Race, Ethnicity, and Health Disparities in US Children With COVID-19: A Review of the Evidence and Recommendations for the Future

Abstract

Coronavirus disease 2019 (COVID-19) is an important cause of morbidity in children in the United States (U.S.). Moreover, the U.S. has witnessed significant disparities affecting American Indian/Alaska Native, Black, and Hispanic/Latino children, stemming from systemic racism and social-structural inequalities and not differences in innate biological susceptibility. We review what is known on COVID-19 and health disparities in disease burden, access to care, pharmaceutical interventions, and clinical research in children, with a focus on the U.S. context. In addition, we propose strategies to communicate scientific data in ways that do not promote racism and biological susceptibility themes, and to address pediatric disparities in clinical infectious diseases research.

The impact of the COVID-19 pandemic on patients with juvenile idiopathic inflammatory myopathies

“…Given that patients in black and Hispanic populations may have more complications related to JDM (19,20) and were disproportionately impacted by the COVID-19 pandemic with higher risk for poor physical and mental health outcomes (7,21), our study may be inadvertently biased to those with less severe outcomes. Larger investigation into a more diverse patient population would be bene cial in further evaluating these results.…”

Improving Minority Representation through COVID-19 Community Research Partnership

“…Black and Hispanic children have higher rates of multi-system inflammatory syndrome (MIS-C) than expected by proportion in the general US population; additionally, Black children have higher rates of MIS-C compared to all children with COVID-19 [3]. Disparities also exist in access to testing and treatment for COVID-19 [4].…”

Feasibility and Acceptability of Spanish-language Facebook Group on Latino Parents’ COVID-19 Vaccine Beliefs: Case study of the Brigada Digital de Salud

“…Racial/ethnic disparities in COVID-19 morbidity and mortality in the U.S. have become apparent, with Latino adults being 1.5 times more likely to be infected, 2.3 times more likely to be hospitalized, and are 1.8 times more likely to die from COVID-19 (1)(2)(3)(4)(5). Studies have also shown that during various periods of the pandemic, Latino children under age 18 have had higher COVID-19 case rates, hospitalization, related multisystem in ammatory syndrome (MISC-C) and deaths than White children (6)(7)(8)(9)(10)(11).…”

“…Parent intentions to vaccinate younger Latino children have remained low. Data collected during July 1-September 30, 2022 as part of the National Immunization Survey indicated that among U.S. Latino parents with unvaccinated children, the proportion responding that they "de nitely wouldn't" or "probably wouldn't vaccinate their child" was 31.5% for children ages [5][6][7][8][9][10][11]17.5% for children/adolescents ages 12-15, and 15.2% for adolescents ages (16)(17). By comparison, 2 studies in 2022 and 2023 by Fisher and colleagues showed that almost half of U.S. Latino parent participants did not intend to vaccinate their child under age 5, and just over one-fth were unsure (22,24).…”