Study: Racial Disparities Affect How Sick Kids Get With COVID-19

Racial disparities, such as lifelong lack of access to health care and nutritious foods, or working at jobs where it’s hard to practice social distancing, profoundly affect how likely people are to get sick – and to what extent – from the coronavirus. Two new studies highlight how children are particularly affected by these disparities when they fall ill from COVID-19.

According to the Centers for Disease Control and Prevention, Hispanic children hospitalized with COVID-19 were eight times more likely than white children to require intensive care, and Black children were five times more likely. Hispanic children suffering from the virus were also more likely to be hospitalized than children from other groups for whom race and ethnicity were reported.

The CDC analyzed reported cases of COVID-19 from 14 states from March 1 through July 25. Of the 576 hospitalized kids, almost half were Hispanic, about 30 percent were Black, and just 14 percent were white.

One reason, the authors say, may be that communities of color are disproportionately represented among frontline and essential workers, whose jobs make it harder to maintain adequate social distancing. If those workers get the virus, even if they don’t show symptoms, the children in their homes are also at greater risk of exposure.

Underlying health conditions make things worse. Among the children for whom other medical information was collected, almost all had one or more underlying health conditions that can worsen the course of COVID-19 infection, including premature birth, chronic lung disease and obesity.

With schools reopening across the country, and the potential for another surge in COVID-19 cases this fall, this disparity could have serious implications for children already facing pandemic-related stress, food shortages, educational inequities and other concerns.

The second study, published in the peer-reviewed journal Pediatrics, summarized results from a coronavirus test site in Washington, D.C. It showed that children from low-income communities and communities of color are much more likely to test positive for the virus. Among 1,000 children tested, about one in five were positive. Almost half were Hispanic, 30 percent were non-Hispanic Black children and seven percent were white.  

These disparities were also associated with income, as reported in census block data from the American Community Surveys for 2014 to 2018.

Children in households in the highest one-fourth of income – families earning more than $158,000 a year – tested positive at a rate of 9 percent, whereas 38 percent of children from families in the lowest quartile were infected. This means that the children with the fewest economic resources are getting sick the most, and because of historical injustices and segregation, the wealth gap is widest between white Americans and communities of color.  

From this test data, it follows that children from communities of color and low-income communities also have higher rates of known exposure to the coronavirus.

The authors suggest this could be because besides workplace exposure, people of color may face other factors that increase their likelihood of infection, such as greater reliance on public transportation. Communities of color have also long been exposed to higher levels of industrial pollution and worse air quality, factors that increase COVID-19 mortality rates. What’s more, because children couldn’t get tested without a doctor’s referral, the incidence of illness in low-income communities and communities of color may have been underreported.

As school districts weigh decisions about when to reopen, they must recognize how racial and income disparities may mean higher vulnerability to the virus. Schools must take steps to foster flexibility as well as educational and social support and services for the students and families who need it the most.

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