The COVID-19 pandemic has posed a number of challenges for accessing health care and child care. Disruption of preventive health care can lead to challenges in the identification of health conditions, providing routine vaccinations, tracking developmental milestones, intervening early on identified health concerns, and providing support to families.¹⁴ Telemedicine was widely adopted during the pandemic, which provided easier access to both sick and preventive care, while also protecting against the spread of disease. Recent Household Pulse Survey research shows that households experiencing material hardships—such as difficulty paying rent or mortgage, food insufficiency, or difficulty paying household expenses—were more likely to report missed/delayed preventive visits than those who did not experience material hardships.¹⁴ Working from home or workplace closures were also experienced by many parents or caregivers. Because of these workplace changes, parents or caregivers often experienced material hardships and/or lost the access to child care, which contributed to work-related disruptions.

Figure 7. Percentage of households where all children attended a preventive check-up in the last 12 months overall and by material hardships, December 29, 2021–February 7, 2022

• From late December 2021 to early February 2022, approximately 68% of households with children reported that all children had a preventive check-up in the past 12 months.
• The percentage of households with all children having a preventive check-up was lower in households experiencing material hardship than in households that did not experience material hardships, including not being current on rent or mortgage (58% versus 70%), difficulty paying usual household expenses (64% versus 71%), and children not eating enough because of lack of affordability (58% versus 70%).
• According to poverty and insurance status, the percentage of households with all children having a preventive check-up was highest among households with a poverty status equal to or greater than 400% (78%) and those with privately insured adults (73%), and lowest among households with a poverty status of less than 138% (61%) and those with uninsured adults (53%), respectively.

Figure 8. Percentage of households with any children who had a telehealth visit in the last 4 weeks, April 14, 2021–February 7, 2022

• The percentage of households with any children who had a telehealth visit in the last 4 weeks decreased from 24% (mid- to late April 2021) to 17% (late January–early February 2022).
• According to race/ethnicity and insurance status, children's telehealth visits were highest among households with adults who identified as Hispanic (18%) and adults with public insurance (19%), and lowest among households with adults who identified as White, non-Hispanic (15%) and adults with no insurance (14%).

Figure 9. Percentage of households experiencing disrupted child care arrangements overall and by poverty status, July 21, 2021–February 7, 2022

• Disrupted child care among households with children in a child care arrangement ranged from 25% of households (late July 2021) to 35% (early February 2022).
• With the exception of the last data collection period (early February 2022), the percentage of households reporting disrupted child care was higher among households with incomes at or below 200% poverty (25% to 34%), compared with households with incomes above 200% poverty (19% to 29%). During the period ending with February 7, 2022, both income groups had the same prevalence of disrupted child care (36%).
• Reports of disrupted child care were highest among households with adults who identified as Black, non-Hispanic or Other, non-Hispanic (36%) and Hispanic (32%), and lowest among households with adults who identified as Asian or Pacific Islander, non-Hispanic (27%). Additionally, reports of disrupted child care were highest among households with adults who had a bachelor's degree or higher (36%) and lowest among adults who had less than a high school diploma or an alternative credential such as a General Educational Development (GED) certificate (27%).

Figure 10. Percentage of households reporting work-related impacts among households that experienced child care disruptions by poverty status, December 29, 2021–February 7, 2022

• As a result of child care disruptions, many households with children experienced work-related impacts, with notable differences by income level: Households with incomes at or below 200% poverty more frequently took unpaid leave (31%), left a job (18%), did not look for a job (16%), or lost a job (10%), while households with incomes above 200% poverty more frequently took paid leave (48%), cut work hours (43%), and supervised children while working (44%).

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