549 - Increased challenges accessing child care during the COVID-19 pandemic among parents with young children

Access to child care reduces barriers to education and workforce entry and retention, especially for women who often bear caregiving responsibilities. Prior research shows that parents who are unable to work or further their education due to difficulties accessing child care (child care constraints) are at an increased likelihood of fair/poor child and parent health and material hardships. The COVID-19 pandemic forced widespread closures and reduced capacities of child care providers.

Objective: To examine how the pandemic affected access to child care for parents with young children, and to assess differences by maternal nativity.

Design/Methods: Longitudinal data (9/2020-3/2021) with families with children < 4 years interviewed in-person pre-pandemic (1/2018-3/2020) in hospital settings in 4 U.S. cities (Boston, MA, Philadelphia, PA, Little Rock, AR, Minneapolis, MN). Phone follow-up surveys with parents included child care constraints (CCC): when a parent is unable to work or pursue education as much as desired due to difficulties obtaining child care. Adjusting for covariates, repeated measures logistic regression with a COVID indicator evaluated the change in CCC over time. Interaction between nativity and COVID indicator were used to examine differences by maternal nativity.

Results: Among 1,087 parent/child dyads, 43.3% (n=469) at follow-up vs 30.2% (n=323) pre-pandemic reported CCC. 35.8% (n=389) of parents reported that they lost access to child care during the pandemic; 18% (n=196) reported no child care prior to the pandemic. Compared to pre-pandemic, adjusted analyses showed greater odds (AOR 1.48 (95%CI:1.16, 1.88)) of CCC during the pandemic. However, the significant increase in CCC was limited to US-born mothers (pandemic vs. pre-pandemic AOR 1.83 (95%CI:1.41, 2.38)). There was no significant difference among immigrant mothers.

Conclusion(s): Parents with young children had greater odds of CCC during vs. pre-pandemic, consistent with reports that necessary public health measures and economic fallout caused significant child care disruptions. US-born mothers were more likely to report CCC during the pandemic. There was no significant change among immigrant mothers, potentially indicating differences in pre-pandemic care arrangements. Policies stabilizing child care businesses and decreasing access barriers are an essential support for families with young children.