Beyond meeting basic needs, children also need positive experiences and stable, nurturing relationships and environments in which to thrive (9).

Sixteen months after the coronavirus disease 2019 (COVID-19) outbreak, California adults with caregiving responsibilities for children ages 0-17 were still experiencing, among other disruptions, closure of their children's schools (24%) and child care facilities (5%), cancelation of children's health care appointments (6%), and postponement of young children's vaccinations (11%), according to estimates from the third wave of a questionnaire administered in July 2021. At the time of the Wave 3 questionnaire, almost half of caregivers statewide (46%) were more than slightly concerned that their youngest school-aged child was falling behind at school, and a similar share (42%) were more than slightly concerned for their oldest child's emotional or mental health in the previous month.

Use of social safety net resources remained high in Wave 3: Among caregivers who had used safety net resources at any time during the pandemic (56%), a large majority (more than 4 in 5) were using them at the time of questionnaire. Across waves, caregivers in lower-income households were more likely to have accessed safety net resources in the period after the COVID-19 outbreak, and also to have suffered negative impacts on their household financial situation during the pandemic. While fewer than one-third (32%) of all California caregivers had experienced a negative overall financial impact in Wave 3, nearly half (49%) of those with annual household incomes below $30,000 had been negatively impacted.

In Wave 3, 29% of California caregivers had in the previous month experienced feelings of nervousness or stress always or most of the time, and 20% felt difficulties piling up so high that they could not be overcome. Overall, fewer than 40% felt confident in their ability to control important things in their lives at least most of the time. In the previous week, an estimated 19% of caregivers had felt angry with their children every day and 20% had physically disciplined their children by spanking, slapping, or hitting. Among caregivers of children with special health care needs (CSHCN), estimates of daily feelings of anger towards children (24%) and physical discipline (35%) were higher than for caregivers in households without CSHCN (17% and 13%).

The coronavirus disease 2019 (COVID-19) pandemic led to increases in illness, mortality, poverty, hunger, unemployment, housing instability, mental health problems, and other hardships for U.S. families (1, 2). This crisis exacerbated existing economic problems and disparities, with job losses disproportionately affecting lower-income families, people of color, women, immigrants, and less-educated workers (2, 3, 4). It also underscored existing inequities in the health care system and in social determinants of health, as vulnerable populations who have long experienced disparities in access to care and health outcomes were hit hardest by COVID-19 (5, 6).

The potential effects of this crisis on children are particularly concerning, as adverse childhood experiences (ACEs)—traumatic conditions and events such as poverty, family mental health problems, and caregiver death, among others—can have harmful, long-term effects (7). For example, children exposed to multiple ACEs are more likely to develop negative health behaviors and chronic diseases in adulthood (7). Policymakers can help children and families recover from the effects of the pandemic, achieve economic stability, and access critical services including quality medical, mental health, and child care (2). Policymakers also can work toward ensuring that all families have equitable opportunities to help their children thrive, including adequate educational and community resources, as well as safe, stable, nurturing environments in and outside the home (2, 8).

Policy and program options to mitigate the effects of the COVID-19 pandemic and promote child and family health and well being include:

• Ensuring that federal and state safety net policies and investments—such as cash and food assistance, paid leave benefits, unemployment insurance, and housing, health insurance, and child care assistance—are sufficient to meet family needs (2, 3)
• Assuring that even during economic and public health crises, every child has access to family centered, culturally competent, and coordinated health care within a medical home, particularly children with special health care needs who require uninterrupted care (6, 9, 10)
• Promoting proactive policies and investments that help reduce family stress and increase stability for children, e.g., assuring that quality child care is affordable and accessible, supporting universal high-speed internet access to reduce barriers to health care and education, ensuring that support services such as home-visiting programs are available to families in need, and supporting family-friendly business practices (3, 8, 10)
• Establishing effective, consistent mental health and trauma screening and referral systems in pediatric care and other settings (1, 10, 11)
• Ensuring that all children, youth, and families have access to culturally competent, trauma informed, and resilience-building systems of mental health, substance abuse treatment, and other community support services (10, 12)
• Assuring that all schools (especially those in low-income communities) provide positive and supportive environments, social-emotional education, and effective systems to address students' academic, physical, emotional, behavioral, and family needs (10)
• Promoting long-term community-based efforts to provide children and youth with positive experiences, relationships, and opportunities, such as quality after-school programs, summer programs, and safe places to play and exercise (10)
• Addressing the root causes of health inequities through strategies such as public health community partnerships that engage and support marginalized populations; also, adopting a comprehensive approach to health care that goes beyond treating illness to addressing community factors—such as safe housing and access to healthy food—that impact health (5)