Material Hardship Research Articles

When One Is Not Enough: Exploring the Intersection of Multiple Public Benefits and Multiple Material Hardships in Low-Income Single-Mother Families

When One Is Not Enough: Exploring the Intersection of Multiple Public Benefits and Multiple Material Hardships in Low-Income Single-Mother Families

Evaluating the long-term effects of income assistance for material hardship among families with children

BackgroundAs a key aspect of poverty, material hardship describes day-to-day struggles in affording necessities. In explorations of policy initiatives that mitigate material hardship, evidence suggests direct income support can be effective in alleviating hardship. However, research investigating the long-term effects of income supports is limited, and it remains uncertain as to how benefit receipt may mitigate material hardship for families with children across time. MethodsTo explore the associations between income assistance and material hardship longitudinally, we utilised data from four waves of the Growing Up in New Zealand birth-cohort study (n = 5964), where family experiences were tracked between birth and adolescence. The variables of interest included mother-reported receipt of income benefits and material hardship from when the children were aged 9-months, 54-months, 8-years, and 12-years. Multilevel logistic regression analysis was employed to examine the associations between benefit receipt and material hardship in the short- and long-term. Interaction terms between benefit receipt and time were incorporated in the modelling to determine whether receiving benefits corresponded with significant changes in the likelihood of experiencing material hardship at specific time points. ResultsThe key results suggest that benefit receipt in early childhood reduced the likelihood of experiencing material hardship at subsequent time points at least until adolescence, when controlling for key sociodemographic characteristics. ConclusionThese findings provide insight into the associations between early childhood income supports and reductions in the likelihood of experiencing material hardship in the long-term, to emphasise the potential for such interventions to have longstanding effects. By elucidating the associations between benefit receipt and subsequent material hardship, this research gives direction for policy interventions and timely support for families.

Individual-Level Experiences of Structural Inequity and Their Association with Subjective and Objective Sleep Outcomes in the Adolescent Brain Cognitive Development Study

PurposeResearch has documented that adolescent sleep is impacted by various stressors, including interpersonal experiences and structural disadvantage. This study extends existing knowledge by empirically examining interconnected individual experiences of structural inequity and assessing its association with subjective and objective sleep outcomes. MethodsWe utilized data from the Adolescent Brain and Cognitive Development Study to identify seven conceptual domains of structural inequity: perceived discrimination, low school inclusivity, neighborhood safety, unmet medical needs, legal problems, material hardship, and housing insecurity. We operationalized experiences of structural inequity as latent classes, a cumulative exposure, and each domain separately. Sleep disturbances were measured using the Sleep Disturbance Scale, and sleep duration was assessed using Fitbits. Mixed effects linear regression estimated the association between our measures of structural inequity, longitudinal sleep disturbances, and cross-sectional sleep duration. ResultsLatent class analysis revealed common exposure profiles (low risk, interpersonal, and systemic) of experiences of structural inequity across our sample. In longitudinal models, structural inequity was associated with higher Sleep Disturbance Scale scores, whether measured as latent classes, a cumulative exposure, or individual domains. Individuals with interpersonal exposures, those with at least one exposure, and those with legal problems, material hardship, and housing insecurity had lower mean sleep duration. DiscussionResults are consistent with literature that frames structural inequity as a lifelong determinant of sleep disturbance and duration. Adolescence represents a crucial time for interventions aimed at improving sleep and redressing inequities throughout the life course; our work can inform the development of policies and interventions toward this end.

Association between financial hardship and psychological burden and the role of social and mental health support: An observational study.

We aimed to assess the association between medical financial hardship and psychological burden and the moderating role of social and mental health support. 2021 United States National Health Interview Survey was used. Financial hardship was defined as having financial worry, material hardship, or cost-related care nonadherence. Psychological burden was measured using perceived general health status, satisfaction with life, and serious psychological distress (SPD). Of 29,370 included adults, 49% experienced financial hardship in the last 12 months. Financial hardship was associated with a higher psychological burden (odds ratio [OR], 3.58; 95% confidence interval [CI], 2.43-5.47 for SPD). Eleven percent received counseling/therapy from mental health professionals, and 90% had experienced frequent social support. Frequent social support was associated with lower financial hardship (OR, 0.71; 95% CI, 0.63-0.80) and psychological burden (OR, 0.28; 95% CI, 0.19-0.42 for SPD). Previous mental health support was associated with higher financial hardship (OR,1.40; 95% CI, 1.28-1.54) and psychological burden (OR, 9.75; 95% CI, 6.97-13.94 for SPD). Those experiencing financial hardship had lower odds of SPD if they received mental health support in the last 12 months (OR, 0.57; 95% CI, 0.39-0.85). Future interventions should also focus on improving social support and mental health for patients as a way of mitigating medical financial hardship.

Material Hardship and Encampment Relocation Among Unhoused People who Use Drugs: Confirmatory Factor Analysis and Structural Equation Modeling of a Scale Measure

Material Hardship and Encampment Relocation Among Unhoused People who Use Drugs: Confirmatory Factor Analysis and Structural Equation Modeling of a Scale Measure

Material, Psychological, and Behavioral Financial Hardship Among Lesbian, Gay, and Bisexual Cancer Survivors in the United States.

Driven by anti-LGBTQ+ stigma, emerging literature suggests that lesbian, gay, and bisexual (LGB) cancer survivors experience financial hardship (FH) more frequently than heterosexual survivors. However, few studies have used nationally representative samples to estimate this inequity. National Health Interview Survey data from 2019 to 2022 were pooled and weighted. Outcomes included material, psychological, and behavioral FH. The behavioral domain was further broken down into subdomains including medical care, prescription medications, and mental health care. Multivariable logit models controlling for a variety of factors were used to generate LGB and heterosexual predicted probabilities and differential effects for each FH outcome. Stratified estimates were generated by sex and age groups. A total of N = 374 LGB and N = 12,757 heterosexual cancer survivors were included in this analysis. In adjusted analyses, LGB cancer survivors had significantly higher material (19%, 95% CI, 15 to 24 v 12%, 95% CI, 11 to 13; P = .004), psychological (44%, 95% CI, 38 to 51 v 37%, 95% CI, 36 to 38; P = .035), and behavioral (23%, 95% CI, 18 to 28 v 13%, 95% CI, 13 to 14; P < .0001) FH than heterosexual survivors. LGB cancer survivors also had higher medical behavioral (11%, 95% CI, 7 to 15 v 7%, 95% CI, 6 to 7; P = .030), prescription medication behavioral (14%, 95% CI, 10 to 19 v 10%, 95% CI, 9 to 10; P = .032), and mental health behavioral (9%, 95% CI, 6 to 13 v 3%, 95% CI, 3 to 4; P < .0001) FH than heterosexual survivors. Stratified estimates revealed young LGB cancer survivors had the highest probability of each outcome (material: 31%, 95% CI, 23 to 40; psychological: 58%, 95% CI, 50 to 66; behavioral: 45%, 95% CI, 36 to 53). In this nationally representative analysis, LGB cancer survivors experience substantial inequities in all FH outcomes. It is crucial that future FH interventional work should prioritize populations at the highest risk of FH, such as LGB cancer survivors.

Prevalence of financial hardship and health-related social needs among patients with missed radiology appointments

PurposeWe aimed to evaluate the prevalence of financial hardship and Health-Related Social Needs (HRSN) among patients who missed their radiology appointment. MethodsEnglish-speaking adult patients, with a missed outpatient imaging appointment at any of a tertiary care imaging centers between 11/2022 and 05/2023 were eligible. We measured self-reported general financial worry using Comprehensive Score for Financial Toxicity (COST), imaging hardship (worry that the current imaging is a financial hardship to patient and their family), material hardship (e.g., medical debt), cost-related care nonadherence, and HRSNs including housing instability, food insecurity, transportation problems, and utility help needs. Results282 patients were included (mean age 54.7 ± 15.0 years; 70.7 % female). Majority were non-Hispanic White (52.4 %), followed by Asian (23.0 %) and Hispanic (16.0 %) racial/ethnic background. Most missed appointments were patient-initiated (74.8 %); 13.5 % due to cost or insurance coverage and 6.4 % due to transportation and parking. Mean COST score was 26.8 with 44.4 % and 28.8 % reporting their illness and imaging as a source of financial hardship. 18.3 % and 35.2 % endorsed cost-related care nonadherence and material hardship. 32.7 % had at least one HRSNs with food insecurity the most common (25.4 %). Only 12.5 % were previously screened for financial hardship or HRSNs. Having comorbidity and living in more disadvantaged neighborhoods was associated with higher report of financial hardship and HRSNs. ConclusionFinancial hardship and HRSNs are common among those who miss radiology appointments. There needs to be more rigorous screening for financial hardship and HRSNs at every health encounter and interventions should be implemented to address these.

Material hardship and telomere length in children

Material hardship and telomere length in children

Economic hardship and the role of cost in childcare decisions: An exploratory study

The high cost of US childcare has become burdensome to most families with young children, yet little is known about how childcare costs shapes parental childcare decisions. This study addresses a critical gap in knowledge by examining how economic hardships shape parental childcare decisions, along with the individual and community characteristics associated with the influence of cost on childcare decisions. Guided by the accommodation model and family stress model, we used data from a statewide consumer survey in Iowa to conduct the first known study to examine associations between household constraints (i.e., economic hardships) and respondent reports that cost influenced their childcare decisions at least once in the previous year (i.e., systemic barriers to childcare). As hypothesized, each form of economic hardship was associated with increased odds of cost influencing childcare decisions. Our logistic regression demonstrated that every standard deviation increase in our financial stress scale resulted in a 110% increase in the odds of cost influence, while each additional experience of material hardship (out of 16) increased the odds of cost influence by 10%. Additionally, we identified demographic variations, with cost playing a more prominent role for people who were Hispanic/any race, unemployed, and were between the ages of 18- to 34-years old. Overall, findings demonstrate that economic hardships are constraints that, coupled with systemic barriers like cost, shape childcare decisions across demographic groups, communities, and income brackets. Findings also suggest the need for more public support to alleviate the costs of childcare among all families, such as expanding childcare subsidies or funding the provision of care, which may mitigate the risk of negative outcomes associated with economic hardship.

Understanding racial differences in financial hardship among older adults surviving cancer.

Despite Medicare coverage, financial hardship is a prevalent issue among those diagnosed with cancer at age 65 years and older, particularly among those belonging to a racial or ethnic minority group. Sociodemographic, clinical, and area-level factors may mediate this relationship; however, no studies have assessed the extent to which these factors contribute to the racial/ethnic disparities in financial hardship. Surveys assessing financial hardship were completed by 721 White (84%) or Black (16%) patients (aged 65 years and older) who were diagnosed with breast (34%), prostate (27%), lung (17%), or colorectal (14%) cancer or lymphoma (9%) at the University of Alabama at Birmingham between 2000 and 2019. Financial hardship included material, psychological, and behavioral domains. Nonlinear Blinder-Oaxaca effect decomposition methods were used to evaluate the extent to which individual and area-level factors contribute to racial disparities in financial hardship. Black patients reported lower income (65% vs. 34% earning <$50,000) and greater scores on the Area Deprivation Index (median, 93.0 vs. 55.0). Black patients reported significantly higher rates of overall (39% vs. 18%), material (29% vs. 11%), and psychological (27% vs. 11%) hardship compared with White patients. Overall, the observed characteristics explained 51% of racial differences in financial hardship among cancer survivors, primarily because of differences in income (23%) and area deprivation (11%). The current results identify primary contributors to racial disparities in financial hardship among older cancer survivors, which can be used to develop targeted interventions and allocate resources to those at greatest risk for financial hardship.

DEI-05. ASSESSING HOUSEHOLD MATERIAL HARDSHIP IN CHILDREN WITH CENTRAL NERVOUS SYSTEM (CNS) TUMORS

Abstract BACKGROUND Household material hardship (HMH) is defined as unmet basic needs including food, heat, housing, or transportation. Researchers have documented higher rates of poor nutrition, injury, infectious disease, and hospitalization in healthy children living in families with household material hardship. Furthermore, targeted interventions exist to modify these health outcomes. However, little is known regarding the relationship between social determinants of health and their impact on overall and quality of survival for children with brain or spinal cord tumors. The current available information is based upon retrospective and secondary data sources, often limited to basic socioeconomic factors such as race and ethnicity. The objective was to describe the change in household material hardship through patient reported outcome measures from baseline to six-months and explore the association between social determinants of health, including prospective household material hardship data, and clinical outcomes among children with brain and spinal cord tumors. METHODS We aimed to enroll 150 patients with a brain or spinal cord tumors who were followed by the Pediatric Neuro-Oncology Program at Riley Hospital for Children at IU Health. These participants were approached during their routinely scheduled clinic visits by a member of the study team. Written or verbal consent/assent was obtained, and their data was transcribed into a REDCap™ database. RESULTS To date, we have enrolled 118 children onto this study, with 35/76 participants completing their six-month follow-up survey. In line with Kira Bona’s previous work, we have found that around 30% acknowledged one positive domain of household material hardship. Additionally, we have found that almost 40% of our cohort fall below the 200% Federal Poverty Level, which is often considered a cutpoint for lower socioeconomic status. CONCLUSIONS We have shown that collecting prospective patient reported sociodemographic information is feasible in a busy clinical setting.

Household material hardship and distress among parents of children with advanced cancer: A report from the PediQUEST Response trial.

The prevalence and characteristics of household material hardship (HMH) in families of children with advanced cancer and its association with parent distress are unknown and herein described. Parents of children aged ≥2 years with advanced cancer at five cancer centers completed baseline surveys as part of the PediQUEST Response trial. HMH (housing, energy, and food) was operationalized as binary (≥1 HMH domains), ordinal (zero, one, or two or more HMH domains), and housing based (none, nonhousing [food and/or energy], only housing, or housing+other). Associations between HMH and parent distress measured by the State-Trait Anxiety Inventory-State and the 10-item Center for Epidemiologic Studies Depression Scale were estimated via linear models adjusting for confounders. Among 150 parents, 41% reported ≥1 HMH (housing, 28% [only housing, 8%; housing+other, 20%]; energy, 19%; food, 27%). HMH was more prevalent among Hispanic, other non-White race, Spanish-speaking, and single parents and those with lower education (associate degree or less) or who were uninsured/Medicaid-only insured. Parents endorsing HMH reported higher anxiety (mean difference [MD], 9.2 [95% CI, 3.7-14.7]) and depression (MD, 4.1 [95% CI, 1.7-6.5]) scores compared to those without HMH. Distress increased with the number of hardships, particularly housing insecurity. Specifically, parents experiencing housing hardship, alone or combined, reported higher distress (housing only: anxiety: MD, 10.2 [95% CI, 1.8-18.5]; depression: MD, 4.9 [95% CI, 1.3-8.6]; housing+other HMH: anxiety: MD, 12.0 [95% CI, 5.2-18.9]; depression: MD, 4.8 [95% CI, 1.8-7.8]). HMH is highly prevalent in pediatric advanced cancer, especially among historically marginalized families. Future research should investigate whether interventions targeting HMH, particularly housing stabilization efforts, can mitigate parent distress. In our cohort of parents of children with advanced cancer, household material hardship (HMH) was highly prevalent and significantly associated with higher parent distress. Housing hardship was the primary driver of this association. Families of children with advanced cancer may benefit from systematic HMH screening as well as targeted HMH interventions, especially stabilizing housing.

Disentangling the impact of poverty threshold and material hardship on child maltreatment: a mediating role of parenting aggravation

ABSTRACT To examine the role of subjective and objective poverty in relation to child maltreatment through parenting aggravation, the current study selected the biological mothers in wave 5 of the Future of Families & Child Wellbeing Study. The results showed that material hardship was consistently associated with all the child maltreatment outcomes through parenting aggravation, while only certain poverty threshold categories were related to physical abuse, neglect, and ever CPS involvement. Caregivers whose income is above 200% but experiencing more material hardship and those whose income is below 200% and experiencing more material hardship, showed a higher likelihood of child maltreatment.

Financial toxicity during pediatric cancer therapy: A qualitative analysis.

11056 Background: Childhood cancer treatment may often result in adverse financial consequences—also termed financial toxicity (FT)—for patients and families. Limited research has specifically examined mechanisms and drivers of FT salient to pediatric oncology. Methods: Using a phenomenological approach, we conducted in-depth interviews with a purposive sample of English- and Spanish-speaking parents of children receiving treatment for cancer at our institution. Parents were interviewed 6-18 months after a first cancer diagnosis, a period chosen to balance accumulation of financial challenges after treatment initiation with minimal recall bias. Interviews were coded by 3 investigators using an inductive, open-ended approach. We performed thematic analysis of interview transcripts focused on elucidating the main components of FT and relationships between them, identifying ameliorating and exacerbating factors, and exploring the impact of FT on patient and family well-being. We organized relationships between themes into a conceptual framework. Results: We interviewed 21 parents (86% mothers, 59% &gt;40 years old, 33% non-Hispanic White, 47% college-educated, 42% of those reporting had a household income of $50-100k, equal proportions above/below this). We identified 5 themes. Four themes pertained to primary elements of FT: (1) increased out-of-pocket spending, often related to additional caregiving and household coordination needs; (2) reduced income, primarily from employment changes inadequately covered by paid leave; (3) new material hardship, with families unable to afford costs of living when previously able to do so; and (4) elevated psychological distress regarding finances. We also identified an additional theme pertaining to response behaviors directed at managing FT, effects of which could be positive (“adaptive behaviors”), negative (“maladaptive behaviors”), or mixed. Response behaviors included reducing discretionary spending, selling off assets, skipping meals, requesting money from strangers, and rummaging through discarded items. Several exacerbating and ameliorating factors pertinent to the development of FT emerged, including household location, composition, wealth, employment flexibility, resource provision, and duration and severity of treatment. Parents provided perspectives regarding policies or interventions to mitigate FT, such as toolkits to better connect families with financial resources and extended paid family leave. Conclusions: Families of children with cancer face a wide range of financial toxicity throughout treatment, and many of these experiences differ considerably from those of adult patients. Many families reported substantial impact and unmet needs. These findings will help inform the design of quantitative measures specific to pediatric cancer and identify unique targets for intervention development and policy change for children with cancer.

Material Hardship and Mental Health Among Older Americans During the COVID-19 Pandemic

Material Hardship and Mental Health Among Older Americans During the COVID-19 Pandemic

Family structure and material hardship: Child and adolescent pathways to health and well‐being

AbstractChildren's early experiences have potential to shape their development through early childhood, middle childhood, and into adolescence. Family structure at birth and material hardship may offer insight into how children's health and well‐being are shaped within their family of origin. The current paper examined (a) the association between family structure at birth and material hardship 1‐year post‐birth and (b) the differential impact of race on the associations between family structure and material hardship. We further explored the association between family structure and material hardship on self‐reported health in (a) middle childhood and (b) adolescence. Using the Future of Families and Child Wellbeing dataset, an ordinary least squares (OLS) regressions and structural equation path models (SEM) were used to examine associations between family structure, material hardship, and health outcomes (body mass index [BMI], anxiety, and suicidal ideation). Results indicated that family structure predicted material hardship at 1‐year until maternal characteristics were taken into account. Race/ethnicity did not moderate the association. Also, family structure at birth was indirectly associated with youth anxiety through material hardship but did not account for BMI or sucidical ideation. Social supports and state policies should prioritize maternal health access and ensure families are able to meet their basic needs to mitigate children's health risks.

Comparison of Financial Hardship and Healthcare Utilizations Associated with Cancer in the United States Medicare Programs during the COVID-19 Pandemic.

In the United States, Medicare beneficiaries diagnosed with cancer often face significant financial challenges due to the expensive nature of cancer treatments and increased cost-sharing responsibilities. However, there is limited knowledge regarding the financial hardships and healthcare utilizations faced by those enrolled in Medicare Advantage (MA) compared to those in traditional fee-for-service Medicare (TM) during the COVID-19 pandemic. Our study aims to investigate the subjective financial hardships experienced by individuals enrolled in TM and MA and to determine whether these two Medicare programs exhibit differences in healthcare utilization during the pandemic. We utilized data from the 2020-2022 National Health Interview Survey (NHIS), focusing on nationally representative samples of cancer survivors aged 65 or older. Financial hardship was categorized into three distinct groups: material (e.g., problems with medical bills), psychological (e.g., worry about paying), and behavioral (e.g., delayed care due to cost). Healthcare utilization included wellness visits (preventive care), emergency care services, hospitalizations, and telehealth. We used survey design-adjusted analysis to compare the study outcomes between MA and TM. Among a weighted sample of 4.4 million Medicare beneficiaries with cancer (mean age: 74.9), 76% were enrolled in MA plans. Cancer survivors with a college degree (59.3% vs. 49.8%) and high family income (38.2% vs. 31.1%) were more likely to enroll in MA plans. There were no significant differences in any material, psychological, or behavioral financial hardship domains between beneficiaries with MA and TM plans except forgone counseling due to cost. For healthcare utilization measures, cancer survivors in MA were more likely than those in TM to have flu vaccination (77.2% vs. 70.1%) and experience lower hospitalizations (16.0% vs. 20.0%). However, there were no differences in other health service utilizations between MA and TM. While no significant differences were observed in any materialized, psychological, or behavioral financial hardships, older cancer survivors enrolled in MA plans were more likely to receive vaccinations and lower hospitalization rates during COVID-19. Although other preventive or primary care visits (i.e., wellness visits) were higher, their difference did not reach statistical significance. As MA grows in popularity, it is essential to consistently monitor and evaluate the performance and outcomes of Medicare plans for cancer survivors as we navigate the post-pandemic landscape.

Interventions to mitigate cancer-related medical financial hardship: A systematic review and meta-analysis.

This study systematically reviewed interventions mitigating financial hardship in patients with cancer and assessed effectiveness using a meta-analytic method. PubMed, Cochrane, Scopus, CINAHL, and Web of Science were searched for articles published in English during January 2000-April 2023. Two independent reviewers selected prospective clinical trials with an intervention targeting and an outcome measuring financial hardship. Quality appraisal and data extraction were performed independently by two reviewers using a quality assessment tool. A random-effects model meta-analysis was performed. Reporting followed the preferred reporting items for systematic review and meta-analyses guidelines. Eleven studies (2211 participants; 55% male; mean age, 59.29 years) testing interventions including financial navigation, financial education, and cost discussion were included. Financial worry improved in only 27.3% of 11 studies. Material hardship and cost-related care nonadherence remained unchanged in the two studies measuring these outcomes. Four studies (373 participants; 37% male, mean age, 55.88 years) assessed the impact of financial navigation on financial worry using the comprehensive score of financial toxicity (COST) measure (score range, 0-44; higher score=lower financial worry) and were used for meta-analysis. There was no significant change in the mean of pooled COST score between post- and pre-intervention (1.21; 95% confidence interval, -6.54 to 8.96; p=.65). Adjusting for pre-intervention COST, mean change of COST significantly decreased by 0.88 with every 1-unit increase in pre-intervention COST (p=.02). The intervention significantly changed COST score when pre-intervention COST was ≤14.5. A variety of interventions have been tested to mitigate financial hardship. Financial navigation can mitigate financial worry among high-risk patients.

Food Insecurity Pipeline: How Latinx Immigration-Impacted Students in Higher Education Navigate the Food Insecurity Cycle

Systemic inequities increase the risk of material hardships, including food insecurity, among immigrant households. Informed by 33 qualitative interviews with Latina/o/x undergraduate students who are undocumented or U.S. citizens with undocumented parents, we examine their experiences of food insecurity in their day-to-day lives. We find a food insecurity pipeline as students’ experiences of food insecurity begin early in childhood in their homes and continue in their adulthood on their college campuses. Food insecurity has implications for their well-being, and they rely on their strengths and networks to survive food insecurity. The study has implications for immigration policy, practice, and higher education institutions serving this vulnerable population.

Family Stress Processes Underlying COVID‐19–Related Economic Insecurity for Mothers and Fathers and Children's Internalizing Behaviour Problems

ABSTRACTCOVID‐19 and its economic fallout have resulted in unprecedented financial insecurity and material hardship for many American families, with a disproportionately negative impact on children and families from socioeconomically disadvantaged contexts. The current study applied the family stress model to examine the family processes underlying pandemic‐related economic insecurity and children's internalizing behaviours. Online survey data from an economically diverse sample of mothers and fathers, who experienced at least one type of pandemic‐related economic insecurity in the United States (N = 259), were collected across two longitudinal time points in the early weeks of COVID‐19: (1) 14 April and (2) 30 April of 2020. Parental depressive symptoms, negative partner relationship quality and harsh parenting were tested as mediators. Results from the path model showed that pandemic‐related economic insecurity was associated with higher levels of parental depressive symptoms, which were then associated with higher levels of negative partner relationship quality. Negative partner relationship quality was subsequently associated with more harsh parenting, which was then associated with increased child internalizing behaviours. Indirect effects were found for all hypothesized mediators. The family stress model can be applied and extended to the early COVID‐19 period. Child and family social work implications include targeting parents' mental health, relationship quality and parenting behaviours, as well as directly addressing financial and material hardship, to mitigate the adverse effects of pandemic‐related economic insecurity on children's mental health.