Families of color and families of children with asthma have suffered greater COVID-19 pandemic-related consequences compared with non-Hispanic White (NHW) families, according to results of a study recently published in Journal of Pediatric Psychology.
While the adverse effects of COVID-19 are pervasive, it appears that the burden has been greater for parents of children with chronic medical conditions and for Black, Indigenous, or other People of Color (BIPOC) families. Previous studies have suggested that social determinants of health (SDOH) such as discrimination, poverty, access to health care and housing have highlighted ethnic/racial disparities and are linked to negative outcomes in both COVID-19 patients and in patients with asthma. However, there have been limited studies specifically investigating the psychosocial burden on BIPOC families and on families of children with asthma.
The goal of this study was to quantify group differences in SDOH and psychosocial impacts of COVID-19 in 4 groups: NWH parents of children with asthma, NWH parents of healthy children (referent), BIPOC parents of children with asthma, and BIPOC parents of healthy children.
A total of 321 participants were recruited using the crowdsourcing participant panel Prolific. Parents completed the COVID-19 Adolescent Symptoms and Psychological Experience Questionnaire-Parent (CASPE-P) and the Mental Health Impacts module and the Coronavirus Impacts and Pandemic Stress module from the Johns Hopkins University COVID-19 Community Response Survey.
Across the 4 study groups, there were no differences in COVID-19 exposure and treatment after controlling for parent age, education, and child asthma status.
In terms of differences across the 4 groups in SDOH, food insecurity was more likely among BIPOC parents of children with asthma vs NHW parents of healthy children. Discrimination was experienced more in both BIPOC groups compared with NHW parents of healthy children. BIPOC parents of children with asthma (P =.08) and BIPOC parents of healthy children (P =.01) were more likely to feel they would have received better health care if they were of a different race or ethnicity vs NHW parents of healthy children.
Group differences in SDOH related to COVID-19 were more significant in BIPOC parents of children with asthma vs other groups. Both BIPOC parents of healthy children and NHW parents of children with asthma reported greater income loss than NHW parents of healthy children. NHW parents of children with asthma reported greater difficulty in accessing health care vs NHW parents of healthy children. Parental, but not child, history of COVID-19 was associated with increased risk of SDOH across all groups.
Both BIPOC groups and NHW parents of children with asthma reported more psychosocial issues than NHW healthy children. Both BIPOC groups and NHW parents of children with asthma were more worried about income loss than parents of NHW healthy children, but there was no difference in general COVID-19 anxiety.
This study highlights the need for further research and targeted interventions to support BIPOC families and families of children with asthma and to reduce health care inequities both before and after COVID-19.
Clawson AH, Nwanko CN, Blair AL, Pepper-Davis M, Ruppe NM, Cole AB. COVID-19 impacts on families of color and families of children with asthma. J Pediatr Psychol. 2021;46(4):378-391. doi:10.1093/jpepsy/jsab021