A Year in the Life of a Pandemic
by Philip Fisher, PhD, Joan Lombardi, PhD, Nat Kendall-Taylor, PhD
One year ago last week, we wrote our first posting on data from the RAPID-EC national survey of families with young children. Even in this time of chaos and uncertainty, there was a set of ideas that were clearly emerging.
The unfolding global pandemic was unlike anything any of us had ever experienced.
Building on extensive prior research showing that early life experiences shape the architecture of the developing brain and other biological systems, we knew that the stress and adversity that accompanied the COVID-19 pandemic would have important effects on infants and young children.
We could tell that voices of families with young children were not being heard, and that gathering and rapidly disseminating high-quality data about their experiences was essential to inform policy decisions, resource allocations, and service delivery. With a team that brought together science, advocacy, and communications perspectives on child development, we were in a unique position to gather and disseminate these data.
The situation was evolving and changing rapidly and that it was necessary to gather data at very frequent intervals.
We are deeply grateful to the families who have shared their stories with us over the past year, to our team members who have gathered, analyzed, and disseminated the data, and to our many partners in policy, advocacy, research, and philanthropy who have contributed their expertise to the project.
To date there have been 54 RAPID-EC online surveys and 10,707 families across all 50 states who have participated. These families are diverse in terms of race/ethnicity, income, and family structure. They have contributed to an extensive and growing one of a kind quantitative dataset, and given voice to their experiences in over 140,000 responses to open-ended questions. The RAPID-EC survey has helped tell the story of American families with young children during this remarkable time.
Many of the issues that we have seen affecting families over the last year predate the pandemic and will remain once infection rates fade out and masks come off. These are issues that have long-demanded but not received adequate attention. They are issues that we must keep in focus during the recovery period and beyond. The RAPID-EC team will be continuing to survey families with young children, and adding to their voices, those of child care providers, but in this posting, we look back at three overarching findings from the first year of the survey.
1. The pandemic has made it difficult for many families with young children to pay for basic needs, which has had negative effects on caregiver and child wellbeing.
In the past year, the RAPID-EC survey showed that the pandemic has caused a “chain reaction of hardship” for many families with young children. Throughout the pandemic a very large proportion families with young children have been experiencing some form of material hardship (i.e., difficulty paying for basic needs like food, housing, and utilities): consistently throughout the past year, no less than 1 in 4 households with young children and at many times as many as one in 3 were experiencing such hardship.
We found that this material hardship is affecting family wellbeing. We measured emotional distress in adults as a composite of depression, anxiety, stress, and loneliness (on a 1–100 scale); and emotional distress in children as a composite of fearfulness/anxiety and fussiness/defiance (also on a 1–100 scale). As the severity of material hardship increased, so did emotional distress in both parents and children.
Looking across our weekly surveys we saw that the relationship between material hardship and emotional distress unfolded in a predictable way: parental reports of material hardship in any given week were associated with increased adult distress in subsequent weeks, and adult distress was, in turn, associated with increased child distress in the weeks that followed. We have described this effect as the “chain reaction of material hardship.”
We also found that emotional support was a powerful buffer against this chain reaction: adults who reported high levels of emotional support were less likely to be negatively affected by material hardships. When caregivers had emotional support it also protected their children from the negative effects of material hardship.
In the recent months we have seen another promising finding. As two stimulus payments became available between February and March, the proportion of families reporting material hardship has fallen back to levels seen in the early days of the pandemic. Importantly, for families whose financial circumstances improved during this time, there has been a corresponding decrease in emotional distress. Although we cannot discern from our data whether there is a causal relationship between these trends, it is promising that both indicators are moving in a positive direction. It will be important to determine if these recent trends continue, stabilize, or reverse as more time passes. RAPID-EC will be gathering information on this topic in the coming weeks and months in order to answer these questions.
Importantly, these recent trends should not obscure the fact that currently one in four families with young children — or about 3.6 million families in America — still cannot pay for basic needs and experience the resulting challenges to caregiver and child wellbeing.
Overall, we have seen that increases in material hardship negatively impact caregiver and child wellbeing, but also that this cascade can be stopped and reversed when families with young children have the support they need.
2. Long-standing racial inequality in families with young children has increased over the last year
The second fact that has consistently stood out in the RAPID-EC data and in other data is that structural inequalities based on race/ethnicity, which are long-standing and were well-documented prior to the pandemic, have gotten worse during the pandemic. For example, across the entire first year of the survey, Black and Latinx families have experienced significantly higher rates of material hardship than White families, and more Black and Latinx households that were middle/upper income before the pandemic have been experiencing hardships than White families in these same income levels. Indeed, during many weeks of the survey the proportion of Black and Latinx families unable to pay for basic needs was twice that of White families.
Not only have Black and Latinx families experienced more material hardship than White families during the pandemic but the differences between these groups has grown wider during this time. Notably, for Black households, this trend may be coming to an end; whereas it appears to be continuing for Latinx households, perhaps owing to greater barriers and worries associated with accessing governmental pandemic financial relief.
One finding of particular concern is that, compared with White families, a significantly larger proportion of Black and Latinx families who had been of middle/upper income prior to the pandemic, experienced difficulty paying for basic needs during the pandemic. Other research has documented differences in wealth between Black and White households earning similar incomes; as a result of our country’s history of structural racism. Black families also face challenges in accumulating wealth that their White counterparts do not. Differences in wealth along with a greater tendency to be supporting extended family members, and less secure jobs help explain why Black families at middle and upper income levels experienced greater levels of material hardship than White families of similar income levels during the pandemic.
These structural inequalities were also seen in our analyses of responses to the open-ended question, “What are the biggest challenges that you and your family are facing during the pandemic?” The bars below show the relative frequency with which specific topics occurred in responses offered by Black as compared to White respondents, after controlling for income. As the figure shows, Black and White families have experienced the pandemic in very different ways. For White families the primary challenges have been around social deprivation, whereas for Black families the primary challenges have been meeting basic needs.
It is clear that, because of inequities long-built into our structures and systems, Black families have born a heavier load during the pandemic and that the stress and challenges of the last year have only widened differences between the experiences of White and Black families with young children.
3. The Pandemic has Placed Extra Weight on Families with a Child with Special Needs
Our data, and other reports, have also shown that families with a child with special needs, in which numerous economic and social disparities were documented prior to the pandemic, have experienced disproportionately greater challenges in many domains over the course of the pandemic. These families have also had less access to social and emotional supports than other families.
For example, special needs households experienced higher rates of material hardship than other households, perhaps in part due to higher expenses associated with caring for a special needs child. Rates of emotional distress for both parents and children in special needs households have also been consistently higher throughout the pandemic. In addition, there are healthcare disparities between these and other households: 50% of special needs children missed a well-baby or well-child visit, significantly more than the 39% of other households. Also, one in four children with special needs (significantly more than other children) also did not receive routine vaccinations or preventative well-child visits.
This is especially concerning for families with children with special needs where such services are essential for monitoring of developmental progress and assuring referrals for early intervention services.
In addition, while other families may have been able to access and benefit from virtual services, it is well-documented that remote service delivery for children with special needs is challenging and not optimally effective. It is thus our expectation that children with special needs will benefit from additional support and access to in-person services in the aftermath of the pandemic.
Looking forward
Although the RAPID-EC survey was born out of the need to hear the voices of families with young children during pandemic, the story lines in our data are rooted in longstanding challenges that American families with young children faced prior to the pandemic. The pandemic did not cause these issues to arise, but rather has pressurized and thrown them into relief in a way that commands the attention of the general public and its policy makers. As we look ahead to the second year of the survey and beyond, our team is focused on extending the survey in three ways:
1. Focus on key issues related to early childhood policy and programs.
We are examining four areas where emerging federal, state, and local policy are focusing. These are pillars of stability and wellbeing that all families need to thrive. Our recurrent survey will allow us to track the impact of policies on these areas of wellbeing across time.
Financial stability and relief from material hardship
Access to integrated child and family services to promote health, behavioral health, housing, education
Adequate emotional support from both formal (e.g., child care, home visitation) and informal (family, friends, and other community members) sources
Time to focus on health and wellbeing, including paid sick leave and personal time, paid vacation time, and maternity/paternity leave
2. A new recurring survey of child care providers (RAPID-CC).
It has become apparent in our RAPID-EC survey data and in information from other sources that the recovery from the pandemic, and more generally the wellbeing of young children and families in the US, is inextricably tied to child care. Families need child care so that they can return to work, and this care needs to be high-quality, safe, and flexible; and, employers need child care so that their employees can return to work. In this country, child care comes in many types: Home and center-based, regulated and unregulated formal care, and many types of informal care provided by family, friends, and neighbors.
In March of 2021, we launched the first in what will be recurring bi-monthly RAPID-CC surveys of child care providers, which will parallel our RAPID-EC surveys. The RAPID-CC surveys will fill in some of the information gaps related to how providers are faring, what they need to be successful, and whether there are subgroups based on location (rural vs. urban), race/ethnicity, and other demographics, with different needs and assets.
3. Local and other targeted surveys.
Although many of the policy decisions that will impact households with young children will be made at the federal level, the implementation of these policies (and related systems and programmatic-level changes) will occur at state, county, and community levels. As such, we are planning to initiate partnerships that will allow for surveys to be carried out in local contexts with representative participation from specific communities. In this way, the RAPID surveys will become a tool for including family and provider voices in understanding the evolving needs of households with young children and the immediateecosystems in which they exist. We also plan to oversample from specific subgroups in which disparities and inequalities continue to exist, including Black and Latinx households and providers, households with a child with special needs, and other groups.
As we enter the second year of RAPID, we recognize the power of hearing from parents of young children and child care providers. They have faced circumstances that few anticipated and have made the wellbeing of children their top priority, often risking their own health in doing so. As we continue our work, our goal remains the same: elevate their voices and celebrate their efforts.