COVID-19 and mental health equity in the United States

A recent commentary in Social Psychiatry and Psychiatric Epidemiology emphasized the disproportionately adverse mental health impacts of the COVID-19 pandemic (Purtle, 2020). While this perspective focused specifically on disparities in financial insecurity and grief stemming from disparities in COVID-19 mortality in adults, we expand this view to incorporate a developmental perspective of the pre-existing inequities experienced by children and families that have been magnified by COVID-19 in the United States. The COVID-19 pandemic is an abrupt and chronic stressor that puts many children and adolescents at risk for developing mental and behavioral health disorders—particularly those from disadvantaged backgrounds and marginalized communities, as the pandemic has illustrated in the U.S. Before the COVID-19 pandemic, these children were already more likely to experience severe economic hardship, lack access to quality education and other resources critical for coping with adversities, and be at increased risk for maltreatment and exposure to home or community violence, all of which can result in increased risk for adverse health outcomes (Nurius et al., 2015; Jones et al., 2018). Moreover, BIPOC (Black, Indigenous, People of Color) families in the U.S. face systemic racism and discrimination. These inequities are only magnified and perpetuated by the COVID-19 pandemic (Figure 1) (Beaunoyer et al., 2020; Hooper et al., 2020; Turner Lee, 2020a; Van Dorn et al., 2020). Open in a separate window Figure 1 The COVID-19 pandemic magnifies and exacerbates existing inequities (left) for disadvantaged children and families in the United States (indicated by thicker arrows in right), thereby placing them at greater risk for recurring suboptimal health outcomes and exacerbation of existing inequities. The asterisks (*) denote increased risk factors for disadvantaged children and families during COVID-19, which are not mutually exclusive. These are also potential points for intervention.