The combination of a global health emergency and an economic downturn is unprecedented. But research evidence on the effects of previous crises and other challenging circumstances can shed light on the potential impact of lockdown and the recession on children’s health.
The current situation of a global pandemic, lockdown measures across countries and the resulting recession has never been experienced in modern times. Thus, there is no direct evidence of the impact of a recession caused by lockdown on children’s health. Instead, here we discuss some of the ways in which children are affected by the current crisis, and summarise the research evidence on those specific areas.
What does evidence from economic research tell us?
First, there are studies that look at the impact of recessions on children’s health, and specifically the effects of being in utero during a recession on health outcomes at birth and later in life. One study examines the Dutch population born between 1812 and 1912, and finds that the state of the business cycle at birth affects mortality: being born in a recession reduces lifespan by about 5% (Van den Berg et al, 2006).
While the children born in economic downturns of previous centuries may have suffered from malnutrition, that is less likely today. But the effects of exposure to recessions in utero have also been documented for more recent times. One study shows that the stress experienced by Icelandic mothers during the collapse of the banking sector in 2008 reduced the birthweight of babies who were in the first trimester at the height of the crisis (Olafsson, 2016).
Research also finds that during a recession, children’s mental health outcomes worsen, and the use of special education services for emotional problems also rises (Golberstein et al, 2019).
Effects of conditions in early life on health and outcomes in later life
Beyond the effects of recession on children’s health, what has been much more widely studied in economics is the impact of economic disadvantage on children’s health and outcomes in later life. Research in economics, as well as other disciplines, shows that economic disadvantage in childhood and during pregnancy can worsen health both in childhood and subsequently in adulthood through a number of channels.
When discussing this body of research evidence, it is worth keeping in mind that the impact of disadvantage or poverty in a recession, when a larger proportion of the population is in the same situation, may differ from a situation where a family remains disadvantaged, in poverty or unemployment in more usual economic times. But this evidence indicates some of the ways in which economic disadvantage has an impact on children’s health.
An extensive review of the evidence documents the clear links between parents’ circumstances and children’s health (Currie, 2009). Furthermore, there is clear evidence of how children’s health in early life has an impact on their eventual life outcomes, such as health, education and job market outcomes.
For example, birthweight is associated with health and other outcomes later in life. This link exists even when studying twins who have different birthweights due to differences in the amount of nutrition they received in utero, but otherwise experience the same family environments (for example, Black et al, 2007).
An analysis of UK data finds that psychological problems in childhood have a large effect on an individual’s earnings, work, marriage stability and other factors later in life (Goodman et al, 2011). This illustrates the stark and lifelong effects that early childhood conditions have on health.
Potential effects of lockdown
The lockdown measures may also exacerbate some of the health effects that a recession or economic disadvantage have on children. In particular, even in the absence of a recession, the different effects that the lockdown measures have on families may increase existing inequalities in both income and economic status as well as health.
In the lockdown, children are losing out on in-person schooling. Economic research has clearly documented that people with higher levels of education have better health, but it is unclear whether more schooling improves health, or whether those who are healthier end up getting more education. Studies that look at changes in compulsory schooling age and other educational reforms show no clear direct impact of schooling on health later in life (Janke et al, 2020).
Related question: What will be the impact of lockdown on children's development?
When the lack of human capital accumulation through schooling is combined with the lockdown situation, the effects may be starker. As children are confined to their homes and do not get to socialise with friends, this can increase stress in their life due to stressful environments at home.
One study finds that children’s stress, in particular, is increased by poor mental health of mothers, if parents do not spend much time children, and by harsh parenting styles (Moroni et al, 2019). These factors are particularly important in lockdown and can further amplify differences in children’s social and emotional skills.
Furthermore, children are also losing out on services other than schooling. One example of services that have been reduced due to the Covid-19 crisis are Children’s Centres that offer educational activities, healthcare and other support services to families with small children.
Most of these Centres were created as part of the Sure Start programme, which was launched in the late 1990s with the intention of providing support for families with children under the age of 5. Research finds that Sure Start has had positive health effects especially for the most disadvantaged children in terms of reductions in rate of hospitalisations while the children are in primary school (Cattan et al, 2019).
More than having an impact on just health, evidence from a randomised experiment of providing parenting investments over the first five years of children’s lives in Ireland shows a causal link between participation in the programme and improved outcomes in cognitive abilities and behaviours (Doyle, 2020).
Similarly, research on the US programme of food stamps shows that the health effects of such support may be felt far into the future. One study finds that access to food stamps in childhood leads to a significant reduction in the incidence of conditions such as obesity, high blood pressure, heart disease and diabetes in adulthood (Hoynes et al, 2016).
How reliable is the evidence?
The evidence on how economic disadvantage affects the health of children both in their childhood and later in life is strong and well documented. The key question is the degree to which this evidence can be generalised to the current situation, and whether the lockdown and the recession might mitigate or exacerbate the mechanisms identified in the research.
On the one hand, the psychological impact of going through a difficult time as a society as a whole where everyone faces the same lockdown restrictions may mitigate some of the otherwise negative psychological or economic effects.
On the other hand, the lockdown will hit families in different ways, and it is most likely to worsen existing inequalities between families with children. These inequalities may transfer into greater inequalities in health and other outcomes later in life.
To understand the impact of the current recession and lockdown on children, we need to understand which factors drive the effects of recession and disadvantage on children’s health and which of those factors are at play during this recession. The simultaneous and multidimensional nature of the changes that are being experienced by children during the pandemic makes this particularly challenging since these mechanisms have typically been isolated and studied on an individual basis in research. Their effects may interact in complex ways.
Where can I find out more?
Supporting parents and children in the early years during (and after) the COVID-19 crisis: Gabriella Conti discusses how parents and children could be supported during the current crisis to reduce inequalities between families.
Children’s socio-emotional skills and the home environment during the COVID-19 crisis: Gloria Moroni, Cheti Nicoletti and Emma Tominey describe their work on how the home environment affects children’s socio-emotional skills.
Who are UK experts on this question?
- Emma Tominey, Professor at the Department of Economics at the University of York
- Sarah Cattan, Associate Director at the Institute for Fiscal Studies
- Gabriella Conti, Associate Professor in Economics in the Department of Economics at UCL
- Gerard Van den Berg, Professor of Economics at University of Bristol
- Alissa Goodman, Professor of Economics at UCL Institute of Education and Director of the Centre for Longitudinal Studies