The COVID-19 pandemic poses an acute threat to the well-being of children and families due to challenges related to social disruption such as financial insecurity, caregiving burden, and confinement-related stress (e.g., crowding, changes to structure, and routine). The consequences of these difficulties are likely to be longstanding, in part because of the ways in which contextual risk permeates the structures and processes of family systems. The current article draws from pertinent literature across topic areas of acute crises and long-term, cumulative risk to illustrate the multitude of ways in which the well-being of children and families may be at risk during COVID-19. The presented conceptual framework is based on systemic models of human development and family functioning and links social disruption due to COVID-19 to child adjustment through a cascading process involving caregiver well-being and family processes (i.e., organization, communication, and beliefs). An illustration of the centrality of family processes in buffering against risk in the context of COVID-19, as well as promoting resilience through shared family beliefs and close relationships, is provided. Finally, clinical and research implications are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Risk and resilience in family well-being during the COVID-19 pandemic.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(11)60555-2.pdf

Inequality in early childhood: risk and protective factors for early child development

Gender inequality and restrictive gender norms: framing the challenges to health

In Aldous Huxley’s dystopia, Brave New World, there were fi ve castes. The Alphas and Betas were allowed to develop normally. The Gammas, Deltas, and Epsilons were treated with chemicals to arrest their development intellectually and physically, progressively more aff ected from Gamma to Epsilon. The result: a neatly stratifi ed society with intellectual function, and physical development, correlated with caste. That was satire, wasn’t it? We would never, surely, tolerate a state of aff airs that stratifi ed people, then made it harder for the lower orders, but helped the higher orders, to reach their full potential. Were we to fi nd a chemical in the water, or in food, that was damaging children’s growth and their brains worldwide, and thus their intellectual development and control of emotions, we would clamour for immediate action. Remove the chemical and allow all our children to fl ourish, not only the Alphas and Betas. Stop the injustice now. Yet, unwittingly perhaps, we do tolerate such an unjust state of aff airs with seemingly little clamour for change. The pollutant is called social disadvantage and it has profound eff ects on developing brains and limits children’s intellectual and social development. Note, the pollutant is not only poverty, but also social disadvantage. There is a clear social gradient in intellectual, social, and emotional development—the higher the social position of families the more do children fl ourish and the better they score on all development measures. This stratifi cation in early child development, from Alpha to Epsilon, arises from inequality in social circumstances. Emphasising social circumstances and the social gradient is not to say that all diff erences in early child development can be linked to the social environment. Were the conditions under which children grew and developed to be equalised there would still be diff erences between individuals in cognition and social and emotional development. Twin studies show substantial heritability of cognitive ability, for example. That said, the Flynn eff ect refers to the substantial increases in IQ scores that have occurred over time that are due to the environment, broadly conceived. The evidence shows clearly that social conditions infl uencing parenting aff ect children’s ability to reach their potential and are the major determinants of the social gradient in early child development. This social gradient, in its turn, has a profound eff ect on children’s subsequent life chances. We see a social gradient in school performance and adolescent health; a gradient in the likelihood of being a 20 year old not in employment, education, or training; a gradient in stressful working conditions that damage mental and physical health; a gradient in the quality of communities where people live and work; in social conditions that aff ect older people; and, central to my concern, a social gradient in adult health. A causal thread runs through these stages of the life course from early childhood, through adulthood to older age and to inequalities in health. The best time to start addressing inequalities in health is with equity from the start. But intervention at any stage of the life course can make a diff erence. Relieving adult poverty, paying a living wage, reduction in fuel poverty, improving working conditions, improving neighbourhoods, and taking steps to reduce social isolation in elderly people can save lives. The health gradient to which these life course infl uences give rise is dramatic. There is a cottage industry, taking subway rides in various cities and showing how life expectancy drops a year for each stop. The gap at the ends of the gradient is truly large. In the London Borough of Westminster, UK, there is an 18 year gap in male life expectancy between the most and least salubrious parts of the borough. Similarly, in the US city of Baltimore there is a 20 year gap at the ends of the gradient. 20 years is huge—it is the gap in life expectancy between women in India and in the USA. Health inequalities are perhaps the most damning indictments of social and economic inequalities. These subway rides used social characteristics of area of residence. We see similar social gradients in health if we classify people by education, wealth, income, or occupational status. All societies have social and economic inequalities and all societies have social gradients in health, but the magnitude varies. At the UCL Institute of Health Equity, London, UK, we led a review of social determinants and health inequalities for the European Commission. As part of that review we examined life expectancy at 25 years by level of education. In each country there is a gradient in life expectancy—the higher the level of education, the longer the life expectancy. Three striking fi ndings emerged from the comparison. First, average life expectancy is lower in the countries of central and eastern Europe than in Sweden, Italy, and Norway. In other words we must add to our concern health inequalities between countries as well as those within countries. If we extend beyond Europe we see diff erences in life expectancy of 40 years and more. Second, the gradient is steeper in the east than in the west. Third, and linked to the steeper gradient, the country diff erences in life expectancy are much greater for people with little education than they are for people with tertiary education. The health risks associated with being low status vary greatly. The variation in health inequalities gives grounds for optimism. The data show shallower socioeconomic gradients are possible. Further, Estonia, Romania, and Hungary are able to achieve good health. They do it for people with tertiary education. The challenge is to bring the health level of the more disadvantaged up to the level Lancet 2015; 386: 2442–44

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)00150-6.pdf

The Health Gap: The Challenge of an Unequal World

Since the beginning of the twenty-first century, research on stigma has continued. Building on conceptual and empirical work, the recent period clarifies new types of stigmas, expansion of measures, identification of new directions, and increasingly complex levels. Standard beliefs have been challenged, the relationship between stigma research and public debates reconsidered, and new scientific foundations for policy and programs suggested. We begin with a summary of the most recent Annual Review articles on stigma, which reminded sociologists of conceptual tools, informed them of developments from academic neighbors, and claimed findings from the early period of “resurgence.” Continued (even accelerated) progress has also revealed a central problem. Terms and measures are often used interchangeably, leading to confusion and decreasing accumulated knowledge. Drawing from this work but focusing on the past 14 years of stigma research (including mental illness, sexual orientation, HIV/AIDS, and race/ethnici...

The Stigma Complex.

Social environments and experiences get under the skin early in life in ways that affect the course of human development. Because most factors associated with early child development are a function of socio-economic status, differences in early child development form a socio-economic gradient. We are now learning how, when, and by what means early experiences influence key biological systems over the long term to produce gradients: a process known as biological embedding. Opportunities for biological embedding are tethered closely to sensitive periods in the development of neural circuitry. Epigenetic regulation is the best example of operating principles relevant to biological embedding. We are now in a position to ask how early childhood environments work together with genetic variation and epigenetic regulation to generate socially partitioned developmental trajectories with impact on health across the life course.

/pdf/how-experience-gets-under-the-skin-to-create-gradients-in-47exa9v5y6.pdf

How experience gets under the skin to create gradients in developmental health.

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How experience gets under the skin to create gradients in developmental health.