Child and Family Outcomes Following Pandemics: A Systematic Review and Recommendations on COVID-19 Policies

J Pediatr Psychol. 2020 Nov 1;45(10):1124-1143. doi: 10.1093/jpepsy/jsaa092.


Objective: A systematic review of mental health outcomes and needs of children and families during past pandemics was conducted based on the PRISMA protocol. The objectives were to evaluate the quality of existing studies on this topic, determine what is known about mental health outcomes and needs of children and families, and provide recommendations for how COVID-19 policies can best support children and families.

Methods: Seventeen studies were identified through a search of PsycINFO, PubMed, Scopus, Web of Science, and Google Scholar.

Results: Studies examining child outcomes indicate that social isolation and quarantining practices exert a substantial negative impact on child anxiety, post-traumatic stress disorder, and fear symptoms. Potential risk factors such as living in rural areas, being female, and increasing grade level may exacerbate negative mental health outcomes for children. Studies examining parental and family outcomes indicate that parents experience high stress, anxiety, and financial burden during pandemics. The age of the parent and family socioeconomic status (SES) appeared to mitigate negative outcomes, where older parents and higher SES families had lower rates of mental health problems. Parents' fear over the physical and mental health of their children, concerns over potential job loss and arranging childcare contributes to elevated stress and poorer well-being.

Conclusions: Findings from this review suggest current gaps in COVID-19 policies and provide recommendations such implementing "family-friendly" policies that are inclusive and have flexible eligibility criteria. Examples include universal paid sick leave for parents and financial supports for parents who are also frontline workers and are at an elevated risk for contracting the disease.

Keywords: COVID-19; child; families; infectious disease outbreaks; mental health; pandemics; parents; policy.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Betacoronavirus*
  • COVID-19
  • Child
  • Coronavirus Infections / complications
  • Coronavirus Infections / psychology*
  • Family / psychology*
  • Female
  • Humans
  • Male
  • Mental Disorders / complications
  • Mental Disorders / psychology*
  • Pandemics*
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / psychology*
  • Quarantine / psychology*
  • SARS-CoV-2