COVID-19-Associated Orphanhood and Caregiver Death in the United States
COVID-19-Associated Orphanhood and Caregiver Death in the United States
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DOI：
10.1542/peds.2021-053760
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发表时间：
2021-12-01
期刊：
影响因子：
8
通讯作者：
Unwin, H. Juliette T.
中科院分区：
文献类型：
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作者：
Hillis, Susan D.;Blenkinsop, Alexandra;Unwin, H. Juliette T.
背景：大多数冠状病毒病2019年(新冠肺炎)死亡发生在成年人中，而不是儿童，人们的注意力集中在减轻成年人对新冠肺炎的负担上。然而，成人死亡的一个悲剧性后果是，大量儿童可能会因新冠肺炎相关死亡而失去父母和照顾者。方法：我们使用生育率和过剩以及新冠肺炎死亡率数据来量化美国和每个州与新冠肺炎相关的照顾者损失和孤儿。我们评估了与新冠肺炎相关的孤儿的负担和比率，以及监护和共居的祖父母的死亡率，并按种族和民族进行了评估。我们进一步检查了每个州与新冠肺炎相关的孤儿按种族和民族的差异。结果：我们发现，从2020年4月1日到2021年6月30日，美国有14万儿童经历了父母或祖父母照顾者的死亡。在种族和少数民族儿童中，这种丧失的风险是非西班牙裔白人儿童的1.1到4.5倍。父母和照顾者与新冠肺炎相关的死亡负担最高的出现在西班牙裔儿童的南部边境州，东南部的黑人儿童州，以及美国印第安人和/或阿拉斯加原住民人口的部落地区。结论：我们发现不同种族和民族的父母和照顾者与新冠肺炎相关的死亡分布存在很大差异。新冠肺炎失去照顾者的儿童需要照顾，需要安全、稳定和养育家庭的经济支持、优质托儿和循证育儿支持计划。迫切需要采取以证据为基础的全面应对措施，重点关注受影响最严重的州中风险最高的儿童。
BACKGROUND: Most coronavirus disease 2019 (COVID-19) deaths occur among adults, not children, and attention has focused on mitigating COVID-19 burden among adults. However, a tragic consequence of adult deaths is that high numbers of children might lose their parents and caregivers to COVID-19-associated deaths.METHODS: We quantified COVID-19-associated caregiver loss and orphanhood in the United States and for each state using fertility and excess and COVID-19 mortality data. We assessed burden and rates of COVID-19-associated orphanhood and deaths of custodial and coresiding grandparents, overall and by race and ethnicity. We further examined variations in COVID-19-associated orphanhood by race and ethnicity for each state.RESULTS: We found that from April 1, 2020, through June 30, 2021,>140 000 children in the United States experienced the death of a parent or grandparent caregiver. The risk of such loss was 1.1 to 4.5 times higher among children of racial and ethnic minority groups compared with non-Hispanic White children. The highest burden of COVID-19-associated death of parents and caregivers occurred in Southern border states for Hispanic children, in Southeastern states for Black children, and in states with tribal areas for American Indian and/or Alaska Native populations.CONCLUSIONS: We found substantial disparities in distributions of COVID-19-associated death of parents and caregivers across racial and ethnic groups. Children losing caregivers to COVID-19 need care and safe, stable, and nurturing families with economic support, quality child care, and evidence-based parenting support programs. There is an urgent need to mount an evidence-based comprehensive response focused on those children at greatest risk in the states most affected.