There has been limited data on how the coronavirus pandemic has impacted the lives of lesbian, gay, bisexual, and transgender individuals (LGBT) in the U.S. Drawing on our previous analyses indicating that LGBT individuals are at greater risk of both COVID-19 health and economic outcomes, this analysis examines their views of the vaccine and their role in uptake.  

Key Findings

• This new analysis examines the experiences of LGBT adults from the July COVID-19 Vaccine Monitor and finds that as a group they are more likely to be vaccinated for COVID-19 and less likely to view getting the vaccine as a health risk compared to non-LGBT adults. Previous analyses have found that the LGBT population bears a disproportionate burden from the pandemic, including economic hardships and mental health problems. In addition, research has found that LGBT individuals have higher rates of comorbidities and experience stigma and discrimination in the health system.
• A larger share of LGBT adults than non-LGBT adults say they have received at least one dose of a COVID-19 vaccine (82% vs 66%) and 8 in 10 report being fully vaccinated (80% with one of their one-dose vaccine or two of their two-dose). This may reflect the fact that larger shares of LGBT adults identify as Democrats, a group that has been disproportionately likely to get the vaccine. However, the high level of vaccination among LGBT adults is notable given that they are a younger population. Nearly half (45%) of LGBT adults are under age 30, an age group that has lagged in vaccination rates compared to older populations.
• LGBT adults are more supportive of vaccine mandates than non-LGBT adults. Almost two-thirds of LGBT people (65%) support the federal government recommending that employers require their employees to get the COVID-19 vaccine unless they have a medical exception. Fewer non-LGBT adults agree with government recommended mandates, with the group split between supporting them (50%) and not (47%). Again, this likely reflects the differences in partisan identification between the two populations.
• A larger share of LGBT people than non-LGBT people believe the seriousness of the pandemic has been generally underestimated by the media, which may be a reflection of the disproportionate mental health and economic struggles they have faced. This may also be a factor in their relative enthusiasm and high uptake of the COVID-19 vaccine. Compared to other historically marginalized groups that have tended to have lower vaccine uptake, this high level of vaccination could be an important factor to mitigate further disparities in the pandemic’s impact on the LGBT population.

COVID-19 Vaccination Intentions And Uptake

As of July 2021, eight in ten LGBT adults report being vaccinated for COVID-19, according to the latest KFF COVID Vaccine Monitor. A larger share of LGBT adults report receiving at least one dose of a COVID-19 vaccine than non-LGBT adults (82% vs. 66%). Eight in ten report being fully vaccinated (80% with one of their one-dose vaccine or two of their two-dose). Eighteen percent (18%) of LGBT adults remain unvaccinated, a smaller share than for non-LGBT adults, 32% of whom remain unvaccinated.

Among LGBT adults, a small share (2%) say they want to get vaccinated “as soon as possible,” while 4% want to “wait and see” before getting vaccinated, and 12% say they will “definitely not” get the vaccine (similar to the 14% of non-LGBT adults who express this view).

In KFF’s analysis of April and May polling data, 56% of LGBT adults reported being vaccinated, 5% wanted to get one “as soon as possible,” and another 20% wanted to “wait and see,” mostly matching the reported intentions among the general public, 59% of whom were already vaccinated, 6% wanted it right away, and 14% were “wait and see.” Around 1 in 10 LGBT people reported they definitely would not get vaccinated (11%) or would only get it if required (7%), also similar to intentions among the general population.

Now however, a larger share of LGBT adults report being vaccinated, surpassing rates among the non-LGBT population.

A previous KFF analysis examined the demographic groups among the unvaccinated population finding adults who are still unvaccinated tend to be older, more Republican-leaning, less educated, and lower income, with each of those groups making up a larger part of unvaccinated than the vaccinated group. Party identification, in particular, tends to be a strong predictor of vaccination intentions.

Higher rates of vaccination among LGBT adults compared to their non-LGBT peers may be associated with strong Democratic party identification, rather than or in addition to, sexual orientation or gender identity. Two-thirds of LGBT adults identify as Democrats or lean that way compared to 43% of non-LGBT adults. By contrast, more than a third (36%) of non-LGBT adults identify or lean Republican compared to 14% of LGBT adults. Additionally, LGBT adults tend to be younger and lower income, two groups that tend to have low vaccination rates. Almost half (45%) of adults who identify as LGBT are under age 30 compared to 19% of non-LGBT adults, and half (51%) of LGBT adults compared to a third (34%) of non-LGBT people report having household incomes under $40,000. High self-reported vaccination rates among LGBT people could be driven by their Democratic partisanship, but also is in spite of their relatively young age and lower incomes.

Views of covid-19 and the vaccine

In addition to higher vaccination uptake, LGBT individuals have different views of how the media has portrayed the severity of the pandemic, as well as the relative risk of the vaccines versus the virus.

Three in 10 (31%) LGBT adults say what is said in the news “generally underestimates” the seriousness of the pandemic compared to one in five (18%) non-LGBT adults. Another four in ten LGBT adults (40%) say the news is “generally correct” in its portrayal of the seriousness of the pandemic, which is similar to the share of non-LGBT adults who report the same (44%).

Consistent with views of the pandemic generally, a large majority of LGBT adults say becoming infected with coronavirus is a bigger risk to their health than getting vaccinated (82%), while 14% think getting vaccinated is a bigger risk. About 7 in 10 (69%) non-LGBT people agree that becoming infected is a bigger risk, though this share is somewhat less than among the LGBT group.

Similar to other adults, LGBT people generally have high levels of confidence in the effectiveness of the COVID-19 vaccines. Two-thirds of LGBT people think the available COVID-19 vaccines are “extremely” or “very” effective at preventing vaccinated individuals from getting seriously sick or hospitalized if infected (67%) and dying from COVID (66%). Another 56% say the vaccines are effective at preventing infection if exposed to someone who is sick and 45% say the same of passing coronavirus on to others.

Mandates

LGBT adults are more supportive of vaccine mandates than non-LGBT adults. Almost two-thirds (65%) of LGBT people support the federal government recommending that employers require their employees to get the COVID-19 vaccine, unless they have a medical exemption. Fewer non-LGBT adults agree with the government recommended mandates, with the group split between supporting them (50%) and not (47%). Given that views on government mandates divide sharply along partisan lines, this division of opinion between LGBT adults and non-LGBT adults likely reflects the fact that LGBT adults lean more Democratic, as noted above.

This KFF COVID-19 Vaccine Monitor was designed and analyzed by public opinion researchers at the Kaiser Family Foundation (KFF). The survey was conducted July 15-July 27, 2021, among a nationally representative random digit dial telephone sample of 1,517 adults ages 18 and older (including interviews from 322 Hispanic adults and 300 non-Hispanic Black adults), living in the United States, including Alaska and Hawaii (note: persons without a telephone could not be included in the random selection process). This includes 95 adults who identify as LGBT, 1,403 who are not LGBT, and 19 respondents who said they didn’t know or refused to answer. Phone numbers used for this study were randomly generated from cell phone and landline sampling frames, with an overlapping frame design, and disproportionate stratification aimed at reaching Hispanic and non-Hispanic Black respondents as well as those living in areas with high rates of COVID-19 vaccine hesitancy. Stratification was based on incidence of the race/ethnicity subgroups and vaccine hesitancy within each frame. High hesitancy was defined as living in the top 25% of counties as far as the share of the population not intending to get vaccinated based on the U.S. Census Bureau’s Household Pulse Survey.  The sample also included 28 respondents reached by calling back respondents that had previously completed an interview on the KFF Tracking poll at least nine months ago. Another 118 interviews were completed with respondents who had previously completed an interview on the SSRS Omnibus poll (and other RDD polls) and identified as Hispanic (n =50 ; including 21 in Spanish) or non-Hispanic Black (n=68). Computer-assisted telephone interviews conducted by landline (176) and cell phone (1,341, including 1,015 who had no landline telephone) were carried out in English and Spanish by SSRS of Glen Mills, PA. To efficiently obtain a sample of lower-income and non-White respondents, the sample also included an oversample of prepaid (pay-as-you-go) telephone numbers (25% of the cell phone sample consisted of prepaid numbers) Both the random digit dial landline and cell phone samples were provided by Marketing Systems Group (MSG). For the landline sample, respondents were selected by asking for the youngest adult male or female currently at home based on a random rotation. If no one of that gender was available, interviewers asked to speak with the youngest adult of the opposite gender. For the cell phone sample, interviews were conducted with the adult who answered the phone. KFF paid for all costs associated with the survey.

The combined landline and cell phone sample was weighted to balance the sample demographics to match estimates for the national population using data from the Census Bureau’s 2019 U.S. American Community Survey (ACS), on sex, age, education, race, Hispanic origin, and region, within race-groups, along with data from the 2010 Census on population density. The sample was also weighted to match current patterns of telephone use using data from the January- June 2020 National Health Interview Survey. The weight takes into account the fact that respondents with both a landline and cell phone have a higher probability of selection in the combined sample and also adjusts for the household size for the landline sample, and design modifications, namely, the oversampling of potentially undocumented respondents and of prepaid cell phone numbers, as well as the likelihood of non-response for the re-contacted sample. All statistical tests of significance account for the effect of weighting.

The margin of sampling error including the design effect for the full sample is plus or minus 3 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available by request. Sampling error is only one of many potential sources of error and there may be other unmeasured error in this or any other public opinion poll. Kaiser Family Foundation public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.

This work was supported in part by grants from the Chan Zuckerberg Initiative DAF (an advised fund of Silicon Valley Community Foundation), the Ford Foundation, and the Molina Family Foundation. We value our funders. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.

Key Findings

Historically, the LGBT+¹  community has faced mental health and substance use problems at higher rates than their non-LGBT+ peers. The COVID-19 pandemic, which has disrupted the lives of people across the globe, has negatively impacted LGBT+ people’s mental health in disproportionate ways. In this data note, we pull together data from nationally representative surveys, adding to a small but growing evidence base on the impact of the pandemic on LGBT+ people.

• LGBT people reported the COVID-19 pandemic negatively impacted their mental health both more widely and more severely than their non-LGBT peers. They report that their sleep, appetite, and temper were negatively impacted at higher rates than non-LGBT people. They also report that they were more likely to seek out mental health care during the pandemic than non-LGBT people, including via telemedicine.
• A range of factors may contribute to these mental health disparities among LGBT+ people during the COVID pandemic, including different work, life, and health care experiences. LGBT+ people more commonly report quitting a job because of COVID-19, taking time off work because of becoming ill with COVID-19 or quarantining, or taking time off work to care for a family member who was sick with COVID-19 or quarantining than non-LGBT+ people. Given that LGBT+ have lower-incomes than their non-LGBT+ peers, disruptions in employment could be especially challenging for families and harmful to mental health.
• Another factor that may drive these disparities is LGBT+ people’s higher rates of mental health and substance use problems pre-pandemic, including those related to more common experiences of stigma and discrimination compared to their non-LGBT+ peers. These underlying experiences could have made LGBT+ people more vulnerable to stress during the pandemic.
• Despite LGBT+ people reporting accessing mental health care at higher rates than non-LGBT+ people, many still face barriers, particularly financial ones, to getting the care that they need. LGBT+ people are more likely to report they could not afford mental health care and say they face challenges with medical bills than their non-LGBT peers. Other reported roadblocks include problems getting appointments and negative provider experiences.

Taken together, these findings may help to identify and inform opportunities to address and mitigate mental health disparities among LGBT+ people. These could include adopting culturally appropriate policy solutions and approaches to engaging the community, as well as efforts to address wider, systemic factors that drive stigma and discrimination.

Introduction

Historically, the LGBT+ community has faced mental health and substance use problems at higher rates than their non-LGBT+ peers and experiences during the COVID-19 pandemic have been no exception. The pandemic has negatively impacted LGBT+ people’s mental health in disproportionate ways. Pulling together data from three nationally representative surveys in this area, we explore a range of factors related to LGBT+ people’s mental health during the pandemic including assessment of mental health, access to and affordability of mental health services, and underlying experiences of stigma, discrimination, and negative encounters with health care providers.

Data in this analysis comes from: KFF’s monthly COVID Vaccine Monitor, KFF’s Women’s Health Survey, and new KFF analysis of publicly available Survey of Household and Economics and Decisionmaking (SHED) data from the Federal Reserve.

The Impact of COVID-19 on LGBT People’s Mental Health and Care Seeking

LGBT individuals report that worry and stress related to the COVID-19 pandemic negatively impacted their mental health more often and more severely than non-LGBT people. These negative mental health impacts were especially pronounced for all people before vaccines were widely available. The KFF COVID-19 Vaccine Monitor found that in the December 2020/January 2021 period, three-quarters of LGBT people (74%) reported that worry and stress from the pandemic negatively impacted their mental health compared to half (49%) of non-LGBT people. This includes about half of LGBT people (49%) who said the coronavirus was having a “major impact” on their mental health, twice the share of non-LGBT individuals who reported the same (23%) (Figure 1).

While the share reporting negative mental health impact of the pandemic fell for both groups in July 2021, a time of widely available vaccination and partial reopening, LGBT people continue to report the pandemic has negatively impacted their mental health both more widely and more severely than non-LGBT people. In July, six in ten LGBT people reported that the pandemic negatively impacted their mental health, about half (31%) of whom say that the impact has been major. By comparison, 37% of non-LGBT people reported a negative mental health impact in this period, 17% of whom say that the impact was major (Figure 1).

Specifically, compared to non-LGBT people, larger shares of LGBT people say worry or stress related to the coronavirus caused them to experience difficulty with sleep (39% v. 21%), problems with their appetite (41% v. 18%), and difficulty controlling their temper (23% v. 10%) in the past two months. They report similar rates of headaches or stomachaches, worsening chronic conditions (e.g. blood pressure or diabetes), and increased alcohol or drug use. LGBT people are more likely to report that they have experienced at least one of these impacts than non-LGBT people (55% v 34%) (Figure 2).

A range of factors may contribute to these mental health disparities among LGBT+ people, including their different circumstances during the pandemic. For example, the 2020 KFF Women’s Health Survey found larger shares of LGBT+ people reported having to quit a job for a reason related to COVID-19 compared to non-LGBT+ individuals (15% v. 7%). Additionally, 19% of LGBT+ people report taking time off work because of personally becoming ill with COVID-19 or quarantining, compared to 11% of non-LGBT+ individuals. One in ten (10%) LGBT+ people report taking time off work to care for a family member who was sick with COVID-19 or is quarantining (v. 5% of non-LGBT people) (Figure 3). While these factors could be stressful for any individual, given that LGBT+ people tend to be lower income than their non-LGBT+ peers, disruptions in employment could be especially challenging for families and harmful to mental health.

In addition, LGBT+ people faced higher rates of mental health and substance use problems pre-pandemic, which may be related to common experiences with stigma and discrimination. KFF analysis of 2020 Survey of Household and Economics and Decisionmaking (SHED) data reveal that 19% of LGBT+ people report experiencing discrimination or unfair treatment in the past 12 months versus 9% of non-LGBT+ people (Figure 4). These experiences with unfair treatment and discrimination were similar prior to and during the pandemic but the underlying stress associated with them could have made LGBT+ people more vulnerable to pressures related to the pandemic.

LGBT+ people also report seeking mental health care during the pandemic more than non-LGBT+ people. One in four (25%) LGBT+ people report seeking mental health care because of the pandemic, compared to 1 in 10 (12%) non-LGBT+ people, potentially reflecting their higher reported needs in these domains (Figure 5).

Additionally, LGBT+ people reported using telehealth more widely since the pandemic began than non-LGBT+ people (49% v. 34%) and among LGBT+ people who reported COVID era telehealth use, 25% say it was for mental health services, a higher share than non-LGBT+ telehealth users (14%) (Figure 6).

Barriers to Mental Health Care

Even as LGBT people have a greater need for mental health care during the pandemic, and report seeking such care at higher rates, all those who require mental health services may not be receiving them. SHED data reveal that in 2020, one-in-five (19%) LGBT+ people say they could not afford mental health care or counseling during the past 12 months compared to a smaller share of non-LGBT people (5%) (Figure 7). LGBT+ people’s lower income levels and higher rates of pandemic related employment disruptions compared to non-LGBT+ peers could make accessing and affording mental health care especially difficult for this group.

Indeed, 30% of LGBT individuals report trouble paying medical bills in the past year, compared to 19% of non-LGBT individuals (Figure 8). Of LGBT people who had trouble paying medical bills over half (58%) attributed that trouble, at least in part, to the COVID-19 pandemic.

In addition to financial challenges, difficulty in obtaining appointments during the pandemic may also present a barrier. Nearly one-third (29%) of LGBT+ people said they were unable to get a health care appointment during the pandemic (not limited to mental health services), similar to the share among non-LGBT+ people (25%).

Negative provider experiences may also deter LGBT+ people from getting the care they need. Compared to non-LGBT people, LGBT+ people are more likely to report a provider has not believed they were telling the truth (16% v. 8%), suggested they were to blame for a health problem (13% v. 8%), assumed something without asking (21% v. 11%), and dismissing their concerns (29% v. 16%). Altogether, over one-third (36%) of LGBT+ people reported at least one of these negative experiences with a provider, compared to fewer than one in five (22%) non-LGBT+ people. (Figure 9)

Implications

Larger shares of LGBT+ people experienced negative mental health effects from the COVID-19 pandemic than non-LGBT people. While LGBT+ people were more likely to report seeking mental health care during the pandemic, not all those who need services are obtaining them. Many report barriers to receiving care, particularly related to affordability. However, difficulty getting appointments during the pandemic may also play a role, as might negative past provider experiences. Experiences of stigma and discrimination were widespread among LGBT+ people prior to the pandemic and these underlying disparities could make weathering pandemic related stress more challenging. These findings are important both given the mental health disparities LGBT+ populations have traditionally faced and as the pandemic created new stressors disproportionately impacting the community. As such, targeted and culturally appropriate policy solutions and approaches to engaging the LGBT+ community would be beneficial. Additionally, addressing the wider, systemic factors that drive stigma and discrimination may help to mitigate these disparities.

COVID-19 Vaccine Monitor DataMethodology and toplines can be found here for Dec. 2020/Jan. 2021 data and here for July. In addition to the detail provided in the link, the July COVID-19 Vaccine Monitor is a nationally representative random digit dial telephone sample of 1,557 adults, including 95 adults who identified as lesbian, gay, bisexual, or transgender. The margin of sampling error is plus or minus 13 percentage points for the full LGBT sample and 3 percentage points for the non-LGBT sample.

Women’s Health Survey DataMethodology and topline can be found here.

Survey of Household Economics and Decisionmaking (SHED)The Survey of Household Economics and Decisionmaking (SHED) is an annual survey of adults conducted by the Federal Reserve Board. The survey is based on the Ipsos KnowledgePanel, a nationally representative probability-based online panel. Ipsos selected respondents for KnowledgePanel based on address-based sampling (ABS). The questions asked of the panel are intended to gather information from the individual about how they make household economic decisions. All data is the most current available.  The data presented here are from the 2020 survey with the exception of the estimates of being a victim of violence which is from the 2019 survey. SHED survey finishes data collection in October and then releases the report and public use file in May of the following year. LGBT+ adults include those who self-identify as lesbian, gay, bisexual, transgender, or something else (other than straight or cisgender).

1. Where possible in this analysis we use the inclusive term LGBT+. LGBT+ includes people who identify as lesbian, gay, bisexual, transgender, or another sexual orientation or gender identity aside from heterosexual or cisgender. When LGBT is used, the more limited term describes the population a particular survey reflects. ↩︎

Key Findings

• As students head back to school amid uncertainty caused by the coronavirus pandemic, the latest report from the KFF COVID-19 Vaccine Monitor finds parents reporting notable adverse impacts of the pandemic on children’s academic and social development. About four in ten parents of children ages 5 and over say at least one of their children fell behind academically (39%), rising to half of Hispanic parents (50%) and those with lower household incomes (51%). More than a third (36%) of parents say their child fell behind in their social and emotional development and about three in ten (29%) say their child experienced mental health or behavioral problems due to the pandemic. Notably, parents whose children attended school all or mostly online, or who had a mix of online and in-person schooling were more likely than parents whose child attended school all or mostly in-person to say they had a child who had these adverse effects even after controlling for other demographic factors and type of school.
• When asked about more specific problems that may indicate mental health concerns among children, about four in ten parents (42%) report that at their children experienced at least one new mental health symptoms in the past 12 months that they had not been experiencing them before the pandemic including difficulty concentrating on schoolwork (27%), problems with nervousness or being easily scared or worried (19%,) trouble sleeping (18%), poor appetite or overeating (15%), and frequent headaches or stomachaches (11%). Mothers – who tend to take on greater responsibilities for childcare and are often the primary health care decision makers in a family– are more likely than fathers to say one of their children experienced most of the symptoms since the pandemic began.
• The KFF COVID-19 Vaccine Monitor finds that nearly four in ten parents say they or another adult in their household left a job or changed work schedules to care for their children in the past year. Notably, more than half of Black parents (53%) and parents with lower household incomes (51%) say they or another adult in their family left a job or changed schedules in order to care for their children. One in five parents overall say the person in their household who left a job or changed their work schedule is still not working or continues to work reduced hours, rising to one-third of Black parents and nearly four in ten lower-income parents.
• Household employment disruptions may also be related to children’s wellbeing. Parents in a household with an employment disruption are more likely than those who didn’t experience a disruption to say their fell behind academically (51% vs. 32%), fell behind in their social or emotional development (49% vs. 28%), or experienced mental health or behavioral problems (41% vs. 21%). Parents in a household with an employment disruption are also more likely than those who did not experience a disruption to say their child has developed a new mental health symptom since the pandemic began (56% vs. 33%).
• Along with negative impact on children’s mental health, the pandemic appears to have taken a mental health toll on parents. A majority (54%) of parents say the pandemic has had a negative impact on their mental health, compared to 39% of adults overall who say the same. Mothers, Black and Hispanic parents, those with lower incomes, and parents whose household experienced a work disruption due to increased childcare needs have been particularly affected with at least six in ten in each of these groups saying it the pandemic had a negative impact on their mental health.

Effects of the pandemic on children’s academic and emotional development

As students head back to school amid uncertainty caused by the coronavirus pandemic, this new report from the KFF COVID-19 Vaccine Monitor examines parents’ assessment of the toll the pandemic has taken on their children and on their own mental health and financial wellbeing over the past 18 months.  When asked about specific ways the pandemic may have affected their children, about four in ten parents of children ages 5 and over say at least one of their children fell behind academically (39%), while more than a third (36%) of parents of children of any age say their child fell behind in their social and emotional development and about three in ten (29%) say their child experienced mental health or behavioral problems due to the pandemic.

Notably, half of Hispanic parents say one of their children fell behind academically as a result of the pandemic compared to about a third of White parents (35%) who say the same. Across income groups, half (51%) of parents with a household income under $40,000 say their child fell behind academically compared to about a third (32%) of those with incomes of $90,000 or more.

The coronavirus pandemic caused a tremendous amount of disruption to the 2020-2021 school year. Across the country, millions of students and teachers had to transition to online learning. Previous KFF research at the beginning on the 2020-2021 school year found that about two-thirds of parents were worried about their child falling behind academically or in their social and emotional development if they did not return to in-person school. Indeed, most students were not able to attend in-person school fulltime during this past school year. KFF’s most recent COVID-19 Vaccine Monitor finds that a majority of parents say their child attended school at least partially online during the previous school year (72% of parents of 12-17 year-olds and 62% of parents of 5-11 year-olds). Notably, we find that parents of children whose school was at least partially online are more likely than those whose kids attended school mostly or completely in-person to report that one of their children have experienced a negative impact to their wellbeing¹ . These differences may be at least partially due to differences in other demographic characteristics of parents whose child’s schools offered in-person schooling compared to those who did not. However, using a statistical technique called multivariate regression, we find that even after controlling for parent’s race and ethnicity, gender, income, region, age, educational attainment, and party identification and whether they had a child attending private or public school, parents with a child who attended school at least partially online are more likely than those whose children attended school all or mostly in person to report their child experienced a negative impact to their wellbeing due to the pandemic.

Parents whose children attended school all or mostly online, or who had a mix of online and in-person schooling were more likely than parents whose child attended school all or mostly in-person to say they had a child who fell behind academically (47% vs. 26%), fell behind in their social or emotional development (46% vs. 31%), or experienced mental health or behavioral problems (39% vs. 22%).

When asked about more specific problems that may indicate mental health concerns among children, about one in four parents (27%) say their children had difficulty concentrating on schoolwork or completing assignments and that this was a new problem they were experiencing since the pandemic began. About one in five say a child experienced new problems with nervousness or being easily scared or worried (19%) or trouble falling or staying asleep or sleeping too much (18%). In addition, 15% of parents say their children exhibited poor appetite or overeating (15%) and about one in ten say they experienced frequent headaches or stomachaches (11%). Overall, four in ten parents (42%) report that their children experienced at least one of these symptoms in the past 12 months and had not previously been experiencing them before the pandemic.

With the exception of difficulty concentrating on schoolwork, mothers – who tend to take on greater responsibilities for childcare and are often the primary health care decision makers in a family– are more likely than fathers to say one of their children experienced each of the symptoms since the pandemic began. Overall, about half (47%) of mothers report that their child experienced a new problem compared to about to four in ten fathers (37%).

Notably, half of Hispanic parents (52%) and lower-income parents (49%) say one of their children exhibited one of these mental health symptoms in the past 12 months which were not present before the pandemic. In addition, parents of children who attended school at least partially online are more than twice as likely as parents whose children attended school all or mostly in person to say their child experienced new problems concentrating on schoolwork or completing assignments in the past 12 months (41% vs. 17%).

Childcare Needs And Employment Disruptions

In this past year, the pandemic not only affected children, but has also had an impact on working parents and families across the country. A recent KFF analysis of the Census Household Pulse Survey shows that households with children were more likely to have experienced employment loss. The most recent KFF COVID-19 Vaccine Monitor finds that nearly four in ten parents say they or another adult in their household left a job or changed work schedules to care for their children in the past year. As one might expect, parents of younger children are more likely than those of children ages 12 and older to say their household had an employment disruption due to childcare needs in the past year. In addition, Black parents (53%) and Hispanic parents (44%), those with a household incomes under $40,000 (51%), and parents under age 40 (44%) are more likely than their counterparts to say they or another adult in their family left a job or changed schedules in order to care for their children.

Notably, one in five parents of kids ages 5 and over say at least one of their children had to take on new duties helping to care for siblings or other family members as a result of the pandemic, including 28% of Black parents and 26% of Hispanic parents compared to 15% of White parents.

When asked more specifically how their work arrangements changed to accommodate for increased childcare needs during the pandemic, 16% of parents say they or another adult in their household changed their work schedule and a further 10% say they cut back on hours. About one in ten parents (11%) say they or another adult in their household stopped working temporarily in order to care for their children, rising to one in five among Black parents (20%) and parents with a household income under $40,000 (21%). A further 9% of parents say in the past year they or another adult in their household stopped working permanently in order to care for their children, rising to 17% among Black parents and those with lower household incomes.

Many parents who stopped working or adjusted their work schedules to take care of children during the pandemic have still not returned to work or to their previous schedules. Overall, about half (54%) of parents who report a work disruption due to childcare needs (21% of parents overall) say the person in their household who left a job or changed their work schedule is still not working or continues to work reduced hours. Overall, one-third of Black parents and one in four Hispanic parents say their household has not resumed their previous employment hours after having a childcare-related employment change during the pandemic. Low-income parents are particularly hard-hit, with roughly four in ten parents (39%) with a household income under $40,000 saying their household has not resumed their previous employment hours.

These employment disruptions have added an additional burden to what has already been a difficult year for many parents across the country. Large majorities say their household employment disruption due to childcare needs has had an impact on their stress level (50% say it has had a major impact, 36% a minor impact), their family finances (44% major, 35% minor), and their own mental health (31% major, 39% minor).

Again, Black and Hispanic parents are particularly impacted with about one in four saying their household experienced an employment disruption and that it has had a major impact on their family’s finances and on their stress level. Among lower-income parents, one-third say report experiencing a household employment disruption that has had a major impact on their stress level (33%), and on their family finances (33%) and one in five (21%) report such a disruption has had a major impact on their mental health.

The Impact Of Employment Disruption On Children

When parents experience disruptions in their employment due to increased childcare needs, this may also have an impact on the wellbeing of their children. When assessing the impact of the pandemic on their children, parents in a household that experienced an employment disruption are more likely than those whose household did not experience a disruption to say their child fell behind academically (51% vs. 32%), fell behind in their social or emotional development (49% vs. 28%), experienced mental health or behavioral problems (41% vs. 21%), or had to take on new care duties for siblings or other family members (33% vs. 11%). Overall, about seven in ten parents in households that experienced an employment disruption say one of their children has experienced at least one of these things compared to 44% of those who did not experience a disruption.

Similarly, parents who experienced a household employment disruption are also more likely than those who did not experience a disruption to say their child has developed a new mental health symptom since the pandemic began (56% vs. 33%). Nearly four in ten parents in households that experienced an employment disruption say their child has had difficulty concentrating on schoolwork (37%), about three in ten say their children have exhibited nervousness or being easily scared or worried (29%), and about one in four say they had sleeping disturbances (26%) or issues with eating (26%). One in six say their child experienced frequent headaches or stomachaches (17%).

Mental Health Of Children And Their Parents

Previous KFF research has shown the even before the pandemic, many children in the U.S. were experiencing mental health problems and there was some evidence last year that the pandemic may have been exacerbating the issue. While three in ten parents report that their children experienced mental health or behavioral problems as a result of the pandemic and an even larger share say their children have experienced new symptoms in the past 12 months that may be associated with mental health concerns, a much smaller share (17%) report that their children received mental health services in the past 12 months. One in nine parents overall (11%) say there was a time in the past 12 months when they thought their child may have needed mental health services or medication but didn’t get them.

Access to mental health services appears to be an issue for those parents who say they thought their child might need mental health care but they were unable to get it. The main reasons parents cite for why their child was unable to get needed mental services include that they could not find a provider (32%), that they were too busy or could not get the time off work (16%), and that they could not afford the cost (15%).

In addition to the effects on children’s mental health, parents themselves are disproportionately likely to say the pandemic has had a negative impact on their own mental health. About four in ten adults overall (39%) report that stress and worry related to coronavirus has had a negative impact on their mental health, a share that rises to 54% among parents (compared to 37% of adults without children at home). The stress and worry over the pandemic has especially affected mothers, Black and Hispanic parents, those with household incomes under $40,000, and parents whose household experienced a work disruption due to increased childcare needs, with at least six in ten in each of these groups saying it has had a negative impact on their mental health.

Mental Health Impacts Over The Course Of The Pandemic

Previous KFF research has found that the share of adults reporting symptoms of anxiety or depressive disorder rose to about four in ten during the pandemic, up from about one in ten who reported these symptoms in 2019. While still large share of adults say the stress and worry due to the pandemic has had a negative impact on their mental health, it has decreased slightly from March 2021 (47%) to 39% in the July KFF COVID-19 Vaccine Monitor, and is down considerably from 53% a year ago. While the share of adults in the U.S. who are reporting negative mental health impacts from the coronavirus is down slightly, the survey was fielded largely before the news of the increased threat of the Delta variant.

A majority of parents and more than four in ten Hispanic adults, women, those with a chronic health condition, and health care workers say stress and worry related to coronavirus has had a negative impact on their mental health. Smaller shares of non-parents, adults ages 65 and older, men, and those with higher incomes say they have experienced mental health impact from the coronavirus. Previous studies have shown that men, older adults, and Black adults may be less likely to report mental health difficulty and more likely to face challenges accessing mental health care.

This KFF COVID-19 Vaccine Monitor – Parents and the Pandemic was designed and analyzed by public opinion researchers at the Kaiser Family Foundation (KFF). The survey was conducted July 15-August 2, 2021 via telephone and online among a nationally representative sample of 1,259 adults who are the parent or guardian of a child under the age of 18 living in their household. The sample includes 351 parents reached through the July 2021 KFF COVID-19 Vaccine Monitor and 908 who were reached online through a probability-based online panel (SSRS Opinion Panel). The Vaccine Monitor respondents were reached through a random digit dial telephone sample of adults ages 18 and older (including interviews from 101 Hispanic parents and 64 non-Hispanic Black parents), living in the United States. Phone numbers used for the telephone component were randomly generated from cell phone and landline sampling frames, with an overlapping frame design, and disproportionate stratification aimed at reaching Hispanic and non-Hispanic Black respondents as well as those living in areas with high rates of COVID-19 vaccine hesitancy. The sample also included 43 parents by calling back respondents that had previously competed an interview on a KFF poll (n=11) or SSRS omnibus poll (n=32). The comparison sample of non-parents was also drawn from the July 2021 KFF COVID-19 Vaccine Monitor. See the July 2021 KFF COVID-19 Vaccine Monitor for further details on the telephone component.

For the online component, invitations were sent to panel members who previously identified as the parent of a child ages 5 to 17.  As with the telephone component, Hispanic and Black respondents were oversampled.  The SSRS Opinion Panel is a nationally representative probability-based web panel. SSRS Probability Panel members are recruited randomly in one of two ways: (a) Through invitations mailed to respondents randomly sampled from an Address-Based Sample (ABS). ABS respondents are randomly sampled by MSG through the U.S. Postal Service’s Computerized Delivery Sequence (CDS). (b) from a dual-frame random digit dial (RDD) sample, through the SSRS Omnibus survey platform. Sample for the SSRS Omnibus is obtained through Marketing System Groups (MSG).

The combined telephone and online parent samples were weighted to match the sample’s demographics to the national parent population using data from the Census Bureau’s 2019 U.S. American Community Survey (ACS). Weighting parameters included sex, age, education, marital status, child age, and region, within racial/ethnic groups. The weights take into account differences in the probability of selection for each sample type (phone and web). This includes adjustment for the sample design and geographic stratification of the telephone sample, within household probability of selection, and the design of the panel-recruitment procedure.

The margin of sampling error including the design effect for the full sample of parents is plus or minus 4 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available by request. Sampling error is only one of many potential sources of error and there may be other unmeasured error in this or any other public opinion poll. Kaiser Family Foundation public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.

This work was supported in part by grants from the Chan Zuckerberg Initiative DAF (an advised fund of Silicon Valley Community Foundation), the Ford Foundation, and the Molina Family Foundation. We value our funders. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.

1. Parents who said they had at least one child who attended school all or mostly online, or a mix of online and in-person were coded as All/Mostly/Mix Online. ↩︎