By Danielle G. Dooley, Asad Bandealy, and Megan M. Tschudy, JAMA Pediatrics, May 13, 2020
For general pediatricians who have worked in busy practices delivering well-child care, administering immunizations, and supporting children and families with social needs, the empty clinic hallways and examination rooms are a stark reminder of who is missing from the daily news feed about the coronavirus disease 2019 (COVID-19) pandemic: children, particularly those who live in poverty. The rate of serious illness among young children from the novel coronavirus is very low.1 Yet to slow the spread of the virus, all states have closed schools, disrupting routines critical to learning, nutrition, and social development. Directly and indirectly, low-income children have been forced to subordinate their own well-being for the greater good. To recognize and respect this sacrifice, the US should make a commitment to provide them with the opportunities they have long deserved.
In the pre–COVID-19 era, the US was not known for its generosity toward children. Nearly 1 in 5 children in the US live in poverty, a substantially greater proportion than for adults. Poverty disproportionately affects African American, Hispanic, and American Indian/Alaska Native children.2 The effects of poverty, especially childhood poverty, are pervasive. Childhood poverty is associated with injuries, chronic illness, and mental health difficulties, with consequences lasting not only throughout childhood but also the life course and well into adulthood.
Rather than ameliorate these inequities, the US educational system has often reinforced them through insufficient and inequitable funding systems. School districts serving low-income children have more run-down school facilities, fewer curricular offerings, and less experienced teachers.
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