Philadelphia remains the poorest of America’s major cities. Children are especially affected, with 37% living in poverty. This poverty burden lies disproportionately on racial and ethnic minorities: a 2018 report stated that 38% of Philadelphia’s Black children and 49% of its Hispanic children live in poverty, compared to about 16% of their White counterparts. Low-income children face a greater risk of personal victimization and child abuse, higher rates of adverse health outcomes including chronic disease, mental illness, and lower life expectancy, and lower high school graduation rates. The problem isn’t unique to Philadelphia—other major American cities like Detroit and Baltimore face similar inequity.
While quarantine measures are essential, they have worsened the effects of this nationwide economic inequity. As our nation moves toward reopening, America’s most vulnerable children are poised to enter what we term a chronic readjustment phase in which the lingering effects of today’s pandemic remain bumps on the road to normalcy.
Under normal circumstances, community institutions—especially public schools—offer essential safety nets to support the development and long-term well-being of low income children. School meals provide necessary nutrition; classrooms provide internet and electronics, mentors, and tailored curricula that parents otherwise cannot afford. Physical education classes are beneficial in crowded school districts lacking recreation centers and green spaces. Teachers and school nurses actively monitor children’s health and serve as mandated reporters of suspected child abuse.
In quarantine, Philly’s children have lost their greatest support system. Children are now invisible to most mandated reporters, and child abuse reports have artificially fallen as a result. Further destabilizing these children’s already-precarious situation, many of their parents are among the crowd of blue collar workers who recently filed for unemployment; several were denied their requests. We fear that financial loss and acute stress induced by this crisis could deteriorate safe household conditions and position children for more maltreatment.
These threats to America’s children have not gone unnoticed—institutions, communities, and private entities across the nation have already stepped up to help. Internet providers are offering reduced-price or free high-speed Wi-Fi, a measure that should be implemented in Philly. This would complement the devices provided by school districts for distance learning. Throughout the state, United Way of Pennsylvania has curated a list of existing local food, financial, and medical assistance programs by zip code; community health workers (CHWs) at Penn’s IMPaCT program have been critical in connecting our community’s most disadvantaged families and children to these resources. One West Philly community has even been graced by a food fairy delivering meals directly from distant food distribution centers to neighborhood children.
As many of us gradually exit quarantine with celebration, our city’s children will need even more resources for the additional challenges they will face during this chronic readjustment phase. Children will be coping with a lot of loss. Many will have lost grandparents, teachers, and friends to COVID-19. They will have lost parents who provided “essential services” as custodial staff or domestic workers and risked exposure to higher viral loads. And they will continue to lose economic stability as thousands of businesses close permanently and their parents remain unemployed.
These losses will compound the observed uptick in mental health crises due to COVID-19. Low-income children in precarious settings are at greater risk for substance abuse, PTSD and other anxiety disorders, and suicide. To prevent these astounding blows to children’s health and development, national support for legislation like the CHIP Mental Health Parity Act as well as funding in coronavirus relief plans for community health resources will be imperative.
The most tangible way to address this upcoming crisis will be through schools. Public schools in Philly and across America have not recovered from the 2008 recession, when the economic reverberations led to a decline in student performance—especially in low-income districts where per-student cost decreased by over $6,000. The financial burden of the pandemic will worsen those losses in a time when children will need their most vital support system to be stronger than ever. Philadelphia schools are already planning for major budget cuts in the fall and preparing to lay off teachers and guidance counselors who can promote academic achievement and children’s mental health. To prevent this, federal relief funding for public schools should increase remarkably from the current $13.5 billion allocated in the coronavirus assistance package. On a local level, city funds should be reallocated towards psychological and social services in low-income schools, as well as to improving environmental safety in asbestos-laced school buildings.
To alleviate household financial stress and insecurity, economic support for job-matching programs, housing, and unemployment benefits for families should also be prioritized. Many low-income high schoolers who depend on part-time jobs to save up for college may also need financial opportunities. In addition to sustained employment options, public and private universities should receive and allocate more funding for need-based scholarships.
In Philadelphia, zip code determines health. Children in low-income neighborhoods have always been more vulnerable. Now, locked out of their schools and supportive communities, they have also become invisible. Once the world switches back “on,” we will need to fix the damage done in the darkness of our Philadelphia.
Childhelp National Child Abuse Hotline: 1-800-422-4453
Substance Abuse and Mental Health Services Administration Helpline: 1-800-622-4357
Likhitha Kolla and Diane Rafizadeh are MD-PhD students at the University of Pennsylvania. They can be contacted at [email protected] and [email protected].
Dr. Cindy Christian, a practicing physician and the Chair in the Prevention of Child Abuse and Neglect at CHOP, and Dr. Caroline Watts, Director of School and Community Engagement at Penn GSE, provided guidance for this article.
The opinions expressed in this article do not represent those of the University of Pennsylvania Health System or the Perelman School of Medicine.
