Estimates and Projections of COVID-19 and Parental Death in the US [jamanetwork.com]

By Rachel Kidman, Rachel Margolis, Emily Smith-Greenway, et al., JAMA Pediatrics, April 5, 2021

The scale of COVID-19 mortality in the United States, including among prime-age adults, merits efforts to continuously track how many children are affected by parental death. Children who lose a parent are at elevated risk of traumatic grief, depression, poor educational outcomes, and unintentional death or suicide, and these consequences can persist into adulthood.¹ Sudden parental death, such as that occurring owing to COVID-19, can be particularly traumatizing for children and leave families ill prepared to navigate its consequences. Moreover, COVID-19 losses are occurring at a time of social isolation, institutional strain, and economic hardship, potentially leaving bereaved children without the supports they need.

We estimated the expected number of affected children for each COVID-19 death (the parental bereavement multiplier), allowing us to track parental bereavement as the pandemic evolves. We used kinship networks of White and Black individuals in the US estimated through demographic microsimulation to calculate the bereavement multiplier, then used the multiplier to estimate the scope of parental bereavement under various mortality scenarios (eMethods in the Supplement).² We assumed comparable multipliers for other racial groups. First, we used COVID-19 deaths and excess death counts (to address underestimation of mortality and deaths indirectly due to the pandemic) as of February 2021. Second, to facilitate comparison with a typical year, we extracted the incidence rate of parental bereavement under mortality conditions absent COVID-19 from the microsimulations data.³ Finally, we estimated future bereavement under a natural herd immunity scenario. Note that the main results use population-averaged White and Black bereavement multipliers; prior work found small differences by race.³ For current COVID-19 mortality, we also ran supplemental statistics using race-specific morality and bereavement multipliers. This study uses deidentified, publicly available data and is not considered human subjects research.

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