By: Carmen Le Foulon (GSAS 2014) and Carolina Velasco
Date: July 2020
Field: Health, Public Policy, Early Child Development
Special thanks to: Patronato Madre e Hijo
For more information: [email protected]
Policy interventions to contain the spread of Covid-19 such as quarantines and social isolation are key in the control of the pandemic. But they have spillover effects. One of the most important documented consequences relates to mental health. Previous literature (Brooks et al. 2020) has showed that quarantines and social isolation measures have psychological effects that can last for years. The impacts are more frequent on women, young people, those with lower educational levels and those who care for children. Recent research on the impact of Covid-19 has indeed found greater negative effects on parents who supervise children and adolescents in the US (Kirzinger et al. 2020). Furthermore, mental health of adult care givers is strongly related to the children’s welfare (Jiao et al. 2020, Liu et al. 2020, UNICEF 2020).
This research seeks to understand how different social distancing measures taken in Chile have impacted the most vulnerable families with pre-school children, as well as identify potential risk and protective factors. In particular, we assess the mental health of young children’s principal care givers as well as the children anxiety and other mental health issues as reported by the adult. Through a partnership with Patronato Madre e Hijo (a non-profit organization that provides free health care and other benefits to vulnerable children) we are conducting telephone surveys to a sample of children’s care givers. Beneficiaries come from vulnerable populations, and thus, special care is taken to conduct the study ethically, complying with all the related guidelines.
OBJECTIVES OF THE PROJECT
The main objective of the project is to understand the effect of social distance measures, specially quarantine, in the mental health of vulnerable families with pre-school children, as well as identify protective and risk factors.
A secondary objective is to enable Patronato Madre Hijo to identify the most affected groups and thus, focus their efforts, as well as establish a baseline for continuous future monitoring.
HOW IT IS DONE:
We have built a partnership with Patronato Madre e Hijo, a non-profit private institution created in 1901 whose aim is to support the integral development of vulnerable children during their first years of life. In Santiago, located in the Metropolitan Region, they provide free physical and mental health care to about 1,100 children and their mothers, and in Valparaíso region, to about 1,000 children and their mothers. The research fits into their efforts to better understand their beneficiaries’ conditions of vulnerability as well as identify risks factors to facilitate interventions.
During June and early July, professionals that work or had previously worked at the institution, are conducting telephone surveys to a sample of care givers in both regions. The survey includes questions regarding quarantines, economic and living conditions, and three different sets of questions to assess risk factors, to construct an index of depression and anxiety of care givers, and to measure children’s disruptive and anxiety driven behavior. The battery of questions to construct the index of care giver’s mental health as well those regarding the children’s behavior were proposed by child psychologists in consultation with Patronato Madre Hijo. In addition to the information obtained from the survey, the institution will provide data regarding the care giver socioeconomic characteristics, as well the child’s development previous to the pandemic.
Considering the survey objective (i.e. to measure mental health, household relations), interviewers were selected by Patronato Madre Hijo weighting heavily their capacities as well as their previous knowledge of the beneficiaries, to quickly build rapport and getting honest answers. Up to late June, they had interviewed about 250 respondents. The interviewers were trained by the researchers (virtually) during a session in which ethics consideration were thoroughly discussed. Interviewers understood and share the importance of explaining the voluntary nature of the survey as well as obtaining their informed consent.
A key element in the identification strategy is the difference in the onset of mandatory quarantines due to variations on the place of residence. According to the institution, respondents are fairly similar in terms of observable characteristics across counties. We will further evaluate these claims using data gathered by the institution prior to the pandemic.
Beneficiaries of Patronato Madre Hijo come from different counties in the Metropolitan region, some of them under quarantine for several weeks before the regional lockdown, whereas others not. Furthermore, the institution also has a center in Placilla, a poor area in Valparaíso county, which has only recently been placed under quarantine, and where social distance measures had not been specially enforced by local authorities. These differences are used to build synthetically control and treatment groups.
Table 1 below shows the distribution of children’s year of birth and region of residence from the surveys conducted until June 30th.