RACE, COVID-19, and Health Outcomes Among Individuals Born Preterm

Abstract: This project addresses a critical gap in the understanding of potential links between race, the COVID-19pandemic, and the well-being of children. We will evaluate these relationships by collaborating with other ECHOcohorts, thus increasing the geographical variation of our study sample. Our cohort, derived from the ExtremelyLow Gestational Age Newborn (ELGAN) study, provides the opportunity to evaluate relationships within subsetsdefined in terms of gestational age at birth. Given the high prevalence of early life adversities among individualsborn extremely preterm, we anticipate finding increased vulnerability to the harmful effects of the COVID-19pandemic. Although fewer children than adults have developed life-threatening infections due to COVID-19, thepublic health policies implemented to stop the spread of COVID-19 have disrupted children's lives througheconomic depression, social distancing, and unprecedented educational disruptions. The shift to distancelearning has changed children's home, school, and social environments, but we know very little about the impactof these changes on children's health and development. These disruptions may have stronger negative effectson historically underserved groups, including lower income families, as well as racial and ethnic minorities. Thisproposal seeks to evaluate the unintended psychosocial impacts of COVID-19 public health policies on childrenand families, and to examine if these effects are more prominent within lower income communities andcommunities of color. We examine if COVID-19 Health Policies impose more hardships on families within thesegroups, and if these hardships adversely affect their positive health development, as indexed by academiccompetence and well-being. By collaborating with cohorts comprised primarily of children born near or at term,we will also evaluate whether COVID-19 related stressors have greater impact on a particularly vulnerable groupof children, i.e., those born extremely preterm. Further, we will examine if school practices related to distancelearning and supportive social networks are also associated with child outcomes, independent of COVID-19hardships. This project will identify processes by which public health policies influence families and will identifypractices that promote children's positive health development.