Prevalence of Chronic Illness and Mental Health Among U.S. Child Caregivers During the COVID-19 Pandemic

In a recently published study medRxiv* Preprint Servers researchers assessed the prevalence of chronic illness, depression and stress among U.S. child caregivers during the 2019 coronavirus disease (COVID-19) pandemic.

Study: Prevalence of Chronic Illness, Depression and Stress Among US Child Caregivers During the COVID-19 Pandemic. Credit: Robert Kneschke/Shutterstock


According to the authors, prior to this work, only two other studies examined the physical and psychological conditions of childcare workers in the United States. The study, conducted in Indiana during the pandemic, found that 63% of childcare workers experienced twice the national estimate of 37% for US adults; another, conducted before the outbreak of the pandemic, found that 36.8% to 62.1% of them suffered from moderate to high levels of stress.

Because the well-being of childcare professionals directly or indirectly affects children’s academic and emotional learning outcomes, addressing their condition during the pandemic and beyond is crucial.

About the study

In the current large-scale, national-level study, researchers collected data from 81,682 child caregivers from May 22 to June 8, 2020 via an online survey called Qualtrics® to analyze various physical and mental conditions.

They analyzed four physical health conditions – heart disease, asthma, diabetes and obesity. In addition, mental illnesses such as depression and stress were also assessed. The study analysis took into account their socio-demographic characteristics, including ethnicity/race, age, gender, type of child care, health insurance status, etc.

All participants who self-identified as child caregivers and were at least 18 years of age, resided in a U.S. state or in the District of Columbia, and consented to participate in the study. Of the 94,390 people who accessed the survey, only 82,613 met the inclusion criteria, of which 81,682 (98.9%) were able to provide the necessary data for the analyses.

study results

The survey results showed that the average age of the study participants was 42.1 years; The proportions of female, male and non-binary were 96%, 2.5% and 0.3%, respectively.

In terms of asthma prevalence, 14.3% of child caregivers reported moderate to severe asthma, about 1.2 times the national average for US adult women. In contrast to asthma, the prevalence rates for diabetes, heart disease and obesity were below national rates for adult women in the US at 6.5%, 4.9% and 19.8%, respectively.

A total of 37,376 participants suffered from depression and 66.5% reported moderate to high levels of stress. The prevalence rate of depression within two to three months of the onset of the COVID-19 pandemic was higher than the US national estimates of 16% to 36.1% before the pandemic, and also higher than the estimates of 27.8% to 32.8% for US adults during the pandemic.

The study analysis showed differences related to race, gender, and ethnicity for the physical health status of US childcare professionals, but not related to their mental health statuses during the pandemic.

Of all the physical health conditions examined during the study, the authors observed the most differences for diabetes across all racial groups. Consequently, Hispanics appeared to have a higher risk of diabetes than white childcare workers. Among the non-binary childcare providers, the authors observed an increased risk of asthma and heart disease.

Related to the childcare facility they worked for, professionals working in the government-funded programs appeared to be at higher risk of diabetes and obesity than professionals working in for-profit childcare centers. These findings showed no connection with the sociodemographic characteristics of these workers.

In addition, U.S. child caregivers with asthma, diabetes, or obesity appeared to have better access to health insurance, regardless of their age or other sociodemographic characteristics. Previous findings showing that those with health insurance seek clinical services and therefore receive first-line diagnosis and treatment support this finding.


The study highlighted that US childcare workers’ depression rates during the pandemic were much higher than rates observed before the pandemic. During the pandemic, the prevalence rates of depression, stress, and asthma among these professionals increased at a higher rate than among other US adults.

US policymakers and public health officials should give these findings serious attention and offer much-needed support to child caregivers. While effective and scalable interventions could improve physical and mental health in the short term, addressing issues that are eroding their overall health is critical. For example, long working hours, low wages and high work demands lead to stress, burnout and turnover among these skilled workers.

In the future, examining child caregivers’ health behaviors through mixed-methods research could prove useful in understanding which health initiatives could improve their overall health.

*Important NOTE

medRxiv publishes preliminary scientific reports that have not been peer-reviewed and therefore should not be relied upon as conclusive, guide clinical practice/health behavior or be treated as established information.

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