The Need for Continued Investment in Children and Families

During the COVID-19 pandemic, many children were separated from learning opportunities, stabilizing routines, school-based mental health resources, peer interactions, and programs that typically support their well-being. While some effects of these stressors were immediate, some may not become apparent until later in individuals’ lives.

As of January 2023:

6.5 million
Over 6.5 million deaths from COVID-19 globally, and over 1 million in the U.S.

15 million
Over 15 million children have tested positive, thousands have been hospitalized, and more than 2,100 have died.

My Mom lost her business…we were trying to maintain everything, but the bills kept piling up. Food prices, rent, everything went up...we didn’t know if we were going to get food the next day. It got to the point where I wasn’t able to sleep properly anymore or eat properly anymore, and I did gain a lot of anxiety and depression.



  • Children have faced illness and death. More than 265,000 children have lost a parent or a caregiver to COVID-19

  • COVID-19 is the largest pandemic in the history of the United States. The magnitude and mortality exceeds even that of large-scale natural disasters and portends the risk of negative consequences across health and wellness outcomes, for children and their families, for decades to come.

    While the specific long-term effects are unknown, they are likely to have particularly significant implications for children and families from racially and ethnically minoritized communities and with low incomes.

  • The pandemic has disproportionately affected Black, Latino, and Native American children and families

    view data table

The pandemic has disproportionately affected Black, Latino, and Native American children and families

  Black Hispanic American Indian/
Alaskan Native
Asian White
Cases 1 1.5 1.5 0.7 1
Hospitalizations 2.5 2.4 3.2 0.8 1
Deaths 1.7 1.9 2.2 0.8 1

Immediate Effects of the Pandemic on Children and Families

While some effects of the COVID-19 pandemic on children and families were immediate, some may not become apparent until later in their lives. Overall, the developmental trajectories of children have been disrupted, which could have long-lasting effects on social emotional, educational, economic, and health outcomes.

Economic Well-Being Social & Emotional Development Health Education

Social and Emotional Development

Immediate effects on social and emotional development of children include:

Next: Education


Across all measures of school engagement and learning outcomes, children appear to be worse off than they would have been absent the pandemic, and such negative outcomes are generally more acute for low-income and racially and ethnically minoritized communities.

Immediate effects on educational outcomes include:

Next: Health


Immediate mental and physical health outcomes of children and mothers include:

Next: Economic Well-Being

Economic Well-Being

In the early months of the COVID-19 pandemic families were hit quickly and hard by economic hardship – tens of millions of people lost their jobs, resulting in many families’ inability to pay rent and household bills, and adequately feed their families. While the negative socioeconomic consequences of the pandemic were widespread, this fell particularly hard on children and families in households with low incomes and those from racially and ethnically minoritized groups.

Next: Social & Emotional Development


Without a focused strategy for investing in policies, programs, services, supports, and interventions to correct the life-course trajectories that were altered by the COVID-19 pandemic, society will pay the cost of a generation of children who enter adulthood with worse mental health, a greater burden of chronic disease, and lower academic attainment than their predecessors. These conditions can lead to worse outcomes for these children as they age through adulthood.

Ongoing investments should be targeted to children and families from racially and ethnically minoritized and low-income communities, who bore the brunt of the pandemic as it exacerbated pre-existing societal inequities. Without targeted investments in programs, services, supports, and interventions to counteract the pandemic’s direct and indirect negative impact on child and family well-being, the pandemic’s impacts are likely to be long lasting, with negative effects not only on children and families but also on society at large.

Drawing on available evidence from the COVID-19 pandemic and lessons from previous disaster recovery and public health crises, the report offers a set of recommendations. The recommendations are a path forward to recover from the harms of the COVID-19 pandemic and to address the inequities that have made the pandemic’s impact disproportionate.

Together, the report’s recommendations for programs, supports, and interventions to counteract the negative effects of the COVID-19 pandemic on child and family well-being offer a path forward to recover from the harms of the pandemic, address inequities, and prepare for the future.

Prioritize the immediate and short-term effects—direct and indirect—of the pandemic on children and their families. The federal government should develop a clear plan for supporting children and families, with a focus on those who have faced the greatest negative burden of the pandemic: children and families who are Black, Latino, and Native American and those with low incomes.

Address physical and mental health needs. To address the physical and mental health effects of the pandemic, all children will need access to high quality, continuous, and affordable health care. Children and families need ready access high-quality treatment and preventive behavioral health services in clinical settings, communities, and schools. This can be achieved by strengthening and expanding Medicaid at the federal level—including establishing and enforcing national standards for equitable payment rates, presumptive eligibility, multi-year continuous eligibility periods, and network adequacy.

Address social, emotional, and educational needs:

Enrollment and reengagement
Academic recovery and achievement
Positive social and emotional development
Support and expansion of the education workforce
Preparation for the next pandemic

Address economic and social policy to expand key safety-net programs. The federal government should support federal paid family leave and paid sick leave programs, reissue and continue the pandemic-era expansion of the Child Tax Credit, and incentivize states to expand key safety programs, including Temporary Assistance for Needy Families and childcare subsidies. To enhance safety net capacity, states should be incentivized to expand the number of families served in these safety net programs, raise the floor benefit levels, and reduce administrative burden for program participation.

Address physical and mental health needs:

Medicaid Payment Rates
Presumptive Eligibility for all children
Continuous Eligibility for all children 0-6
Postpartum Coverage to 12 months
Network Adequacy for behavioral health
Medicaid Expansion for parents

Mitigate potential shifts in the life-course trajectories of children and families who have experienced the pandemic. The COVID-19 pandemic has taken a substantial toll on the social, emotional, behavioral, and mental health outcomes of children and adults. Low-income and racially minoritized families have experienced the most negative effects of the pandemic largely because of pre-existing inequities in access to societal opportunities to thrive. Federal, state, and local agencies should develop policies, provide resources, and support targeted interventions that help children and adolescents process their pandemic experience; cope with uncertainty and change; rebuild social, cultural, and community connections; and readjust to group learning environments.

Collect and quickly respond to comprehensive, child- and family-focused data to help understand the pandemic’s ongoing effects on children and families. Evidence about the short-term effects of the pandemic on children, youth, and families is emerging, yet the long-term effects remain unknown. To better understand the pandemic’s effects on life-course trajectories, significant investments are needed to build a pandemic-focused research and data infrastructure. Public and private agencies at the local, state, and federal levels should collaborate on the systematic linking of child and family-level data from health care, education, social services, child welfare, and juvenile justice systems. Federal agencies also should fund rigorous research on the effects of the pandemic.

Prepare schools and early childhood providers for the next pandemic (“pandemic proofing”). Support for enrolling and re-engaging children at all levels of education should be expanded with the goal of returning enrollment and attendance rates in formal education to pre-pandemic levels, if not higher. Investing in evidence-based interventions to promote socioemotional development and address education gaps created during the pandemic can compensate for missed learning and return students’ academic achievement to pre-pandemic grade-level expectations or better. It is also critical to attract and support an expanded educator workforce to strengthen the early childhood sector as well as support the K-12 staffing needed to restore missed learning. Because COVID-19 will likely be circulating for the foreseeable future and other infectious diseases may arise, it is also necessary to invest in infrastructure within school facilities so they can remain open and safe during future surges or a new pandemic.

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