More than 3,600 NC children face caregiver death during pandemic

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This story originally posted online at EdNC.

At least 3,626 children in North Carolina– for most students of color – are currently facing the death of a caregiver from COVID-19. Schools will be responsible for supporting children who have experienced this loss as they learn and grow over the next two decades.

Research published in October in the journal Pediatrics revealed the high number of caregiver deaths among children nationwide, particularly Native American, Hispanic and Black children. The researchers used data on fertility, household composition and death rates related to COVID-19 and excess to estimate what they called “the orphanage associated with COVID-19.” They estimated that at least 1,855 children in North Carolina lost a guardian between April 1, 2020 and June 30, 2021.

The updated estimates now put that number even higher.

A new report released in December by the COVID Collaborative used a similar methodology to extend the previous estimate, including deaths from January 2020 to mid-November 2021. This study estimated that 3,626 children lost caregivers in Carolina North.

For the purposes of both studies, “guardians” are parents, custodial grandparents or grandparents who live in the same household as the children and provide at least some of their basic needs. The death of a guardian can have negative effects on children’s learning and health outcomes throughout their lives.

Children who have lost caregivers are more likely to have mental health issues and low self-esteem. They are also at greater risk for suicide, violence, sexual abuse and exploitation. Additionally, this type of loss is associated with shorter schooling.

Underestimating the deaths of caregivers

In the original research paper and in subsequent interviews, the researchers acknowledge that their methodology likely resulted in an undercoverage of the actual number of child victims of caregiver deaths. This is due in part to the period they studied.

From April 1, 2020 to June 30, 2021, North Carolina recorded nearly 14,000 deaths from COVID. In the six months since the study ended, more than 5,000 additional deaths were reported. There are also many children who live with aunts, uncles or other guardians whose deaths would not have been included in the methodology of either study.

Although the most recent study includes these additional deaths, the likelihood of undercoverage is still present, in part because states like North Carolina are months behind in processing death certificates.

According to Summer Tonizzo, a representative with the North Carolina Department of Health and Human Services, the transition from a paper-based system to a digital database for tracking death certificates means “there may be a period of 3 to 5 months between the date of death and this death certificate. is included in [State Center for Health Statistics] data files. ”This means that some of the data used by researchers to estimate the number of caregiver deaths is out of date.

Susan Hillis, CDC’s COVID response researcher and lead author of one of the studies, said that is why her top priority in addressing this crisis is to get an accurate and timely account of the number of children who have suffered the death of a caregiver and who are these children. .

Responding to information about the delays in registering deaths in North Carolina, Hillis pointed out, “The estimate of the number of children affected will only be as good as your estimates of deaths.”

In general, Hillis says it’s reasonable to estimate that for every four deaths from COVID-19, one child is an orphan.

The death toll in North Carolina is quickly approaching 20,000. According to Hillis’ broad estimate, there could be as many as 5,000 children living in an orphanage associated with COVID-19.

That’s about one in 462 children across the state.

The maps below can help stakeholders begin to predict where these losses have occurred. By comparing the counties’ COVID-19 death rates with the proportion of the population under the age of 18 in each county, it is possible to find counties where both of these rates are high. These counties probably have higher proportions of children who have experienced the loss of a guardian.

No matter where these children are in the state, researchers predict that the racial and ethnic disparities seen among deaths from COVID-19 will also be reflected in caregiver deaths.

Racial and ethnic disparities

The inequitable distribution of caregiver deaths across racial and ethnic categories is of particular concern given that students of color already face a greater risk of exposure to unwanted childhood experiences (ACE) due to various forms of illness. structural inequality. The CDC defines ACE as “potentially traumatic events that occur during childhood (0-17 years)”, including “aspects of the child’s environment that can undermine a child’s sense of security, stability and link “.

The best available data indicates that in North Carolina, the Hispanic population is 9.8%, but Hispanic children represent 21.1% of children who have lost caregivers to COVID-19. Non-Hispanic Native Americans or Alaska Natives make up 1.6 percent of the population, but 5.1 percent of children who have lost guardians. Non-Hispanic blacks make up 22.2 percent of the state’s population, but 38.1 percent of children who have lost guardians. Together, these groups make up only 33.6% of the state’s population, but 64.3% of child victims of caregiver deaths.

Jim Johnson, a professor at UNC’s Kenan-Flagler Business School who studies inequalities, suspects communities have not begun to consider the scale of the impact of COVID deaths.

“I don’t think there is a lot of talk about the loss,” he said. “I think the circumstances, especially in low-income families, are so overwhelming that often people don’t want to talk about these issues.”

Tripp Ake, a psychologist at Duke University Medical Center with over 20 years of experience treating childhood trauma, agrees.

“We are still reflecting on the impact of this pandemic on the functioning of our children and on the ability of caregivers to be able to support them,” he said. “I think a lot of it comes down to the schools. “

Impact on education

Historically, schools have been responsible for providing significant mental health support to children with trauma and ACE, including caregiver deaths. But probably never in the history of the state education system have so many children lost guardians in such a short time. This will present unique challenges for a generation.

For nearly two years, all North Carolina students have been exposed to the continuing stress and uncertainty of the pandemic.

Jay Pearson, associate professor at the Sanford School of Public Policy at Duke University, says this is of particular concern when it comes to students of color.

“The set of conditions that many children of color face in their homes and their immediate social environment are such that there is very little room for the types of primary socialization that ideally prepare them to do well in school,” Pearson said.

Typically, the presence of a caring adult in a student’s life can compensate for exposure to various forms of stress. Children who have lost guardians are likely to be more dependent on teachers and other adults in their lives for the social and emotional support necessary for the development of a healthy brain and body, which can impact their entire lives.

In one interview with the Hechinger report, Cynthia Osborne, director of the Prenatal-to-3 Policy Impact Center at the University of Texas at Austin, explained, “We will see children coming to kindergarten feeling less secure, in need of more help and support. more services. But we will also see it in the decades to come. We will see teens who haven’t been able to achieve the level of executive functioning they need to make better choices. “

COVID Collaborative provides a series of recommendations for policymakers and schools, including developing a coordinated strategy to identify children who have lost a guardian, as well as expanding bereavement skills in schools, access to counseling programs high quality for early childhood, integrating social and emotional development and evidence-based mentoring into school learning and access to mental health care in schools.

To this end, the recently adopted state budget includes funding to ensure that every district in the state has at least one school psychologist, a grant program of nearly $ 9.7 million “to support students in crisis, school safety training and safety equipment in schools ”; and salary supplements for school psychologists, speech pathologists, audiologists and school counselors. There are no plans to specifically address the needs of students whose caregivers have died.


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