Racial and/or Ethnic and Socioeconomic Disparities of SARS-CoV-2 Infection Among Children

Abstract

OBJECTIVES: To evaluate racial and/or ethnic and socioeconomic differences in rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among children. METHODS: We performed a cross-sectional study of children tested for SARS-CoV-2 at an exclusively pediatric drive-through and walk-up SARS-CoV-2 testing site from March 21, 2020, to April 28, 2020. We performed bivariable and multivariable logistic regression to measure the association of patient race and/or ethnicity and estimated median family income (based on census block group estimates) with (1) SARS-CoV-2 infection and (2) reported exposure to SARS-CoV-2. RESULTS: Of 1000 children tested for SARS-CoV-2 infection, 20.7% tested positive for SARS-CoV-2. In comparison with non-Hispanic white children (7.3%), minority children had higher rates of infection (non-Hispanic Black: 30.0%, adjusted odds ratio [aOR] 2.3 [95% confidence interval (CI) 1.2-4.4]; Hispanic: 46.4%, aOR 6.3 [95% CI 3.3-11.9]). In comparison with children in the highest median family income quartile (8.7%), infection rates were higher among children in quartile 3 (23.7%; aOR 2.6 [95% CI 1.4-4.9]), quartile 2 (27.1%; aOR 2.3 [95% CI 1.2-4.3]), and quartile 1 (37.7%; aOR 2.4 [95% CI 1.3-4.6]). Rates of reported exposure to SARS-CoV-2 also differed by race and/or ethnicity and socioeconomic status. CONCLUSIONS: In this large cohort of children tested for SARS-CoV-2 through a community-based testing site, racial and/or ethnic minorities and socioeconomically disadvantaged children carry the highest burden of infection. Understanding and addressing the causes of these differences are needed to mitigate disparities and limit the spread of infection.

Geospatial Analysis of Individual and Community-Level Socioeconomic Factors Impacting SARS-CoV-2 Prevalence and Outcomes

“…As infections with SARS-CoV-2 and its associated illness, COVID-19, have surged across the world, multiple studies have identified higher rates of infection, hospitalization, and mortality among minority populations. [1][2][3][4][5][6][7][8][9][10][11][12] Disparities in infection rates exist even among healthcare workers 13 and children, 14,15 with disparities in mortality rates greatest among young individuals 16 and growing as the pandemic spreads. 17 To date, the relative contributions of pathophysiologic and socioeconomic factors contributing to these disparities remains unclear.…”

Where to make a difference: research and the social determinants in pediatrics and child health in the COVID-19 era

“…Socioeconomically disadvantaged children had a higher likelihood of SARS-CoV-2 infection. 23 Examples of the consequences of the focus on COVID are given in papers from the United Kingdom, which report on possible collateral damage, including decreased vaccination, decreased attendance at hospitals and delayed diagnosis of diseases, as well as the negative impact of isolation on mental well-being. 24,25 Therefore, there is the potential for the following areas of research.…”

“…The consequences are similar to the upper-income countries, but lack of resources and other comorbidities may lead to different outcomes. [45][46][47] In particular, the impact of the decrease in preventive measures such as vaccination, maybe worse than the impact of the infection from the SARS-CoV-2 infection. 48 Research into the global impact on children is urgently required as the social determinants of healthcare is a global issue.…”

Youth sports in the wake of COVID-19: a call for change

“…For example, in a survey of over 13 000 adolescent athletes throughout the country during the COVID-19 restrictions in May 2020, we found that 40% reported moderate to severe depression symptoms and 37% reported moderate to severe anxiety. 3 The burden of COVID-19 has disproportionately affected low income and minority children, 4 and unfortunately this appears to be true in youth sports as well. In the same nationwide survey, we found that adolescent athletes from areas with the highest levels of poverty reported the lowest physical activity levels and the highest levels of depression and anxiety.…”