On kidsdata.org, measures of how children and families in California are faring during the COVID-19 pandemic come from a national questionnaire, Family Experiences During the COVID-19 Pandemic. Caregivers with children ages 0-17 are asked a series of questions relating to the pandemic's impact on family economic security, public service use, emotional and behavioral experiences, health care, child care, and education. Estimates based on their responses are available for California and seven sub-state regions (Los Angeles County and six county groups). At the state level, data also are broken down by household income level, caregiver's race/ethnicity, and for families with and without children with special health care needs (CSHCN).

Before the COVID-19 pandemic, millions of U.S. families already were struggling with poverty, food insecurity, housing instability, mental illness, and difficulty accessing quality health care, education, and other resources (1, 2, 3). The onset of the pandemic dramatically worsened these issues, leaving many parents out of work or with reduced incomes and struggling to meet their families’ basic needs (3, 4). At the same time, families grappled with child care and school closures, shifts to remote learning and working, and disconnection from extended family, friends, and other social supports (3). Many families also experienced illness and the loss of loved ones due to the disease (2). Not surprisingly, mental health problems increased for both children and parents during the pandemic (3).

Some families were particularly vulnerable to the COVID-19 crisis, including those already struggling to make ends meet, hourly workers and those with unstable employment, families of color (who faced inequities in health outcomes and access to care before the pandemic), and families with young children or children with special health care needs (2, 3, 4, 5). The pandemic's effects on young people are of particular concern, as adverse childhood experiences, especially in early childhood, can have negative, long-term impacts on health and well being (6). The more traumatic events a child experiences, the more likely the impact will be substantial and long lasting (6).

Every effort should be made to ensure that children and families recover fully from the pandemic and that their physical, emotional, educational, and material needs are met consistently. Beyond meeting basic needs, children also need positive experiences and stable, nurturing relationships and environments in order to thrive (6).

The COVID-19 pandemic remained a source of disruption and stress for many California families more than two years after outbreak, according to estimates from the fourth wave of a questionnaire administered in June 2022. At the time of questionnaire, a third (33%) of adults with caregiving responsibilities for children ages 0-17 statewide had experienced feelings of nervousness or stress always or most of the time in the previous month, and 23% had felt difficulties piling up so high that they could not be overcome. Overall, fewer than 2 in 5 (36%) felt confident in their ability to control important things in their lives at least most of the time.

Many caregivers expressed concern for their children's physical, emotional, and academic well-being. An estimated 58% were more than slightly concerned for their children's safety following the rollback of masking and other pandemic-related public health measures. At the time of questionnaire, the oldest child of just over half (53%) of caregivers statewide was fully vaccinated against COVID-19. Caregivers also expressed concern for their children's academic progress, with 35% more than slightly concerned that their youngest school-aged child was falling behind at school. At the time of questionnaire—near the end of the 2021-22 school year—the youngest school-aged child of an estimated 42% of caregivers had fallen behind at school during the 2019-20 or 2020-21 school years and still hadn't caught up. Similarly, 36% of caregivers were more than slightly concerned for their oldest child's emotional or mental health in the previous month. During the year prior to questionnaire, among caregivers whose oldest child needed psychological or emotional counseling from a mental health professional, 59% had received services. Estimates of children's receipt of needed mental health counseling were higher among caregivers in households with children with special health care needs (CSHCN) (62%) when compared with households without CSHCN (52%).

The COVID-19 pandemic led to increases in illness, mortality, poverty, hunger, unemployment, housing instability, social isolation, mental health problems, and other hardships for U.S. families (1, 2). This crisis exacerbated existing economic problems and inequities, with financial difficulties disproportionately affecting lower-income families and people of color (1, 2). It also underscored inequities in the health care system and in social determinants of health, as vulnerable populations who have long experienced disparities in access to care and health outcomes were hit hardest by COVID-19 (3, 4).

The potential effects of this crisis on children are particularly concerning, as adverse childhood experiences (ACEs)—traumatic conditions and events such as poverty, family mental health problems, and caregiver death, among others—can have harmful, lifelong effects (5). For example, children exposed to multiple ACEs are more likely to develop negative health behaviors and chronic diseases in adulthood (5). Policymakers can help children and families recover from the effects of the pandemic, achieve economic stability, and access critical services including quality medical, mental health, and child care (3, 6, 7). Policymakers also can work toward ensuring that all families have equitable opportunities to help their children thrive, including adequate nutrition, education, and community resources, as well as safe, stable, nurturing environments in and outside the home (6, 8).

Policy and program options to mitigate the effects of the COVID-19 pandemic and promote child and family health and well being include:

• Ensuring that federal and state safety net policies and investments—such as cash and food assistance, paid leave benefits, tax credits, unemployment insurance, and housing, health insurance, and child care assistance—reach all eligible families and are sufficient to meet their needs (3, 6, 7)
• Assuring that even during economic and public health crises, every child has access to family centered, culturally responsive, and coordinated health care within a medical home, particularly children with special health care needs who require uninterrupted care (7, 9)
• Promoting proactive policies and investments that help reduce family stress and increase stability for children, e.g., assuring that quality child care is affordable and accessible, supporting universal high-speed internet access to reduce barriers to health care and education, ensuring that support services such as home-visiting programs are available to families in need, and supporting family-friendly business practices (5, 7, 8)
• Supporting ongoing efforts to establish effective, consistent mental health and trauma screening, referral, and follow-up care systems in pediatric care and other settings (2, 5, 10)
• Ensuring that all children, youth, and families have access to culturally responsive, trauma informed, and resilience-building systems of mental health, substance abuse treatment, and other school- and community-based support services (5, 7, 10)
• Assuring that all schools (especially those with high concentrations of low-income students, children of color, or other vulnerable populations) provide positive and supportive environments, social-emotional education, and effective, culturally-responsive systems to address students’ physical, emotional, behavioral, and family needs (5, 6, 7, 10)
• Promoting long-term community-based efforts to provide children and youth with positive experiences, relationships, and opportunities, such as quality mentoring, after-school programs, summer programs, and safe places to play and exercise, particularly in vulnerable communities (5, 6, 7)
• Addressing the root causes of health inequities through strategies such as public health community partnerships that engage and support marginalized populations; also, adopting a comprehensive approach to health care that goes beyond treating illness to addressing community factors—such as safe housing and access to healthy food—that impact health (4, 5)