Catlin Dennis, MPH, describes the challenges socially and medically vulnerable youth with diabetes and their families faced during the COVID-19 pandemic.
Difficulty finding accurate information on COVID-19 was a challenge for most of these families, said Catlin Dennis, MPH, the program manager of Novel Interventions in Children's Healthcare (NICH) at Doernbecher Children’s Hospital in Portland, Oregon. Dennis' research on “COVID-19’s Impact on the Most Medically and Socially Vulnerable Youth With Diabetes” was presented at the American Diabetes Association’s 81st Scientific Sessions.
What unique challenges did vulnerable youth with diabetes face during the pandemic?
In terms of unique challenges, we found that our patients and their families were more likely to be exposed to COVID-19. That was because of a couple of different reasons. Many of our kids live in households where there's 10, 12, or 15 people living in the home, so if one person was sick with COVID-19, it was really difficult to control transmission within a large household like that. Many of our parents and caregivers of the kids that we serve worked in essential worker positions. They were at increased risk for exposure simply because they didn't have the luxury of being able to easily work from home.
There's also a disproportionate number of children of color within the NICH program. While this in and of itself doesn't make one more susceptible to COVID-19, we saw that families who were exposed were more likely to be people of color. Like I said, that was consistent with nationwide data demonstrating health disparities in the United States. Then I think some other factors, too, that I've kind of hinted at are, obviously these families were more likely to have lost employment because of the types of jobs that they held. We have a lot of parents and caregivers that worked in the restaurant industry, and we saw major layoffs at the beginning of the pandemic. This has kind of a waterfall effect, of when you lose employment, then you're losing income, [and] that can result in lost housing or food insecurity, and just added mental stress. We saw more anxiety and depression in these families, which isn't something we necessarily measured for. But anecdotally, it was just clear that these families were under an immense amount of stress.
I think difficulty finding accurate information was a challenge for most of these families, particularly families that didn't speak English. We have a lot of families that speak languages that are not commonly translated for, so while the state of Oregon did a pretty good job with translating things in Spanish, we had families that didn't speak Spanish or English. It was really challenging, especially at the beginning of the pandemic, when it felt like updates and news alerts were changing on an hourly basis. Trying to find accurate information and get it translated into that family's language was a challenge.
Just more generally, I think even for our English-speaking patients and families, many of them spoke to just the challenge and overwhelming sense of having too much information to sort through and how difficult it was to find information that they felt was legitimate and credible. Then also how to understand it. I think there was a lot of information that was just really complex, because it's looking at viruses and how vaccines are created and all of those things. Not all of that information was communicated in a way that was going to be accessible for people with varying degrees of health literacy.
I think the the last thing I'll say is just that these are families that typically just don't have a lot of resources. While the pandemic was really challenging for everyone, it certainly was more challenging for some than others. I think some of those things were, families that didn't have high-speed internet really suffered. Families that didn't have devices for internet or enough devices for everyone in the home just saw different outcomes. Even things like resources for childcare, having the ability to bring in a private nanny or someone so you could get work done, and I touched on just even the ability to work remotely or to have the privilege to have a savings account that you could rely on if you lost employment.