A new modeling study published in Pediatrics by a CDC-led team has revealed that one U.S. child loses a parent or caregiver for every four COVID-19-associated deaths. From April 1, 2020, through June 30, 2021, over 140,000 children in the US experienced the death of a parent or grandparent caregiver. 

The modeling analysis used mortality, fertility, and census data to estimate Covid-19 associated deaths of one or both parents and deaths of custodial and co-residing grandparents between April 1, 2020, and June 30, 2021, in the US. “Covid-19-associated deaths” was defined as a combination of deaths caused directly by Covid-19 and those caused indirectly by associated causes, such as decreased access or quality of health care.

The study also revealed significant racial and ethnic disparities in caregiver deaths due to Covid-19. The National Center for Health Statistics data showed that children of racial and ethnic minorities accounted for 65% of those who lost a primary caregiver, while White children accounted for 35%, even though minorities account for just 39% of the total US population. The greatest disparities were found in Southern border states, where Hispanic children accounted for anywhere between 50% and 67% of affected children. In southeastern states, up to 57% of affected children were Black, and in states with tribal territories, American Indian/Alaska Native children accounted for up to 55% of children who lost a parent or other primary caregiver to Covid-19. The study’s authors have pointed to racial and ethnic inequities in disease occurrence, severity, and outcomes to explain the disparities in caregiver deaths.   

The loss of so many caregivers, particularly in Indigenous communities where oral history is often passed down by elders, prompts questions about how to preserve traditions, culture, and community if children cannot be taken in by other family members.   

These domestic projections are in keeping with the global Lancet study, I have previously written about. The Lancet study estimated 1,134 000 children experienced the death of primary caregivers globally, including at least one parent or custodial grandparent, and 1,562 000 children experienced the death of at least one primary or secondary caregiver. As more data continues to emerge it is critical that we address the shadow pandemic of children who have been orphaned or lost a parent or caregiver to Covid-19.        

The loss of a parent or caregiver is devastating and can have a long-term impact on a child or adolescent’s mental and physical health. Depression, post-traumatic stress, shorter schooling, lower self-esteem, increased risk of substance abuse, suicide, and sexual abuse are all linked to losing a parent or primary caregiver during childhood. Studies conducted after World War I, showed that children whose soldier fathers died before or after their birth appeared to have decreased life spans. The anguish and grief of losing a parent or caregiver will only be compounded by the additional stressors and developmental disruptions that Covid-19 has wrought on youth as the pandemic rages on.                

Dr. Susan Hillis, a CDC researcher and co-author of both the Pediatrics and The Lancet studies is calling upon the states and the Biden administration to do more to support these children. Dr. Hillis is urging a comprehensive response that includes financial assistance, mental health services, education, insurance, and increased resources for the foster care system.

We can look to the local and federal initiatives and foundations such as Tuesday’s Children established to support families affected by 9/11 as a blueprint for how we may begin to support the children who have suffered such traumatic losses due to Covid-19