PEDIATRICS recent issues

A Trainee-Led Social Media Advocacy Campaign to Address COVID-19 Inequities

The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the health of people globally. Yet, not all people are being affected by this crisis equally. In the United States, this pandemic has exacerbated long-standing inequities and entrenched structural racism. At the onset of the crisis, few data were available detailing the demographic characteristics of individuals with COVID-19. However, as data emerged, it became apparent that communities of color were disproportionately affected. To illustrate these inequities, we analyzed publicly available race and ethnicity data on COVID-19 cases and deaths and were one of the first groups to compile these findings. We launched a social media campaign to highlight these racial and ethnic inequities and raise awareness among public and elected officials. Given the tremendous amount of missing data, we demanded transparency in state reporting of race and ethnicity data. Using both messaging and mapping tools, we publicized state and city efforts to address these inequities, focusing on the creation of task forces tackling the racial inequities of COVID-19. As racial and ethnic data on COVID-19 cases and mortality became more widely reported, statistics emerged about the downstream effects of these inequities. Despite initial false reassurance that COVID-19 largely spared children, the pandemic has exacerbated many social needs, leading to significant negative impacts on children. For example, as pediatricians, we saw how worsening food insecurity was affecting children. Using social media and infographics, we launched an additional stage of the campaign to illustrate these inequities and highlight advocacy opportunities.

Perspectives on Race and Medicine in the NICU

Current data regarding racial and ethnic disparities in health outcomes of newborns requiring care in an NICU reveal significant differences in quality and access to care that disproportionally affects infants of color, particularly African American infants. These inequalities result in an increased infant mortality rate for Black children and higher preterm birth rates, as well as an increase in deaths due to low birth weight and decreased gestational age. Concurrently, there is emerging research exploring the role of diversity and adequate representation among medical providers in patient outcomes in Black communities. In this editorial, we present commentaries from a medical student, a neonatologist, and a parent of former NICU patients to further explore race in the NICU from different perspectives and understand what can be learned from their experiences about these systemic issues and why representation is a critical component of successful change.

Suicide Ideation and Attempts in a Pediatric Emergency Department Before and During COVID-19

OBJECTIVES:

Elevated rates of mental health concerns have been identified during the coronavirus disease 2019 (COVID-19) pandemic. In this study, we sought to evaluate whether youth reported a greater frequency of suicide-related behaviors during the 2020 COVID-19 pandemic as compared with 2019. We hypothesized that rates of suicide-related behaviors would be elevated between the months of March and July 2020 as compared with 2019, corresponding to the onset of the COVID-19 pandemic.

METHODS:

Routine suicide-risk screening was completed with youth aged 11 to 21 in a pediatric emergency department. Electronic health records data for suicide-risk screens completed between January and July 2019 and January and July 2020 were evaluated. A total of 9092 completed screens were examined (mean age 14.72 years, 47.7% Hispanic and/or Latinx, 26.7% non-Hispanic white, 18.7% non-Hispanic Black).

RESULTS:

Rates of positive suicide-risk screen results from January to July 2020 were compared with corresponding rates from January to July 2019. Results indicated a significantly higher rate of suicide ideation in March and July 2020 and higher rates of suicide attempts in February, March, April, and July 2020 as compared with the same months in 2019.

CONCLUSIONS:

Rates of suicide ideation and attempts were higher during some months of 2020 as compared with 2019 but were not universally higher across this period. Months with significantly higher rates of suicide-related behaviors appear to correspond to times when COVID-19–related stressors and community responses were heightened, indicating that youth experienced elevated distress during these periods.

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