Some children and young people have had a particularly difficult time during the pandemic. This sets them apart.

The new research gives us important knowledge.

It has been more than three years since the outbreak of the COVID-19 pandemic. It appears that the pandemic and its attendant measures have hit some groups more than others.

For the future, knowledge gleaned from the pandemic will be important, both regarding potential long-term consequences and dealing with similar crises in the future.

We have summarized research on the consequences for children and young people’s lives and mental health in OECD countries, particularly the Nordic countries. This gives us important knowledge of the first half of the pandemic, much less about the second half and minimal long-term outcomes.

Based on the knowledge so far, can we say something about the vulnerabilities and characteristics of children and young people who have had a particularly difficult time during the initial phase of the pandemic?

We have achieved the following:

• Violence and abuse
• family relationships
• Psychological health
• Use of ancillary services and health services
• Social health and relationships
• Learning, school and kindergarten

We chose to take a closer look vulnerability factors In all thematic areas mentioned above. Vulnerabilities are important and children and young people in particular may need follow-up and assistance post-pandemic. Additionally, it is important for the preparedness and targeted efforts of these groups in subsequent crisis situations.

Vulnerabilities are factors that seem to affect or characterize children and young people who have been exposed to the epidemic in a particularly negative way.

Some studies have shown that these factors increase the risk of a child/young person getting worse. Other studies have found a relationship between these factors and negative outcomes measured in one or more subject areas during the pandemic.

Bronfenbrenner’s (1979) evolutionary ecology model is useful for showing how these factors are present in different contexts around a child or young person.

In our adaptation of the Bronfenbrenner model, the COVID-19 pandemic is the external context that triggered the implementation of various social measures. This includes, for example, orders on social distancing, but also unemployment as a result of parts of society shutting down.

These social initiatives have affected many public services related to the lives of children and youth, such as schools, kindergartens, educational and psychological services, school health services, child protection, family protection, and more (next level/circle).

How these services and institutions deal with infection prevention measures, in turn, affects the social network around the child, the family, and the child himself (the three innermost levels/circles).

We do not mean that the child/young person (or the family) do not themselves influence their surroundings (in the Bronfenbrenner model the interaction between different levels or contexts is central). But in our model, we emphasize factors both inside and outside the child that contribute to and reinforce the negative consequences of the epidemic.

The model shows how the factors identified in the included studies are important across different domains.

There are varying degrees of research support behind the different factors that we present in the model. Factors will also be able to interact and enhance vulnerability.

negative consequences

Partially different factors of weakness made themselves felt within the six thematic areas. This is what we found about the consequences and negative factors:

• An increased degree of vulnerability to violence and abuse appears to be particularly associated with structural conditions such as unemployment, family conditions such as low socioeconomic status, parental mental health difficulties, substance abuse or crime as well as child and youth deficiency. From safe spaces outside the home and access to ancillary services.
• The increased degree of problems in the family appears to be related to unemployment, lack of open and easily accessible social and support services, lack of a social network, stress, illness or substance abuse in the parents, and behavioral difficulties or grief in the child.
• Increased psychological difficulties appear to be associated with lower socioeconomic status in the family, confined spaces, living with one parent, and child characteristics, such as previous emotional difficulties, born outside the Nordic region, previously subjected to abuse, fear of infection and non-binary identity. In addition, girls reported poorer mental health than boys.
• The increased degree of need for help from mental health care seems to apply particularly to girls as well as children and young adults with eating disorders.
• The increased difficulties in school and school work seem to apply particularly to children and youth who are academically impaired or have learning difficulties, have immigrant backgrounds or who have parents of lower socioeconomic status and cramped living conditions.

What do we know – and what do we not know?

Even now, with a knowledge base from the first year of the pandemic, we can see vulnerabilities of very different kinds, such as low socioeconomic status, eating disorders and LGBTQ+ (gender identity and sexual orientation).

It is important to recognize as a society the vulnerability factors in the future. We must consider measures that address the identified vulnerability factors. The identified vulnerability factors will be important when dealing with subsequent epidemics or other types of crises.

More research needs to be done on the consequences of the pandemic.

Some groups and topics are not particularly studied, such as young children, children and young people with measures of child protection, social development in young people, school refusal and exposure of children and young people to violence.

In some areas, the consequences will only become apparent later. It is essential to have a long term perspective on research.