Childcare insecurity during the COVID-19 pandemic frequently led to employment disruptions

A study published in JAMA Pediatrics shows how frequently childcare insecurity during the COVID-19 pandemic occurred and the effect it had on parental job loss. Employment disruptions due to childcare insecurity existed before the pandemic began, especially for parents of children with special medical needs. But shutdowns and other measures taken to prevent the spread of COVID-19 caused an increase in the number of parents struggling to find adequate childcare in order to maintain employment.

I heard anecdotally about this issue, but wanted to quantify the impacts of the pandemic on parents and children by comparing data taken before and during 2020."

Caleb Easterly, first author, a UNC MD-PhD Program student

The study sample consisted of nearly 50,000 children from newborns to five years old in the 2016–2020 waves of the National Survey of Children's Health, a nationally representative United-States-based survey. The 2020 wave was fielded from July 2020 to January 2021.

"We saw that almost a quarter of parents raising children with special healthcare needs had childcare-related employment disruptions in 2020," said Easterly.

There was a 30-40 percent increase in employment disruptions due to childcare difficulties among all parents, no matter their child's health needs. The across-the-board increase speaks to the broad impacts the pandemic is having across all types of families. However, families with low incomes, children of color and children with special healthcare needs were more affected.

The effects of a parent losing a job or cutting down hours at work can be felt through an entire family. The stress a parent feels trying meet basic needs with reduced or lost income affects their mental health, along with the mental health of their children. Additionally, health insurance is still commonly tied to employment, so when a job is lost, health insurance is lost as well.

"Children are being directly affected with discontinuity in health insurance, which leads to changes in which doctors or clinics are covered on new or temporary insurance policies," said senior author Neal deJong, MD, MPH, assistant professor of general pediatrics and adolescent medicine at the UNC School of Medicine. "This can also lead to missed appointments and missed healthcare opportunities. Things that should be addressed in a visit to their doctor are going untreated and ending up in a visit to the ER."

Researchers say the impacts of these disruptions in employment and healthcare should continue to be studied as the physical and mental toll could have lasting effects. They also suggest the creation of broader systems of care and support for parents and families experiencing these issues.