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COVID deaths leave thousands of U.S. kids grieving parents or primary caregivers

COVID-19 survivors gather in New York and place stickers representing lost relatives on a wall in remembrance of those who have died during the pandemic.
Stefan Jeremiah
COVID-19 survivors gather in New York and place stickers representing lost relatives on a wall in remembrance of those who have died during the pandemic.

Of all the sad statistics the U.S. has dealt with this past year and a half, here is a particularly difficult one: A new study estimates that more than 140,000 children in the U.S. have lost a parent or a grandparent caregiver to COVID-19. The majority of these children come from racial and ethnic minority groups.

"This means that for every four COVID-19 deaths, one child was left behind without a mother, father and/or a grandparent who provided for that child's home needs and nurture — needs such as love, security and daily care," says Susan Hillis, an epidemiologist at the Centers for Disease Control and Prevention and lead author of the new study.

The study, which was published Thursday in the journal Pediatrics, estimated the number of losses from April 1, 2020, through the end of June 2021 at 140,000. And that number has risen in the past three months: Hillis estimates it is around 175,000 today.

"This number will continue to grow as long as our pandemic deaths increase," Hillis says.

These children are going to need support

Once a child loses their parent or primary caregiver, Hillis says, the tragedy is something they live with for "the entire duration of their childhoods."

It's a situation that calls for urgent action, Hillis notes. These children need "understanding, help, support," she says. And it's important "to ensure that they have a safe and loving family to continue to support their needs and nurture."

And, just as COVID-19 has killed more people in communities of color, children in these communities are the most impacted by the loss of parents and primary caregivers.

"Sixty-five percent of all children experiencing COVID-associated orphanhood or death of their primary caregiver are of racial and ethnic minority," says Hillis. "That is such an extreme disparity."

The study defines orphanhood as the death of one or both parents. The study also tracked the loss of caregiving grandparents.

And if you look more closely at individual groups, American Indian and Alaska Native children were 4.5 times more likely to have lost a primary caregiver compared with white children. Black children were 2.4 times more likely and Hispanic children almost twice as likely.

Losing a parent or caregiver in childhood is a significant trauma. The study notes that this type of adverse childhood experience "may result in profound long-term impact on health and well-being for children."

"Adverse childhood experiences are associated with increased risks of every major cause of death in adulthood," says Hillis.

Losing a parent has other long-term effects

And in the short term, the impact of losing a parent or primary caregiver can lead to mental health crises for kids, including increased suicide risk, Hillis says, and "increased exposure to sexual, physical and emotional violence and exploitation."

And in terms of life outcomes, a body of earlier research shows that losing a parent can put kids at a higher risk of economic, food and housing insecurity.

This adds a new layer of risk to kids in communities of color, which are already disadvantaged.

These communities experience inequities in access to health care, housing, education, and other factors that contribute to children's well-being, says Dr. Warren Ng, a psychiatrist at Columbia University who primarily works with kids in communities of color.

"The numbers don't tell the full stories," he says. "The full story is really in the lives and the affected future of these children and adolescents and their families."

Many children didn't even get to say goodbye

Mental health care providers who are seeing the mental health effects of the pandemic on kids say these losses are particularly traumatic. Ng says even grieving has been difficult for them — many didn't even get to see their parents or grandparents in the hospital, or say goodbye.

"One of the things that's unique about the pandemic is that it's also not only deprived us of a loved one, but it's also deprived us of our opportunities that come together, so that families can heal, [and] support one another in order to really get through the most difficult times of life," he says.

The study authors also call for policy action. "What we are proposing is that there be serious consideration to adding a fourth pillar to our COVID response, and that fourth pillar would be called care for children," says Hillis.

This would involve finding resources and coming up with systems for "finding the children, assessing how they are doing and linking them to appropriate care," she says, and strengthening economic support for families who care for the children.

The data highlighted here, especially the racial and ethnic inequities, "really does demand an urgent and effective response for all children," Hillis says.

Copyright 2023 NPR. To see more, visit https://www.npr.org.

Rhitu Chatterjee is a health correspondent with NPR, with a focus on mental health. In addition to writing about the latest developments in psychology and psychiatry, she reports on the prevalence of different mental illnesses and new developments in treatments.
Carmel Wroth is a senior health editor for NPR's Science Desk, where she guides digital strategy for the health team and conceives and edits digital-first, enterprise stories and packages.