While the four walls of my clinic at Arkansas Children's Hospital have felt more virtual due to telemedicine visits, the stress on the parents of my young patients is palpable. They worry about whether or not they will have enough money to pay for rent, food, and medicine, all while taking care of children at home and avoiding getting sick.
We have seen over the past months the toll that the global covid-19 pandemic is having on our local communities. Necessary lifesaving public health measures have led to skyrocketing unemployment rates, and those currently being hit hardest are families with young children, immigrants, and people of color--or as I call them, my patients.
I asked a single mom of kids ranging from elementary to high school age on one of these telemedicine visits if she was able to pick up meals that the Little Rock School District was distributing at drop-in sites around the city. She wasn't; she just didn't want to go out and risk getting the virus. She worried that her resources were wearing thin, and didn't want her teenage kids to work, even part time, which they had done last fall to help out the household.
What worries me the most about the economic fallout from this pandemic is not just the immediate financial implications for families during school, business, and child-care closures, but the long-term impact the economic crisis will have on the health of children and their families. Well before the pandemic hit, families with low incomes in Arkansas struggled to afford basic needs.
Food insecurity--an inability to afford enough food for all family members to lead active, healthy lives--is a telling indicator of economic strain. We know that when families lose income and are unable to make ends meet, they are often forced to reduce the quality or quantity of meals in order to get by. As a result, the health of children and parents suffers.
Unemployment and loss of income--particularly high among those already struggling with low incomes--compounded by sharp increases in grocery prices, are exacerbating these experiences across the nation and in our state. A report from Feeding America projected that Arkansas will have the second highest rate of food insecurity--22.5 percent--in the U.S. as a result of this crisis. In some of the counties in our state, an astonishing 1 in 2 children will face food insecurity.
These impacts are drastically impairing the health and well-being of our children now and will likely persist for years to come. During the Great Recession, my colleagues at Children's HealthWatch and I documented a sharp rise in food insecurity among families with young children which continued years after the economy as a whole recovered.
While leaders in Congress propose another round of Economic Impact Payments, we know issuing more direct payments that reach all children until the economy recovers and increasing benefits in the Supplemental Nutrition Assistance Program (SNAP) are critical for health. Both of these measures are ready to be deployed and together will ensure that families are able to afford basic needs while also providing a much-needed boost to local economies.
The single mom I talked with in the spring pointed out that she received SNAP benefits and was thankful--and relieved!--to see the supplemental benefit added in April. She was also happy to hear that Pandemic SNAP (also called P-EBT) was a possibility on the horizon.
As a pediatrician, I know that dose matters. Any medication I give depends on the right dosage in order to be effective.
SNAP and cash payments are effective treatments for reducing food insecurity and poverty and improving health, but the current measures, though bumped up due to the pandemic, still do not deliver the right dose to adequately alleviate the economic strain families face now and in the future.
With negotiations underway in Congress on a fourth and potentially final stimulus package, we need to ensure additional, inclusive direct payments and a 15 percent increase in SNAP benefits are passed before Congress adjourns till September.
In the face of covid-19, we must enact strong, evidence-based measures that respond to the realities of families with children. That means ensuring families have financial resources to afford food, rent, health care, and medicines without sacrificing other basic needs.
Without swift, long-term solutions on the federal level, I worry that the health of my patients and their families will suffer well beyond the final days of the covid-19 pandemic itself. Solutions that mitigate the stress parents of my patients are under are within reach; Congress can act now to ameliorate these hardships and promote child and family health.
--–––––v–––––--
Eduardo Ochoa, MD, FAAP, is a practicing pediatrician at Arkansas Children's Hospital.