By Christopher Spencer Greeley, JAMA Pediatrics, August 3, 2020
The coronavirus disease 2019 (COVID-19) pandemic has exposed the frailty of the just-in-time medical system currently in place in the United States. Large gaps in access to care, unequal distribution of testing, and disparities in mortality rates in many ways reflect the greater inequalities that many communities and families were confronting daily before COVID-19. These inequities now may mean life or death. COVID-19 is not the great equalizer it is often referenced to be. It does not affect all communities, all families, or all children equally. Some neighborhoods are ravaged by food insecurity, loss of hourly wage jobs, and threats of evictions, while for others, COVID-19 is disrupting and troubling but not a true existential threat.
As is often the case, inequalities affect children most harshly. Built and unbuilt power structures in communities are often indifferent to the needs of children. While the current decrease in calls to child welfare services as reported in many states may be because of school closures (in that teachers are the most common reporters to Child Protective Services [CPS]), there remains a growing concern that the family and community disruption caused by COVID-19 may result in an increase in violence toward vulnerable children and/or parents.
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