COVID-19 racial, ethnic disparities affect kids, too

The legacy of systemic health and social inequities has put people from racial and ethnic groups at increased risk of getting sick and dying from COVID-19. These inequities and their impact are reflected among children of color.

The latest figures from the Coronavirus in kids (COVKID) Tracking Project indicate that as of September 29, the number of COVID-19 cases among children and teens is close to the three-quarters of a million mark with 749,864 cases and 137 deaths. More than 75 percent of the deaths are of Hispanic, Black and American Indian children, according to new data from the Centers for Disease Control and Prevention (CDC).

More than 1,400 children have been hospitalized with severe complications from COVID-19. Hispanic children were at greatest risk of severe disease and were hospitalized at a rate eight times that of white children. Black children were hospitalized at a rate five times that of white children. 

American Academy of Pediatrics President Dr. Sally Goza has noticed that “while much remains unknown about COVID-19, we do know that the spread among children reflects what is happening in the broader communities.”

Researchers and doctors posit that the disproportionate deaths among youths reflect the same racial disparities that are well documented among adults, as COVID-19 disparities among Black and Hispanic adults are disproportionately high.

According to a pediatric infectious disease specialist at the Cleveland Clinic in Cleveland, Ohio, one factor for the deaths in children could be underlying disparities. Of the 75 percent who died, three-quarters of them had at least one underlying condition that made them more vulnerable to complications from COVID-19. Most frequently noticed were asthma and obesity – two conditions that disproportionately occur in children of color.

The CDC report pointed to underlying disparities in social determinants of health that put children of color at higher risk of infection and heightened risk of poor outcomes.

Leading the list of social disparities is poverty. Children and youth of color are more likely to experience crowded living conditions, food and housing insecurity. They are more likely to have parents who are front-line, blue-collar or essential workers who cannot work from home and are less likely to be able to practice safe social distancing at work (for example, if they work in a restaurant’s small kitchen).

Other disparities include wealth and education gaps; racial discrimination, and difficulty accessing healthcare because of a lack of family resources such as health insurance, child care, transportation and sick leave. Our efforts must be consistent and intentional in working to address societal inequities that contribute to these disparities.

Researchers at Harvard have documented higher infection rates in communities with high proportions of immigrants, high numbers of food service workers and high numbers of people living in large, shared households. They note that immigrants may hesitate to seek medical care, in part because they lack adequate paid sick leave.

“When it rains it pours,” as the saying goes. Since mid-May 2020, CDC has been tracking reports of multisystem inflammatory syndrome in children (MIS-C), a rare but serious condition associated with COVID-19. MIS-C is a new syndrome, and many questions remain about why some children develop it after a COVID-19 illness or contact with someone with COVID-19, while others do not.

There have been approximately 935 cases in 44 states. Seventy percent of the cases have been Black and Hispanic children. Additional studies into MIS-C are needed to learn why certain racial or ethnic groups may be affected in greater numbers and what risk factors may contribute to this phenomenon. Black and Hispanic children lead in numbers of infections and deaths from COVID-19 and now are leading in this new and mysterious disease as well. 

For a long time, it was believed that children didn’t get COVID-19 infection or die from it, so testing was not freely or routinely offered to children. Unfortunately, the true number of children who have been infected with the coronavirus may not be known. Now that the 2020-2021 school year is in session across the country more schools are mandating testing for children to gauge the prevalence of the disease in their communities.  We can expect to see increased infection rates, which could also mean an increase in numbers of deaths. 

The American Academy of Pediatrics recommends that any child 6 months or older get a flu shot — in line with recommendations from the U.S. Centers for Disease Control and Prevention. Pediatricians say it’s more important than ever to make sure kids get either the flu shot or the protective nasal spray before the end of October.

Photo: Copyright (c) 2009 Xavier Donat