The lack of a national policy agenda for children during Covid-19 — and beyond — causes grave harm

As a neonatal intensivist, helping families and newborns in distress is part of my job. In the intensive care unit, the distress is obvious. Covid-19 is shining a light on distress in children and families that has been largely hidden.

My colleagues and I recently published the results of the Vanderbilt Child Health Poll, a national survey of more than 1,000 parents that was conducted in June 2020. We wondered how parents and children were coping with disruptions to their life because of Covid-19. We asked an array of questions ranging from how people’s mental health is faring to their use of nutritional support programs, such as the Supplemental Nutrition Assistance Program (SNAP).

What we found unnerved me.

Parents reported they are under siege by a perfect storm of events. U.S. families are struggling. On top of deteriorating physical and mental well-being for both them and their kids, parents’ responses sketch a dim outlook for the long-term healthy growth of their children.

Kids are faring worse today than they were in February. It took a global pandemic mere months to leave millions more children going hungry, living in a patchwork of child care, missing appointments with their pediatricians, and losing health insurance as their parents lost their jobs.

The pandemic has surfaced existing limitations that have strained for years the ability of some parents to raise healthy children, given the chronic underfunding and fragmentation of our nation’s programs for children. We know the problem, but will we take the right steps to solve it?

As Covid-19 continues its march through communities around the country, we have a responsibility to curb its spread as quickly as possible for the health of future generations. The well-being of children is shaped by factors and people outside their homes and pediatricians’ offices. Schools and stable child care are arguably just as important for children as access to health care. Those institutions need our support now as they adapt to meeting the needs of children.

Our results affirmed what other surveys have found: Millions of families need help putting food on their tables. The reality is that for millions of U.S. children, schools provide not only education but nutrition. Since March, public schools have pivoted to a nutrition-to-go model that provided food to anyone who asked for it, but this program will sunset unless the administration takes action.

We need to fortify school administrators, teachers, and staff as a first, urgent step to supporting kids through this crisis. Schools are confronting staggering obstacles that range from conducting school virtually to implementing physical distancing programs. Worrying about feeding children shouldn’t be yet another challenge for them. They provided meals before the pandemic and have continued to do so, but they need the resources to continue as we move further into this pandemic, even if it isn’t safe for schools to physically open.

I’m often astonished that programs for U.S. children are scattered across various agencies. Some programs vary by state. Some even vary by county. This fragmentation underscores that we have not holistically prioritized the health of children in the same ways we have prioritized other vulnerable populations, like the elderly. Children are twice as likely to live in poverty than the elderly, and far more likely to be uninsured.

I’ve seen our systems work better. The White House Office of National Drug Control Policy was established by the Anti-Drug Abuse Act of 1988 to create a coordinating agency to “set priorities, implement a national strategy, and certify Federal drug-control budgets.” This came at a time when there was mounting concern about illicit drug use.

In my two years as an adviser to the Office of National Drug Control Policy, I saw firsthand the power of coordination and strategy. Interagency meetings focused on specific changes, such as rising numbers of prescription opioid-related deaths, and included representation from across the government. Each year, the office published a comprehensive national strategy laden with goal metrics and timelines.

American families deserve this level of thinking, planning, and strategizing for their children.

Congress is currently considering more assistance for children, including the Coronavirus Child Care and Education Relief Act. Our research indicates that families desperately need these immediate reinforcements.

There is no shortage of issues that require immediate action from our nation’s policymakers. But for U.S. children, the early days of Covid-19 exposed an open secret long evident to pediatricians, educators, and childcare workers: We have no national policy agenda for children.

Let’s act now to provide food and security for our nation’s children as they adapt to a new life in the shadow of Covid-19. And let’s not squander this chance to make long-lasting, positive, systematic change to improve the lives of children for generations to come.

Stephen Patrick is a neonatologist at the Monroe Carell Jr. Children’s Hospital at Vanderbilt, director of the Vanderbilt Center for Child Health Policy, and associate professor of pediatrics and health policy at Vanderbilt University School of Medicine.