Tracing the Health Consequences of Family Support during the COVID-19 Pandemic

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PROJECT SUMMARY The initial health impacts of the COVID-19 pandemic have been unequal across social groups, and disparities in the economic impact of COVID-19 have amplified existing economic inequalities and health gaps. When faced with health and economic challenges, Americans often rely on family members, including those who are not coresident, to provide time help, financial assistance, and shared housing. Yet, for many disadvantaged Americans, the increased need for help from family comes at a time when the ability of family to provide help is diminished. Public transfers designed to alleviate economic hardships of the pandemic may interact with family transfers, but the combined effects are unknown. Despite the interdependence of health and economic challenges across generations and the effect of family support on health outcomes in the face of challenges, most research on pandemic effects focuses on individuals and households. This project fills this gap in the research creating a multidimensional contextual database linked to the Health and Retirement Study (HRS) and the Panel Study of Income Dynamics (PSID) to examine the effects of the pandemic across generations of American families. The HRS and PSID have collected data on the health and well-being of individuals and their family members for decades, include supplements on COVID-19 health and economic challenges and on public and private transfers to combat these challenges, and will continue indefinitely to support an understanding of the health impacts during and in the years following the pandemic. This project enhances these data by building a contextual database on the pandemic linkable to the generations of families in the HRS and PSID across dimensions of exposure to risk; state, local, and school policies; local economic conditions; health care availability; preexisting health factors; and structural inequalities. The proposed project addresses four Aims: (1) build and maintain a multidimensional contextual database linked to generations of HRS and PSID families; (2) describe how pandemic-related health and economic challenges differed across groups and were shared within families; (3) assess how care, financial support, and coresidence from family members responded to pandemic- related health and economic challenges and how each interacted with public transfer programs; and (4) study the physical and mental health effects in the immediate aftermath and the years following the pandemic and whether family support and public transfers mitigated negative health effects. Disparities across race-ethnicity, socioeconomic status, gender, age and retirement status, and family structure are assessed in each aim. Causal effects of the impact of the pandemic will be estimated using a combination of subjective assessments elicited from respondents and analytic strategies. The results provide a comprehensive understanding of the health and economic challenges the pandemic posed to American families and how it impacted their physical and mental health. Consortium collaborations will facilitate harmonization of contextual factors and health outcomes and support dissemination of the contextual data resource to the broader research community.