COVID-19-Associated Orphanhood and Caregiver Death in the United States

TL;DR

This study quantifies COVID-19-related orphanhood and caregiver loss in the US, revealing significant racial and regional disparities, and emphasizes the urgent need for targeted support for affected children.

Contribution

It provides the first comprehensive national and state-level estimates of COVID-19-associated orphanhood and caregiver loss, highlighting disparities across racial and geographic groups.

Findings

Over 140,000 children lost caregivers due to COVID-19 in the US.

Higher risk of caregiver loss among children of racial and ethnic minorities.

Disproportionate burden in specific states and regions for minority children.

Abstract

Background: Most COVID-19 deaths occur among adults, not children, and attention has focused on mitigating COVID-19 burden among adults. However, a tragic consequence of adult deaths is that high numbers of children might lose their parents and caregivers to COVID-19-associated deaths. Methods: We quantified COVID-19-associated caregiver loss and orphanhood in the US and for each state using fertility and excess and COVID-19 mortality data. We assessed burden and rates of COVID-19-associated orphanhood and deaths of custodial and co-residing grandparents, overall and by race/ethnicity. We further examined variations in COVID-19-associated orphanhood by race/ethnicity for each state. Results: We found that from April 1, 2020 through June 30, 2021, over 140,000 children in the US experienced the death of a parent or grandparent caregiver. The risk of such loss was 1.1 to 4.5 times higher among children of racial and ethnic minorities, compared to Non-Hispanic White children. The highest burden of COVID-19-associated death of parents and caregivers occurred in Southern border states for Hispanic children, Southeastern states for Black children, and in states with tribal areas for American Indian/Alaska Native populations. Conclusions: We found substantial disparities in distributions of COVID-19-associated death of parents and caregivers across racial and ethnic groups. Children losing caregivers to COVID-19 need care and safe, stable, and nurturing families with economic support, quality childcare and evidence-based parenting support programs. There is an urgent need to mount an evidence-based comprehensive response focused on those children at greatest risk, in the states most affected.