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Pandemic highlights health care inequities among at-risk pediatric populations :

April 28, 2020

The pandemic’s impact on at-risk groups has drawn concern from pediatricians as more data point to the need for health care providers to address barriers to healthy outcomes for vulnerable populations.

Recent Centers for Disease Control and Prevention (CDC) data point to an overrepresentation of COVID-19 hospitalizations among racial and ethnic minority populations and highlight factors that put at-risk groups at substantially higher risk of death than white and Asian persons. CDC reported that studies are underway to understand and potentially reduce the impact of COVID-19 on racial and ethnic minority groups.

Like many health conditions that disproportionately impact vulnerable populations of color, COVID-19 has inequitably affected children and youths from immigrant families and other vulnerable populations, according to two Pediatrics Perspectives published today.

The pandemic has resulted in children and youth who are from immigrant families, ethnic and racial minority groups and those who are LGBTQ, homeless, maltreated, in foster care, and/or struggling with substance use being separated from the safety nets services designed to protect them. Among factors placing these children and youth at increased risk are:  

  • Sheltering in place and physical distancing directives that keep children from safe places such as schools and may leave them in environments that expose them violence (physical abuse, sexual abuse, neglect and domestic violence).
  • Lack of access to health insurance, health care and lack of paid leave for families, many of whom are working in “essential” jobs during the COVID-19 pandemic.
  • Distrust or fear of seeking health care by African Americans and immigrant families.

The American Academy of Pediatrics has stressed the importance of continued care for children during the pandemic. This includes in-person visits where community circumstances allow and provision of telehealth for some health supervision visits, and acute and chronic care visits delivered by general pediatricians, pediatric subspecialists and pediatric surgeons. Delaying child health visits puts children’s health at risk, the AAP said.

To help ensure care for at-risk populations, the CDC offers the following guidance:

  • Identify and address implicit bias that could hinder patient-provider interactions and communication.
  • Provide medical interpretation services for patients who need them.
  • Work to reduce cultural barriers to care.
  • Connect patients with community resources that can help people with underlying conditions adhere to their care plans and including assistance getting extra supplies and medications and providing reminders to take their medicines.
  • Encourage patients to call with questions and seek care.

Pediatricians can find more support and information on caring for patients during COVID-19 at

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