The forgotten victims of the pandemic: children and adolescents

Claudio A. Castillo, MA
Associate Professor, Institute of Nutrition and Food Technology, University of Chile; and Professor, Centre for Public Health, University of Santiago de Chile

Despite the achievements of past decades, the future of children and adolescents today is more uncertain. The pandemic exposed inequities —tolerated by our societies until now— not only in terms of health, but also in social and economic areas, which have resulted in a greater impact on vulnerable populations.

Before COVID-19, in Latin America and the Caribbean this group was already harder hit by multidimensional poverty and income poverty, which have negative effects throughout life, as studies have long shown.

And the scenario worsened. The measures adopted to mitigate the effects of the emergency dramatically transformed the daily lives of children and adolescents, affecting their social ties, play spaces and access to schooling and exposing them to early adversities that are associated with subsequent deficits in learning, behaviour and physical and mental well-being. The greater the scarcity, the deeper the effects. Children who are deprived of responsive care at home, who were previously unattended or without access to essential services, are and will continue to be the most exposed to toxic stress.

ECLAC has warned of significant increases in poverty in the region due to the pandemic and the resulting social and economic crisis.[1] This is key: intersectional perspectives on the life cycle show how the simultaneous experience of different forms of discrimination —whether by gender, age, ethnicity or socioeconomic position— is a determinant of differentiated risk exposure and is associated with premature morbidity and inequalities in healthy development.

In this context, the interruption of essential services, vaccines and health care, as well as the reduction in available food, can lead to a devastating increase in maternal and child deaths. Furthermore, the increase in malnutrition in its various forms, the loss of caregivers and the greater stress will also affect future generations, given the physiological, psychological and epigenetic changes that are produced in utero and during the first years of life.

Mental health is another current and future concern, as indicated in the 2021 Report on the State of the World’s Children from UNICEF. It has been shown that children suffer stress more acutely if they are separated from one or both parents, and the outlook is more complex in the face of a loss of primary or secondary caregivers. And this is a reality: it is estimated that between March 2020 and April 2021, about 600,000 children and adolescents under the age of 18 years were orphaned as a result of COVID-19 in Argentina, Brazil, Colombia, Mexico and Peru.

For adolescents —who are more sensitive to social stimulus and have a greater need for interaction— the pandemic has prevented face-to-face contact, which is crucial for peer acceptance. This could have far-reaching implications. For the moment, socialization has been replaced with digital interaction which, while growing exponentially, has also revealed the violence inherent in online forums, social media and messaging networks and the associated threats to the integrity and/or security of this group.

The interruption of access to mental health services for adolescents is a major concern, in a context of closed schools. In more normal circumstances, these spaces allow for the timely detection of the risks and symptoms of anxiety or depression, for example.

It is imperative to dedicate efforts and resources to developing innovative community-based mental health programmes for children and adolescents and their parents. It is especially important to forge alliances with academia and to train people in early detection, timely resolution and crisis intervention.

The conclusion is unmistakable: the failure to act now will perpetuate the intergenerational cycle of poverty, inequality and social exclusion.