COVID-19 and children's health in the United States: Consideration of physical and social environments during the pandemic

Jose R Suarez-Lopez,Maryann R Cairns,Kam Sripada,Lesliam Quiros-Alcala,Howard W Mielke,Brenda Eskenazi,Ruth A Etzel,Katarzyna Kordas

doi:10.1016/j.envres.2021.111160

Abstract

Public health measures necessary to counteract the coronavirus disease 2019 (COVID-19) pandemic have resulted in dramatic changes in the physical and social environments within which children grow and develop. As our understanding of the pathways for viral exposure and associated health outcomes in children evolves, it is critical to consider how changes in the social, cultural, economic, and physical environments resulting from the pandemic could affect the development of children. This review article considers the environments and settings that create the backdrop for children's health in the United States during the COVID-19 pandemic, including current threats to child development that stem from: A) change in exposures to environmental contaminants such as heavy metals, pesticides, disinfectants, air pollution and the built environment; B) changes in food environments resulting from adverse economic repercussion of the pandemic and limited reach of existing safety nets; C) limited access to children's educational and developmental resources; D) changes in the social environments at the individual and household levels, and their interplay with family stressors and mental health; E) social injustice and racism. The environmental changes due to COVID-19 are overlaid onto existing environmental and social disparities. This results in disproportionate effects among children in low-income settings and among populations experiencing the effects of structural racism. This article draws attention to many environments that should be considered in current and future policy responses to protect children's health amid pandemics.

Highlights

Compared to adults, children have experienced lower rates of morbidity and mortality from coronavirus disease 2019 (COVID-19), despite having had similar trends in incidence and percent positive test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) (Leidman 2021)
It is believed that stay-at-home and social distancing measures are altering children’s physical and social environments and exposure risks, affecting children already made vulnerable by preexisting socio-economic (Lancker and Parolin 2020; Sharma et al, 2020b), health (Fortuna et al, 2020), and environmental disparities and in justices (Woolf et al, 2020)
We provide a brief discussion of the current threats to child development stemming from environmental contaminants, reduced access to green and blue spaces, changes to social environments including altered social interactions and family dynamics, reduced economic and other safety nets protecting children, and major socialjustice issues that the pandemic has exposed

Summary

Introduction

Children have experienced lower rates of morbidity and mortality from coronavirus disease 2019 (COVID-19), despite having had similar trends in incidence and percent positive test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) (Leidman 2021). Public health measures necessary to counteract the COVID-19 pandemic, coupled with economic effects from a strained labor mar ket, have resulted in dramatic changes to the physical and social envi ronments within which children grow and develop. It is believed that stay-at-home and social distancing measures are altering children’s physical and social environments and exposure risks, affecting children already made vulnerable by preexisting socio-economic (Lancker and Parolin 2020; Sharma et al, 2020b), health (Fortuna et al, 2020), and environmental disparities and in justices (Woolf et al, 2020). This article considers how the COVID-19 pandemic is affecting the environments and settings in which U.S children grow up, and how this public health crisis magnifies the preexisting environmental, health, social and economic inequities. We acknowledge the importance of following COVID-19 public health recommendations, and do not intend to de-emphasize the severity of the virus

Environmental exposures during COVID-19

Food environments

Educational and developmental resources

Findings

Social injustice and racism