This research examined how significant disruptions to children’s health, education, and overall well-being during the COVID-19 pandemic created lasting influences on health, development, and social trajectories through the lifecourse, as well as the risk for long-term health outcomes. The effects of the pandemic were unevenly distributed among children, particularly with respect to race/ethnicity and income, and were anticipated to both reflect and exacerbate the already wide health disparities in the United States.

As vaccines continued to roll out, inequality in access to and take-up of vaccinations could have compounded the disparate outcomes. New York City (NYC), where the 1 million public school children were majority Black or Hispanic (66%) and 74% were low-income, was an ideal place to situate this research. In the health domain, changes in diet and physical activity and missed healthcare may have increased the incidence and exacerbation of chronic diseases like obesity, asthma, and diabetes. The pandemic generated stress and anxiety, with fewer of the usual mental health service supports available, posing a risk for new and more severe health problems. Even after schools fully returned to in-person learning, the educational consequences were expected to be protracted, including declines in academic achievement (test scores), increases in chronic absenteeism, repeating grades, or high school dropout.

The research leveraged the NYC Student Population Health Registry (SPHR), a uniquely inclusive, longitudinal database of all NYC public school students, created jointly by the NYC Department of Health and Mental Hygiene and the NYC Department of Education, to examine these and other outcomes. SPHR linked multiple municipal data sources at the child-level, allowing for an examination of the influence of the COVID pandemic on myriad outcomes.