How COVID-19 Is Hugely Impacting the Health and Well-Being of Low-Income Children

It's commonly said that COVID-19 doesn't discriminate, but this statement is only true to a point. Anyone can be infected by the virus, but studies show that low-income people of color are most at-risk for contracting the virus and less likely to recover from it than white Americans in higher income brackets, due to the systemic racism that affects these populations' job security, health-care access, and more. These populations have also suffered huge financial losses (especially once federal unemployment benefits expired at the end of July), creating a growing hunger crisis and potential housing crisis that could force millions of Americans out of their homes.

But it's not just the paycheck-getters and decision-makers in the family who are impacted by these hardships: The health and well-being of low-income children are most at risk due to the pandemic. Here, experts shed light on the biggest ways low-income children are being affected by the pandemic, and what the solutions to these growing problems looks like.

Combatting rising food insecurity

According to the United States Department of Agriculture, 12 million children lived in food insecure homes in 2019—meaning they did not have consistent, reliable access to food. Because many more Americans are experiencing severe financial hardship due to the pandemic, that number is projected to increase to 18 million children facing hunger this year, according to No Kid Hungry, a non-profit committing to ending childhood food insecurity in the U.S.

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Since the late 1940s, the federal government has tried to help feed hungry kids through the National School Lunch Program (NSLP), which offers free and reduced-priced lunches to over 30 million children. Lisa Davis, the senior vice president at No Kid Hungry, says that for many kids, free lunch is their only decent meal of the day. Yet recent data from the Urban Institute shows that only 60 percent of kids who qualify for free or reduced-price lunch have had access to it since the pandemic started.

Davis says No Kid Hungry, which provides breakfasts, after-school meals, and summer meals to children who qualify for SNAP benefits (a federal food assistance program), quickly pivoted their programming to meet food insecurity needs. First, she says No Kid Hungry established pick-up locations where people could pick up the free meals for their kids, but after realizing that many parents lacked transportation, the group started delivering meals straight to families. "We realized that there was no one-size-fits-all model that worked, so we had to think about utilizing every single tool that we had," Davis says. (For example, the organization also added information about local food pantries to its summer meal hotline, allowing people to more easily find food resources nearby.)

Yolanda Minor, the deputy director of Mississippi programs for Save the Children, says her organization pivoted to serve the needs of rural children specifically. "Food insecurity is a big need for low-income children in rural communities because there often isn't a food pantry nearby that they can access," she says. Like No Kid Hungry, Save the Children is delivering free food to those in need.

Innovation is also happening in cities. One group in New York City, In Our Hearts, has set up 14 community fridges across the city full of free food. Nancy Easton, the co-founder of Wellness in the Schools, a national non-profit that teaches kids healthy habits to learn and live better, says many of the chefs who work with the nonprofit have started volunteering with organizations throughout New York City to help make nutrient-rich free meals for kids available for pick-up or delivery.

Representatives for No Kid Hungry, Save the Children, and Wellness in the Schools all say they expect food insecurity will be a growing problem in the second half of 2020. "Some of the financial breaks low-income families have been given [such as rent forgiveness or unemployment benefits] are going to come to an end, which is going to put greater financial strain on families, including many who have never experienced food insecurity before," Easton says. "Many families are going to be in a tough situation for a very long time."

How the pandemic exacerbates existing health disparities for low-income families

Besides not having enough to eat, the pandemic is negatively affecting low-income children's well-being in other ways. Danielle Dooley, MD, is a pediatrician and the medical director of community affairs and population health at Children's National and recently co-authored a paper on this very subject. "For low-income children, often school is the central place where their physical and mental-health needs are being met," she says. One example of this, she says, is when the school nurse becomes a child's de facto primary care provider. Taking them out of the classroom therefore means they no longer have ready access to these types of services.

No parent (or educator) needs to be told that virtual learning is a poor substitute for in-person instruction, but for some low-income households, this 21st-century solution for isn't even possible, says Dr. Dooley. "You need both internet access and a computer to do virtual learning, which is not something everyone has," she says. This could further widen the achievement gap between low-income kids and their wealthier classmates.

And the technology barrier has larger ramifications beyond a student's ability to learn. While the rise in telemedicine during the pandemic has allowed many parents to keep doctor's appointments for their children, Dr. Dooley says that option is often out-of-reach for low-income families who again, may not always have the technology required. "Additionally, for many parents who have to take public transportation to take their child to the doctor, they may not feel safe doing so during the pandemic, causing children to miss checkups and important vaccinations," she says. These new problems are only compounded by existing barriers low-income families have to accessing the health care they need, such as being under-insured or not being able to afford out-of-pocket costs.

On top of all this, low-income children are at an increased risk for being exposed to the virus. Dr. Dooley says that part of the reason for this is because many people making minimum wage are essential workers and must work to provide for their families. This increases the risk twofold: One, it puts them in more contact with people when commuting and at work—and thus can inadvertently expose their households to the virus. And two, parents often have no choice but to put their children in daycare, which, again, increases the odds of exposure.

How school budget cuts could further impact low-income kids

What the upcoming school year will look like has been left up to individual schools and school districts, and plans vary. Some schools, such as in Los Angeles and San Diego, are committed to 100-percent virtual learning. Others are tip-toeing into reopening, such as in New York City, where school attendance will be staggered. But in all cases, public school funding has decreased.

"States and localities provide the vast majority of funding for schools, roughly 90 to 92 percent," says Michael Leachman, PhD, the vice president for state fiscal policy at the Center on Budget and Policy Priorities. "When state revenue collapses, as they have done now, and their costs have increased, which is happening to fight the virus and also because there's more people who need Medicaid and other assistance because they've lost their jobs, the budget gets squeezed. This leaves [state and local policymakers] to make some pretty bad choices about where to cut the budget—unless they want to massively raise taxes."

Thus, Dr. Leachman says that schools have been forced to cut anything that isn't deemed absolutely "necessary," such as eliminating 468,000 public education jobs that primarily affected special education teachers, teaching assistants, tutors, and school counselors and nurses. One example of such a cut is the dismantling of the Single Shepherd program in New York City, which provided guidance counselors and social workers to some of the city's most vulnerable students—leaving those students with even fewer outlets for mental health-care and other support.

While virtual learning remains inequitable for many kids, the medium has at least allowed some health-related programs to continue. Easton says Wellness in the Schools has started making pre-recorded content, such as fitness breaks and healthy cooking classes for kids, which is being integrated right into virtual classroom learning. They also have segments airing every night at 8 p.m. ET on Bronxnet, a free TV station serving people in the Bronx.

Moving forward through the pandemic

The pandemic is creating a cluster of problems with no easy answers. "We're really at a crossroads in our country about how we're going to invest in children and what that means," Dr. Dooley says. "The effects of what's happening now are going to be long-lasting, so we need to have solutions in place that take that into account."

Easton, of Wellness in the Schools, says in some ways, the pandemic, as well as the Black Lives Matters movement, has shed light on important needs for children that many have overlooked before, such as the free lunch program. "So many people have reached out to me saying they've recognized a need they had been overlooking and want to help," she says. Easton says she's seen more people thinking creatively about how they can help at an individual level, and also what their workplaces can do to help. For example, some food companies, such as Gotham Greens, have donated foods to be used for healthy meals for kids, created by the Wellness in the Schools volunteer chefs.

In May, the House of Representatives passed the $3 trillion HEROES Act, which included $250 billion for education funding. According to Dr. Leachman, this aid money could be extremely beneficial for schools in the short-term—but the bill has yet to pass the Senate and be signed into law. Even if it is passed, that aid money will likely dry up by 2022, he predicts; without further interventions, low-income children will still be left behind.

Plus, if this recession goes anything like the previous Great Recession from the last decade, Dr. Leachman worries that the cuts made to schools will persist long after the pandemic is over and the economy recovers. "Schools are still recovering from those setbacks," he says. "We have 77,000 fewer teachers and school workers now than when the Great Recession really took hold [in 2007-2009], and we have half a million more kids enrolled in our schools. Particularly in states like Arizona, Oklahoma, and North Carolina, school budget cuts were so deep and were never rebuilt in any significant way."

What's clear is that if more effort isn't taken at both macro and micro levels (i.e. with policy solutions and individual action), low-income children will be experiencing the ramifications of the pandemic for many, many years. "We often say, 'children are resilient, they'll recover.' I don't think people are recognizing the very long-term effects of what's happening," Dr. Dooley says. "We need to really ask ourselves, what investments are we willing to make for these children? And what are the long-term consequences of not making them?"