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Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey
Abstract
BACKGROUND: As the coronavirus disease pandemic spread across the United States and protective measures to mitigate its impact were enacted, parents and children experienced widespread disruptions in daily life. Our objective with this national survey was to determine how the pandemic and mitigation efforts affected the physical and emotional well-being of parents and children in the United States through early June 2020. METHODS: In June 2020, we conducted a national survey of parents with children age <18 to measure changes in health status, insurance status, food security, use of public food assistance resources, child care, and use of health care services since the pandemic began. RESULTS: Since March 2020, 27% of parents reported worsening mental health for themselves, and 14% reported worsening behavioral health for their children. The proportion of families with moderate or severe food insecurity increased from 6% before March 2020 to 8% after, employer-sponsored insurance coverage of children decreased from 63% to 60%, and 24% of parents reported a loss of regular child care. Worsening mental health for parents occurred alongside worsening behavioral health for children in nearly 1 in 10 families, among whom 48% reported loss of regular child care, 16% reported change in insurance status, and 11% reported worsening food security. CONCLUSIONS: The coronavirus disease pandemic has had a substantial tandem impact on parents and children in the United States. As policy makers consider additional measures to mitigate the health and economic effects of the pandemic, they should consider the unique needs of families with children.
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“Published reports suggest that the coronavirus disease 2019 (COVID-19) pandemic has had a negative effect on children’s mental health (1,2).”
From Mental Health–Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic — United States, January 1–October 17, 2020 (2020) · cites this paper as [2]
In the citing paper
“The increase in the proportion of ED visits for children’s mental health concerns might reflect increased pandemic-related stress and unintended consequences of mitigation measures, which reduced or modified access to children’s mental health services (2)”
From Mental Health–Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic — United States, January 1–October 17, 2020 (2020) · cites this paper as [2]
In the citing paper
“Research by Patrick et al. (2020) finds that in the year since the beginning of the pandemic, a quarter of parents reported worsening mental health for themselves and a 14% worsening in the behavioral health of their children.”
From Domestic violence during the COVID-19 pandemic—evidence from a systematic review and meta-analysis (2021) · cites this paper as Patrick et al. (2020)
In the citing paper
“They find that the combined impact of lack of child-care due to school closures, reduced access to healthcare due to closures and delays in visits, and declines in food security led to the most substantial declines in a family's mental and behavioral health.”
From Domestic violence during the COVID-19 pandemic—evidence from a systematic review and meta-analysis (2021) · cites this paper as Patrick et al. (2020)
In the citing paper
“Research has already demonstrated the impact of the COVID-19 pandemic among parents and children with respect to social isolation, loneliness, and depression.”
From Domestic violence during the COVID-19 pandemic—evidence from a systematic review and meta-analysis (2021) · cites this paper as Patrick et al. (2020)
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Development of subjective well-being in adolescents before and during the COVID-19 pandemic
Eckert, H., Paschke, P., Wirthwein, L., & Steinmayr, R. (2025) · Frontiers in Education · doi:10.3389/feduc.2025.1485289 · Cited by 4
Practice Challenges for Federally Qualified Health Centers During the COVID-19 Pandemic
Walsh, J. A., & Gearhart, A. T. (2021) · Pediatric Annals · doi:10.3928/19382359-20211117-02 · Cited by 4
Engagement in Meaningful Activities and Psychological Distress During the COVID-19 Pandemic
Tigershtrom, A., & Boyraz, G. (2022) · Journal of Loss and Trauma · doi:10.1080/15325024.2021.2016140 · Cited by 4
“A national survey of 1,011 parents in the U.S. found that during the three months of the COVID-19 pandemic, 27% of parents reported that their mental health was declining, and 14% reported their child’s behavioral health had worsened as well (Patrick et al., 2020).”
BackgroundHolubnycha, L., Khodakovska, O. O., Besarab, T., Dolgusheva, O., & Malieieva, T. (2021) · Revista Amazonia Investiga · doi:10.34069/ai/2021.47.11.8 · Cited by 4
Zampini, L., Zanchi, P., Riva, P., & Tobia, V. (2022) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2022.2062841 · Cited by 5
“Also Patrick et al. (2020) found alarming data about US families' well-being during the COVID-19 crisis, with 27% of parents reporting deterioration of their mental health and 14% reporting deterioration in their children.”
BackgroundThe Effect of COVID-19 on the Mental Health of Military Connected Children and Adolescents
Lawson, M. L., Bowsher, B., & Hansen, S. L. (2022) · Pediatric Annals · doi:10.3928/19382359-20220321-02 · Cited by 4
Cook, J., Pittaoulis, M., Alderfer, J., Gilchrist, K., & Sapia, M. (2022) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2021.0485 · Cited by 4
Conradi, L., Hazen, A. L., & Covert, J. (2022) · Global Implementation Research and Applications · doi:10.1007/s43477-022-00065-0 · Cited by 4
“Many of the effects associated with the pandemic, including social isolation, economic strain, increased stress, mental health challenges, and reduced access to services, have been linked with risk for child abuse (Pereda & Díaz-Faes, 2020; Peterman et al., 2020).”
BackgroundMaskour, L., Batri, B. E., Oubit, S. M., Jeronen, E. K., Agorram, B., & Bouali, R. (2022) · Education Sciences · doi:10.3390/educsci12120892 · Cited by 4
Social Support and Parenting Stress During the Covid-19 Pandemic
Yunisah, Y., Amalia, R. P., Akram, A. R., Moeliono, M. F., & Abidin, F. A. (2022) · Journal of Educational Health and Community Psychology · doi:10.12928/jehcp.v11i3.23801 · Cited by 4
Müderrisoğlu, S., Akkan, B., Semerci, P. U., & Erdoğan, E. (2023) · International Journal on Child Maltreatment Research Policy and Practice · doi:10.1007/s42448-023-00152-1 · Cited by 4
“The pandemic had adverse effects not just on the mental well-being of children but also on their parents (Patrick et al., 2020).”
BackgroundParents’ Discussions of the COVID-19 Pandemic and Death With Young Children
Su‐Russell, C., Greiner, C., Ermer, A. E., & Russell, L. T. (2023) · Journal of Family Nursing · doi:10.1177/10748407231166099 · Cited by 4
“In addition, parents have reported an increase in the loss of childcare, food insecurity, loss of insurance coverage, and worsened children’s behavioral health (Patrick et al., 2020).”
BackgroundInvestigating the factors affecting adolescents’ test anxiety in Greece during the COVID-19 pandemic
Trikoilis, D. (2023) · Pastoral Care in Education · doi:10.1080/02643944.2023.2214920 · Cited by 4
Psychosocial Impact of the COVID-19 Pandemic on Families with a Child in Cancer Treatment
Bates, C. R., Fornander, M. J., Gillette, M. L. D., Covitz, L. M., & Moore, R. M. (2023) · Children s Health Care · doi:10.1080/02739615.2023.2222619 · Cited by 4
“The initial outbreak of the novel coronavirus (COVID−19) presented an acute stressor to families of children with and without chronic medical conditions (Feinberg et al., 2022; Patrick et al., 2020).”
BackgroundBulgarelli, F., & Potter, C. E. (2023) · Multilingua · doi:10.1515/multi-2023-0003 · Cited by 4
Ekas, N. V., Kouros, C. D., Rigsby, B. A., Madison, S., Hymel, J., & Filippi, M. (2023) · Autism · doi:10.1177/13623613231182180 · Cited by 5
“Consistent with emerging COVID-19 research on parent mental health (e.g. Patrick et al., 2020) and study hypotheses, mothers reported higher levels of anxiety compared to fathers in both July and October 2020.”
ResultParents as Teachers as Students: Managing Multiple Roles During the Covid-19 Pandemic
Ancho, I. (2023) · International Journal of Instruction · doi:10.29333/iji.2023.16312a · Cited by 6
“In the case of the United States, a significant impact on parents and children (Patrick et al., 2020) is seen brought about by the pandemic, calling policy experts to address the health and economic consequences of the health crisis.”
Play as a Stress-Coping Method Among Children in Light of the COVID-19 Pandemic: A Review
Raudenská, J., Gumančík, J., Raudenský, M., Pasqualucci, A., Tamayo, M. A. N., Varrassi, G., & Javůrková, A. (2023) · Cureus · doi:10.7759/cureus.43550 · Cited by 6
“Since March 2020, 27% of American parents reported experiencing overall worsening of psychological difficulties, and 14% reported that their children's behavior had worsened as well [3].”
BackgroundInfluentialCognitive-Behavioral Play Therapy and COVID-19 Pandemic Trauma in Preschool Children
Raudenská, J., Gumančík, J., Raudenský, M., Pasqualucci, A., Μoka, Ε., Varrassi, G., Paladini, A., & Javůrková, A. (2023) · Cureus · doi:10.7759/cureus.44249 · Cited by 9
“Since February 2020, when the pandemic started, 14% of American parents reported that their children’s behaviors had worsened and that they were not emotionally stable [20,24].”
BackgroundExamining Adolescents' Mental Health Before and During the COVID-19 Pandemic
Yarger, H. A., Shariq, D. A., Hickey, A. C., Giacobbe, E., Dziura, S. L., & Redcay, E. (2023) · Merrill-palmer Quarterly · doi:10.1353/mpq.2023.a909257 · Cited by 4
“…from prepandemic to during the pandemic are consistent with previous literature, where some negative impacts on youth’s mental health have been observed (e.g., Patrick et al., 2020; Ravens-Sieberer et al., 2021), but some positive outcomes have also been observed (e.g., Patrick et al., 2020).”
BackgroundResultLux, U., Neumann, A., Renner, I., & Ulrich, S. M. (2023) · Psychologie in Erziehung und Unterricht · doi:10.2378/peu2024.art02d · Cited by 4
Akca, S. O., Turan, A. P., & Söngüt, S. (2024) · Journal of pediatric nursing · doi:10.1016/j.pedn.2024.02.007 · Cited by 3
Papatriantafyllou, E., Efthymiou, D., Felekkis, K. N., Solmi, M., Correll, C. U., Thompson, T., Estradé, A., Tsokani, S., Kontouli, K., Seitidis, G., et al. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13185395 · Cited by 4
“A national survey conducted in June 2020 in the United States found that 26.9% of parents and 14.3% of children experienced deterioration in their mental health during the COVID-19 pandemic [28] and that the impact on physical health was comparatively less, but also significant [28].”
BackgroundInfluentialA Framework to Guide Educational Technology Studies in the Evolving Classroom Research Environment
Nagashima, T., Yadav, G., & Aleven, V. (2021) · Lecture notes in computer science · doi:10.1007/978-3-030-86436-1_16 · Cited by 4
Boettcher, J., Nazarian, R., Fuerboeter, M., Liedtke, A., Wiegand‐Grefe, S., Reinshagen, K., & Boettcher, M. (2021) · European Journal of Pediatric Surgery · doi:10.1055/s-0041-1740978 · Cited by 4
Low Job Control and Racial Disparities in Breastfeeding
Whitley, M. D., Ro, A. E., & Choi, B. (2022) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000002591 · Cited by 7
Mudło‐Głagolska, K., & Михайлович, Л. П. (2022) · Przegląd Badań Edukacyjnych · doi:10.12775/pbe.2022.004 · Cited by 4
Advocacy Considerations for the Pediatric Pulmonologist in the Era of the COVID-19 Pandemic
Rao, D., Kopp, B. T., Kamerman‐Kretzmer, R., Afolabi, F., Liptzin, D. R., Balasubramaniam, V., & Sadreameli, S. C. (2021) · Annals of the American Thoracic Society · doi:10.1513/annalsats.202008-1022ps · Cited by 4
Psychological effects of COVID-19 on children of frontline nurses
Mondal, M. S. A., Kabir, H., & Hasan, M. K. (2021) · Population Medicine · doi:10.18332/popmed/142558 · Cited by 3
Beyond COVID-19 Pandemic: How Did Interaction Balances Change Between Children and Caregivers
Karademir, A. (2021) · International Journal of Psychology and Educational Studies · doi:10.52380/ijpes.2021.8.4.632 · Cited by 4
“Positive parental attitude under challenging circumstances is a significant predictor of children's wellbeing (Gassman-Pines et al., 2020; Patrick et al., 2020; Romero et al., 2020).”
BackgroundHasyyati, B. M., & Ninin, R. H. (2022) · Psychocentrum Review · doi:10.26539/pcr.42909 · Cited by 5
Metadata
- Authors
- Patrick, S. W., Henkhaus, L. E., Zickafoose, J. S., Lovell, K., Halvorson, A., Loch, S., Letterie, M., & Davis, M. M.
- Affiliations
- Vanderbilt University (US)
- Vanderbilt University Medical Center (US)
- Northwestern University (US)
- Corresponding author
- Patrick, Stephen W.
- ORCID
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2020-07-24
- Volume
- 146
- Issue
- 4
- Pages
- e2020016824
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W3044545080
- Cited by
- 1,200
- References
- 15
- Citations by year
- 2026: 38 · 2025: 78 · 2024: 137 · 2023: 212 · 2022: 353 · 2021: 343 · 2020: 35
- FWCI
- 94.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Sociology and Political Science › Social impacts of COVID-19
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Food Security and Health in Diverse Populations
- Keywords
- COVID-19 pandemic, parental mental health, child behavioral health, food insecurity, employer-sponsored health insurance, health care utilization, family well-being, pandemic mitigation measures
- MeSH terms
- Child Health, Betacoronavirus, COVID-19, SARS-CoV-2, Child, Child Care, Female, Food Supply, Health Policy, Health Status, Health Surveys, Humans, Male, Mental Health, Parents, Pneumonia, Viral, Public Assistance, United States, Coronavirus Infections, Insurance Coverage, Pandemics
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