Cited by 1,200COVID-19 and Mental HealthSocial impacts of COVID-19Food Security and Health in Diverse Populations

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Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey

Patrick, Stephen W., Henkhaus, Laura E., Zickafoose, Joseph S., Lovell, Kim, Halvorson, Alese, Loch, Sarah, Letterie, Mia, Davis, Matthew M.·2020·Pediatrics

DOI 10.1542/peds.2020-016824

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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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“…into the pandemic, 26.9% of parents reported worsening mental health, and 14.3% reported worsening in their children’s behavioral health, and that women, solo-parents, and families with younger children reported greater proportions of worsening mental and behavioral health (Patrick et al., 2020).”
Influential
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Adiba, A., Sidhu, S. S., Shaligram, D., Khan, M. M., & Qayyum, Z. (2023) · Advances in Psychiatry and Behavioral Health · doi:10.1016/j.ypsc.2023.03.006 · Cited by 3
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Background
Impact of covid-19 outbreak on the behavior of children and adolescents in the Kingdom of Bahrain
Awn, M. A., Mohroofi, A. D., Alsaqer, J. K., Aljowder, A. A., Mohroofi, A. D., & Alsuliti, M. A. (2023) · Medicine · doi:10.1097/md.0000000000035925 · Cited by 3
“[24] These stressors, in turn, may increase psychological strain on the family, including children.”
Background
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Influential
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“…restricciones implementadas para minimizar sus efectos produjeron en la población una drástica disminución de la salud mental (Brooks et al ., 2020; Patrick et al ., 2020), de la salud física (Bates et al ., 2020; Robinson et al ., 2021; Sahu, 2020; Sekulic et al ., 2020) y de las relaciones…”
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BackgroundInfluential
Children caught in the long shadow of COVID-19
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Background
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Background
Trends in Pediatric Head and Facial Trauma During the COVID-19 Pandemic
Dagi, A. F., Parry, G. J., Labow, B. I., & Taghinia, A. H. (2022) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000008776 · Cited by 3
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Background
Factors associated with medication interruption among outpatients with severe mental illness exposed to COVID-19
Jiao, J., Ji, Y., Ren, H., Hao, Y., Shen, X., & Dong, Z. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1086863 · Cited by 3
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“Children who received early intervention services before COVID-19 experienced a disruption of service and faced the challenges of transitioning to telehealth (Patrick et al., 2020).”
BackgroundInfluential
Parenting During a Pandemic
Wamser‐Nanney, R. A., Rodriguez, C. M., Mizock, L. M., & Nabors, L. (2023) · Springer eBooks · doi:10.1007/978-3-031-27580-7_4 · Cited by 3
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Predictors of General Deviance in the Context of COVID-19
Paat, Y., Hope, T. L., Zamora, H., & Hernandez, E. (2023) · International Journal of Offender Therapy and Comparative Criminology · doi:10.1177/0306624x231172644 · Cited by 3
“In other cases, unemployed families faced challenges ranging from the loss of employer-sponsored insurance and regular childcare/school closures, to lack of access to health care and necessities (e.g., food) (Patrick et al., 2020).”
Violence against adolescents during the COVID-19 pandemic in Bandung, Indonesia
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Comparing Anxiety Levels during the COVID-19 Pandemic among Mothers of Children with and without Neurodevelopmental Disorders
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“1 3 Culture, Medicine, and Psychiatry (2024) 48:91–112 negatively impacted by Covid (Alonzo et al., 2022; Brown et al., 2020; Davis et al., 2021a; Patrick et al., 2020; Russell et al., 2020) and our data suggest that parents of first-gen college students are no different.”
Assessing parents’ and children’s psychological well-being and its associated factors during the COVID-19 lockdown in a Tunisian-North African population
guedria, A., Slama, H., Fredj, M. B., Miladi, S., Kefi, H. E., Gatti, S., & Oumaya, A. (2023) · BMC Public Health · doi:10.1186/s12889-023-17206-1 · Cited by 3
“This result is consistent with previous studies evaluating the psychological impact of COVID-19 on parents and reporting that mothers were more severely affected [25–27].”
Result
Links between Children’s COVID-19 Fear and Parents’ Parenting Stress, Overprotective Parenting, Inconsistent Discipline, and COVID-19 Communication
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“Not surprisingly, one recent study found that approximately 37% of parents reported a decline in their own mental health during the height of the COVID-19 pandemic (Patrick et al., 2020).”
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“These challenges have had adverse effects on well-being as parents and children have exhibited elevated levels of emotional distress throughout the pandemic (e.g., RAPID, 2022; Patrick et al., 2020; Singh et al., 2020).”
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“…with a reversal of circadian rhythms, decreased physical activity, unhealthy eating habits, and potential difficulties in family relationships, including exposure to intrafamilial violence/trauma, have heightened concerns about the emotional well-being of the adolescent population [12,14,15].”
Background
How listening to children impacts their quality of life: a cross-sectional study of school-age children during the COVID-19 pandemic in Japan
Yamaguchi, A., Bethell, C. D., Yamaoka, Y., & Morisaki, N. (2024) · BMJ Paediatrics Open · doi:10.1136/bmjpo-2024-002962 · Cited by 4
Family structure, gender, and subjective well-being: effect of children before and after COVID-19 in Japan
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“…examined impact of COVID-19 on SWB, for instance, in Japan (Sugawara et al., 2022; Yamamura and Tsutsui, 2021a), UK (Groarke et al., 2020), and USA (Patrick et al., 2020), However a few works compared situations before and after COVID-19 outbreak, the exception being Cheng et al.’s (2024) study.”
Parent information seeking and sharing: Using unsupervised machine learning to identify common parenting issues
Eldeeb, N., Ren, C., & Shapiro, V. B. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2025.108210 · Cited by 6
Both Me and My Daughter Would Cry Sometimes: Parents’ and Children’s Experiences with Home Education During the Early and Later COVID-19 Pandemic
Yu, E., Burns, S., Jegatheeswaran, C., & Perlman, M. (2025) · Early Childhood Education Journal · doi:10.1007/s10643-025-01887-x · Cited by 3
“This finding contrasts with research indicating that lower socioeconomic status exacerbated the negative effects of the pandemic (Bhogal et al., 2021; Li et al., 2021; Patrick et al., 2020).”
The Emergent Motherhood Mental Health Advantage: Did Pandemic Times Make a Difference?
Nomaguchi, K. M., Milkie, M. A., & Marino, F. A. (2025) · Demography · doi:10.1215/00703370-11979673 · Cited by 3
Impacto del periodo de confinamiento por la pandemia COVID-19 en España sobre la salud y la atención recibida por los niños, niñas y jóvenes con discapacidad originada en la infancia
Lillo‐Navarro, C., Robles‐García, V., del Río, A. Q., Merlo, L. M., Konings, M. J., & Monbaliu, E. (2022) · Fisioterapia · doi:10.1016/j.ft.2022.10.001 · Cited by 3
Impact of COVID-19 on Families with Children: Examining Sociodemographic Differences
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A qualitative exploration of families’ experiences and resilience factors during the COVID-19 pandemic
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Leveraging Longitudinal Pre-pandemic Data to Understand Mental Health Vulnerability and Resilience Among Young People During the Early Pandemic
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Understanding the Health and Well-being of Canadian Black Children and Youth during the COVID-19 pandemic: A Review
Kemei, J., & Salami, B. O. (2022) · International Health Trends and Perspectives · doi:10.32920/ihtp.v2i1.1622 · Cited by 4
COVID-19: Sports activity and health-related quality of life of Swiss children and adolescents before and during the initial stay at home period
Zehnder, C., Nigg, C. R., & Benzing, V. (2022) · Journal of Health Psychology · doi:10.1177/13591053221122722 · Cited by 3
The Impact of Life Stressors Associated With the COVID-19 Pandemic on Essential Workers of Color
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“Essential workers in the United States also experienced conflicts between work and caretaking responsibilities during the pandemic (Goode et al., 2021; Holman et al., 2020; Patrick et al., 2020;Wolfe et al., 2021).”
BackgroundInfluential
Coping and Managing ALS Disease in the Family during COVID-19: Caregivers' Perspective
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“Patrick et al. (2020) emphasized that parents and children were affected by the COVID-19 pandemic to a considerable extent and that 1 out of every 7 parents reported deterioration in their children’s behavioral health.”
Background
Changes in Early Care and Education Settings Amid COVID-19: Voices of Parents
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Psychometric Properties of the Brief Problem Monitor-parent Form in Community and Clinical Samples of Brazilian Children
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“The COVID-19 pandemic has increased these percentages (Racine et al., 2020), impacting the psychological well-being and behavioral health of children and adolescents compared to the pre-pandemic period (Patrick et al., 2020; Gassman-Pine et al., 2020).”
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Zeanah, P. D., Lin, H., Bergeron, M. A., Ackel, K., Olivier, D. F., Rholdon, R. D., & Templet, T. A. (2025) · Journal of Child and Family Studies · doi:10.1007/s10826-024-02994-w · Cited by 2
“Parents also reported increased personal stress and mental health symptoms and increases in children ’ s behavior problems during the pandemic (Brown et al., 2020; Kerr et al., 2021; Patrick et al., 2020).”
Influential
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Miles, J. (2025) · Journal of Drug Education · doi:10.1177/00472379251315064 · Cited by 2
“It also surfaces new challenges, such as the mental health crisis, which is muddying the effectiveness of interventions (Patrick et al., 2020), particularly among young adults (Power et al., 2020; Winkeljohn Black et al., 2020).”
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“These findings are consistent with large scale cross-sectional research conducted during the pandemic (Gadermann et al., 2021; Patrick et al., 2020; Wu et al., 2020) and longitudinal studies exploring predictors of parental mental health outcomes following the pandemic (Russell et al., 2021).”
How Bad Sports Betting Research Can Lead to Bad Sports Betting Regulations
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Charalampopoulou, Μ., Choi, E. J., Korczak, D. J., Cost, K. T., Crosbie, J., Birken, C. S., Charach, A., Monga, S., Kelley, E. A., Nicolson, R., et al. (2022) · Paediatrics & Child Health · doi:10.1093/pch/pxac016 · Cited by 2
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Shchudlo, S., Mirchuk, I., Зелена, О., Klymanska, L. D., Herasym, H. Z., Savka, V. Y., Klimanska, M. B., Haletska, I., Okulicz‐Kozaryn, K., & Ostaszewski, K. (2022) · Alcoholism and Drug Addiction · doi:10.5114/ain.2022.121994 · Cited by 2
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“Those caring for children seemed to experience heightened stress (American Psychological Association [APA], 2020; Patrick et al., 2020; Russell et al., 2020).”
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Impact of 2019 Novel Coronavirus (2019-nCov) Pandemic and Lockdown on Parents and Caregivers in Ontario, Canada
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Parents of children with hearing loss: Impact and exposure of COVID-19 on mental health
Cejas, I., Sanchez, C. M., Holcomb, M. A., & Coto, J. (2023) · PLoS ONE · doi:10.1371/journal.pone.0285249 · Cited by 2
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Distance Learning in an Inclusive Preschool Focused on Autism During the COVID-19 Pandemic
Siller, M., Murthy, H., & Fuhrmeister, S. (2023) · Infants & Young Children · doi:10.1097/iyc.0000000000000244 · Cited by 2
“Research on the impact of the COVID-19 pandemic on children and families highlights the important role of childcare in maintaining established family routines, balancing the parents’ competing demands for time and attention, and supporting the mental/behavioral health of parents and children (Bentenuto et al., 2021; K…”
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Food insecurity among households with children during the early months of the COVID-19 pandemic
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Can a Clinic-Based Community Health Worker Intervention Buffer the Negative Impact of the COVID-19 Pandemic on Health and Well-Being of Low-Income Families during Early Childhood
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What happened to parents’ views of school success for autistic children during the COVID-19 pandemic?
Cheng, S., Cheng, S., Liu, S., & Li, Y. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1211041 · Cited by 2
Trauma-informed education
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Pediatrician-Authored Opinion/Editorial Articles Published in Newspapers Before and After the Start of the COVID-19 Pandemic
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“…months in an online learning environment with limited social interaction returned to their school environments with an increased level of anxiety and dysregulation (Brooks et al, 2020) while others returned to in-person learning with delayed or eroded self-management skills (Patrick, et al. 2020).”
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“The COVID-19 pandemic precipitated worsening mental health among parents and children (6, 7) though few studies have investigated longer-term effects among Black, Indigenous, and Latino/a/e/x parents of very young children (8).”
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Validity and Reliability of the Turkish Version of the Scale for Measuring Well-Being of Children in Lockdown
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“8,9,15,21-25 At the academic and social level, social isolation and lockdowns have prevented children and adolescents in pre-school, elementary, middle, and high schools from going to school for a long time and thus limited their social interactions.”
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Home or away? The relation between open or closed educational frameworks, parental distress, and child difficulties in the context of armed conflict
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“However, such reports are commonly used in challenging times, like COVID-19 lockdowns, and are linked to various child problems (Gassman-Pines, Ananat, & Fitz-Henley, 2020; Patrick et al., 2020).”
Work-family balance in times of COVID-19: a survey-study
Ordóñez, J. L., Martí, A. S., & Estrada, M. R. B. (2024) · Cogent Education · doi:10.1080/2331186x.2024.2329394 · Cited by 3
“Therefore, some of the most significant consequences of the COVID-19 pandemic include (Morero-M (cid:1) ı nguez & Ortega-Gaspar, 2022; Patrick et al., 2021): increased stress and burden; challenges in work-life balance due to the need to juggle professional demands with family obligations;…”

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: Patrick, Stephen W.
Henkhaus, Laura E.
Zickafoose, Joseph S.
Halvorson, Alese
Loch, Sarah
Letterie, Mia
Davis, Matthew M.
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
DOI: 10.1542/peds.2020-016824
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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Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey

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