The Pandemic's Impact on Child Hunger and Vulnerable Seniors

Global health researchers discuss findings on our most precious populations

Families During COVID

By Mary Brophy Marcus

Published February 4, 2021, last updated on February 9, 2021 under Research News

Stay-at-home orders have been at the center of public health recommendations aimed at curbing the fast-moving COVID-19 virus this past year, but they also place huge stressors on families and individuals. Mental health, nutrition and family dynamics have all taken a hit due to lockdowns, new research suggests. 

Duke Global Health Institute (DGHI) experts and some of our partners met Wednesday, Feb. 3, to talk about how people in Duke's hometown of Durham, NC, and other US communities are navigating these challenges of the pandemic.  

Sumi Gupta Ariely, associate professor of the practice in global health, introduced the guests and led the conversation, “Stress and Resilience in Lockdown,” the first of six “Think Global” lectures hosted by DGHI this semester. Gupta Ariely’s “local-is-global” approach to global health work provided a unique launching pad for exploring the subject.

Families Faltering Under Strain of COVID-19

Some preliminary research on the mental health of families in the US South was shared by Amber Rieder, a global mental health postdoctoral associate at DGHI and Duke Institute for Brain Sciences, who has been conducting research on the topic under the mentorship of DGHI’s Eve Puffer. The online survey went out to parents across 18 southern US states — 1,500 parents completed the survey which represented about 1,800 children, ages 3 – 16. They participated in the online questionnaires over the first 6 months of the pandemic. Rieder said while the findings are still preliminary, their analysis so far suggests three key findings:

  • Parents have significant mental health concerns. More than 50% of parents are reporting at least mild symptoms associated with depression with another one-third of families reporting more serious depression symptoms more in line with clinical severity. And 33% of families also screened significantly for anxiety symptoms, a figure that was a little higher than the researchers expected. 
  • Parents are experiencing social, emotional and behavioral difficulties with their children. Three-quarters of parents reported that at least one of their children had experienced a decline in mental well-being since the start of the pandemic.
  • Parents report deterioration in both partner-partner relationships and parent-child relationships.

Also notable, said Rieder, was that more than half of parents were struggling with balancing work and childcare during the pandemic.


In the spring of 2020, research shows 1.15 billion school meals were missed in the United States.

Lindsey Miller — research analyst for the Healthy Eating Research program, based at Duke Global Health Institute

Panelist Anna Gassman-Pines, WLF Bass Connections associate professor of public policy and psychology and neuroscience at Duke, has been surveying a group of retail, food service and hotel workers in Philadelphia since before the pandemic on work conditions and well-being. All have young children between ages 2- 7. 

Gassman-Pines said that since the start of the pandemic in the US, they saw “just how quickly these parents lost access to work. Work hours plummeted very dramatically as soon as the lockdowns and stay-at-home orders were announced.”

Parents’ stress levels also escalated significantly after restrictions went into place due to loss of work hours and income. Follow-up surveys show that in half of families, the parent is screening positive for either major depression or anxiety, or both.

Children Have Lost Access to Healthy Meals

Lindsey Miller, a research analyst for the Healthy Eating Research program, who is based at DGHI, has been studying nutrition and food security in the US. During the panel talk, she noted that pre-pandemic, nearly 11 million children lived in a food-insecure household — meaning they live in a home where regular meals are disrupted because there is not money or access to food for some or all. 

“Childhood food insufficiency rates have skyrocketed during the pandemic, reaching 19.9% by mid-July 2020, compared to 7.7% in 2018,” said Miller.

With schools closed or in remote learning mode, children have lost access to nutritious school breakfasts and lunches. Some children were receiving nearly all their daily calorie and nutrition from meals at school pre-pandemic, especially children from low-income families. 

Despite some creative efforts from schools — such as forming meal pick-up sites, school bus meal drop-offs, and the use of USDA waivers for free meals for students — during a 9-week period in the spring of 2020, research shows 1.15 billion school meals were missed.

Miller said the three biggest concerns related to child food insecurity are:

  • Lack of consistent access to healthy food.
  • Potential for children going hungry.
  • The pandemic has affected the nutrition of children across America but has disproportionately affected children from low-income families and has further exacerbated disparities in America.

Poor nutrition may be leading to other health complications in children, Miller noted.

“We don't have all the data yet, but there's concern that childhood obesity could escalate during the pandemic. Not being in school, there are fewer options for students to be physically active and meals eaten at home aren't as nutritious as school meals,” she said.

Dementia Patients More Vulnerable

Carmelita Karhoff, with Dementia Inclusive Durham, a grassroots volunteer collaborative, spoke about how the pandemic has made those with dementia — already a vulnerable population — at higher risk of contracting COVID-19. 

“Once infected they have a high risk of disease-related mortality,” Karhoff explained. 

She also noted that the impact of isolation on those already challenged is difficult to track and comprehend due to current systems.

Elder abuse and neglect, depression, weight loss and failure to thrive are other sobering COVID-19 fallout her organization is concerned about in older Americans. 

Seeking Solutions

The speakers said solutions may come from different sources, including community organizations, academic institutions, faith communities, and government programs and pandemic-focused funding for schools and families. For example, Karhoff said some Duke students have rallied to support local seniors' needs.

The US can also take a cue from communities around the globe that have been dealing with many of these issues long before the pandemic hit the world.

In fact, said Rieder, “We are working to bring family interventions together here to our local communities in the US using coping initiatives that have been successful in low-income countries."

Please join us for Duke Global Health Institute's next Think Global webinar on Feb. 17 at 12pm ET. Our topic will be "AI and Global Health."