Kids at risk: We must work together to avoid a post-COVID health crisis

This article originally appeared in the San Francisco Chronicle: 

Almost everyone, to some extent, has suffered from the isolation, uncertainty, or emotional and economic effects of the pandemic. But for some kids and families — particularly those who are low-income and part of communities of color — the scars of the pandemic threaten to last a lifetime.

In the short term, the Bay Area’s most vulnerable children are at greater risk for exposure to domestic violence, substance use and mental health challenges as their families try to cope with the added stresses of COVID-19. For some kids and families, sheltering in place means being trapped with an abuser, with less access to help. And during times of lockdown, children often can’t rely on other adults — child-care providers, teachers or even primary health care practitioners — to offer support and intervention.

In the long-term, unless we act swiftly and with coordinated efforts, we are facing a massive public health crisis as these children and families suffer potentially lasting mental and physical effects of stress and adversity. Research has shown that prolonged exposure to stress and trauma such as neglect, violence and racism can harm children’s developing brains and bodies. The constant wear and tear of stress hormones can lead to higher rates of illnesses later in life, like cancer, stroke, heart disease and Alzheimer’s. People who have had four or more adverse childhood experiences, such as exposure to violence or abuse, have more than double the risk of heart disease and stroke and triple the risk of lung disease as others. We also know that exposure to domestic violence in childhood increases the risk of experiencing or perpetrating domestic violence as an adult. 

Unfortunately, these types of adversity are all too common. In California, prior to COVID-19, one in seven children experienced emotional or physical trauma before the age of 5, and 58% of the adult population has been affected, directly or indirectly, by domestic violence. Nationally, before COVID, 60% of people had been exposed to at least one form of adversity, and more than 20% experienced two or more. And, as with COVID-19, childhood trauma disproportionately affects Black and brown communities. Inequities in health care, education and violence — rooted in racism — increase the risk of childhood trauma and domestic violence. The impact of the pandemic has made these problems worse. 

This public health crisis impacts us all. But so far, the response has been piecemeal, with individuals and families left to navigate fragmented and underfunded health care, child services and educational systems. We need to make it easier for families to get help, and involve them in shaping the types of services most meaningful and impactful to them. Confronting this public health crisis is a priority that will require widespread collaboration across systems that care for children in our communities. Often stigmatized, childhood adversity and domestic violence are not individual problems, but ones that affect whole families and communities. 

Fortunately, research shows that children and families are remarkably resilient and can heal, and we know that access to fully coordinated and integrated programs and resources is foundational.

We envision a future in the Bay Area where leaders, communities and residents unite to prevent pervasive adversities in childhood and promote healthy development. To do that, we must reimagine how we support the social, economic and physical well-being of kids and families who have been made vulnerable by long-standing inequities, and who have been disproportionately affected by the pandemic. It will take collaboration across the public, private, health care and non-profit sectors to create policies that alleviate financial hardship and provide paid family and medical leave as well as affordable child care. Together, we can help reduce child poverty and the risks that come with it, providing adequate wages, nutrition, housing assistance and educational opportunities in an integrated and coordinated approach.

With the public spotlight on COVID-19, health equity and racial justice, and new leaders in the White House, now is the time to rebuild differently and change how we invest in our children, families, and communities. Together, the public and private sectors can help advance innovative, holistic, and effective strategies for disrupting childhood adversity and preventing domestic violence.

That’s why our organizations, Genentech and Blue Shield of California Foundation, are founding donors of the All In For Kids Fund dedicated to preventing childhood trauma, breaking the cycle of domestic violence and promoting healing during and after COVID-19 in Bay Area communities.

Although the pandemic has caused immense suffering, it also provides an opportunity to approach systemic challenges in new ways. And, we can all play a role. For leaders in the business and philanthropic communities, we invite you to join us in supporting the All in For Kids Fund. For elected officials, we urge you to prioritize the prevention of childhood trauma and domestic violence, and to include those most impacted in the creation of policy solutions. For residents throughout the Bay Area, collectively we can focus our attention and compassion on driving change at the community level by watching out for each other’s safety and well-being and utilizing the resources available to provide support. Together, we can accomplish change at the scale our communities need and deserve.

Rajni Dronamraju is senior director of corporate giving at Genentech and Debbie I.Chang, MPH, is president and CEO at Blue Shield of California Foundation.