A Tale of Two Pandemics: COVID-19 Hardships are Associated with Race, Income, and Neighborhood Resources

• In Event: Social Inequities in COVID-19 experiences and Child Mental Health: Insights from the NIH ECHO Program

Abstract

Introduction. As the COVID-19 pandemic persists, there is growing concern that hardships faced by families of color are magnified by pre-existing racial and ethnic financial and resource inequities within the US. This presentation will examine racial and ethnic differences in pandemic-related hardships and if observed differences between families of color and White families are accounted for by family-level socioeconomic status and neighborhood-level resources.

Study Population and Methods. The analysis sample included caregiver-identified White (N=8,629), Black (N=2,262), Asian (N=495), Hispanic-Black or Hispanic-White (N=3,155), and Mixed Race (N=1,709) families, drawn from the ECHO Program. COVID-19 questionnaires were administered to primary caregivers of children aged 1 to 18 years between April 2020 and February 2022. These questionnaires assessed family hardships within three domains: financial (e.g., job loss, financial stress due to the pandemic), availability of resources (e.g., material resources, including food and medicine, and daycare), and emotional (e.g., social isolation, community concern, family-work balance). Family SES was indexed by caregiver-reported family income. To assess community-level resources, participants’ current addresses were geocoded and linked to 28 census tract level indicators that reflect educational, health, and financial resources known to support families and children. To characterize neighborhoods, all indicators were included in a Latent Profile Analysis.

Results. As illustrated in Figure 1, five neighborhood profiles were identified and captured variations in resource levels (low, average, high). Four neighborhood profiles were in urban areas, one profile was associated with non-urban areas. White (84%), Asian (70%), and Mixed Race (62%) families were more likely to live in average-to-high resourced urban or non-urban neighborhoods, while Black (78%) and Hispanic (70%) families were more likely to live in average-to-low resourced urban neighborhoods.

Based on regression analyses, Black, Hispanic, and Mixed-Race families reported more difficulties with the availability of material resources, daycare, financial stress, and food insecurity compared to White families during the pandemic. Family income and/or neighborhood resource profile generally explained these differences for Black families, and partly for Hispanic and Mixed Race families. Independent of race, higher family income and living in non-urban neighborhoods were associated with lower levels of financial, food, and material resource availability hardships. Contrary to expectations, White families reported more COVID-19 emotional hardships than families of color: relative to White families, Black and Hispanic families reported fewer concerns about adult social isolation and COVID-19 related community concerns, and Black, Hispanic and Mixed Race families reported fewer family-work balance difficulties. However, relative to White families, Hispanic, Asian, and Mixed Race families reported more child social isolation hardships, while Black families reported fewer. Family income and/or neighborhood resource profile generally accounted for emotional hardship differences across White and Hispanic, Asian, and Mixed Race families, and to a lesser extent for Black families.

Taken together, pandemic hardships varied across race, SES, and geographical setting. Longer term inequities that have affected the neighborhood and financial resources of families of color should be acknowledged and incorporated into future social policy planning and social policy planning, broadly. Different strategies may also be needed for cities versus suburban and rural areas.

Group Authors

The ECHO Consortium

Authors

• Jody M. Ganiban, George Washington University
  Presenting Author

• Chang Liu, George Washington University

• Courtney King Blackwell, Northwestern University

• Sharon Lambert, George Washington University

• Sam Simmens

• Leslie D. Leve, University of Oregon

• Jenae M Neiderhiser, Pennsylvania State University, University Park

• Kaja Z. LeWinn, University of California, San Francisco

• Amy Margolis, Columbia University

• Sara Nozadi, University of New Mexico

• T. Michael O'Shea, University of North Carolina School of Medicine

• Rebecca Fry