No abstract

As ASD prevalence figures continue to increase in the United States, findings surrounding wait time, appointment absenteeism, and clinical models of care are important to improving public health.

By mid-July 2020, more than 138 000 US citizens died of novel coronavirus disease 2019 . 1 While an estimated 0.03% of the deaths were children, aged birth through 14 years, many more children were affected directly by the deaths of their parents, grandparents, and caregivers. 1 Given the human loss and public health efforts to mitigate the incidence of COVID-19, access to pediatric physical and mental health care was significantly impacted.The COVID-19 pandemic revealed glaring health disparities in the US. Health disparities are preventable differences in health outcomes due to racial, ethnic, ability, immigration status, or other marginalizing characteristics. Of 42 states and cities reporting mortality data to the CentersforDiseaseControlandPrevention,34(81.0%)reported higher (>20%) mortality rates among Black individuals in the US than would be predicted based on Black population distribution. 1 Among people of color in the US, the overall state mortality disparities, measured by distribution of COVID-19 deaths, were up to 360% higher for Black individuals in the US than would be predicted based on their state population percentage. 1 Reported COVID-19 mortality rates were up to 1100% higher in 1 state for the American Indian population, up to 167% higher for Asian populations, and up to 219% higher for Hispanic/Latinx populations. 1 The statewide mortality rates, however, may not be the whole story. Some cities have even higher COVID-19 mortality disparities. Health disparities in the US may be primarily caused by structural racism and institutional policies that support residential segregation, underfunded schools, unequal pay and benefits, and lack of universal health care. 2 All states without COVID-19 mortality percentage disparities among the Black population enacted the Affordable Care Act (ACA), compared with the ACA enactment in only 50% of the 10 states with the highest disparity percentages of COVID-19 mortality among Black individuals. 1,3 Tragically, children who live in families with the least resources-those who are poor, disabled, and from marginalized populationsare experiencing the most hardship from the novel coronavirus pandemic due to food scarcity, housing insecurity, and lack of access to health care.What can we do to bridge the physical and mental health care gaps exacerbated during mitigation strategies to reduce COVID-19? Telehealth may provide part of the answer. The ubiquity of cell phones across the US, with approximately 96% of US citizens owning cell phones, supports the expansion of telehealth. 4 The Pew Research Center found an equal distribution of cell phone ownership across White, Black, and Hispanic/ Latinx populations and urban, suburban, and rural environments. 4 Telehealth, therefore, because of its flex-VIEWPOINT