The COVID-19 pandemic has brought to light significant health disparities that have existed in society for decades. Studies exploring the mental health implications have only just begun to emerge. This study sought to understand the experience of burnout among parents during the COVID-19 pandemic. Using a mixed-methods research design, this study analyzes fifteen focus group discussions with school staff (n=22) and parents (n=20) conducted between December 2020- March 2021 in English and Spanish. The study also analyzes a cross-sectional survey administered in 2 waves (February and March 2022) of parents’ pandemic experiences (n=541) conducted in English (n=382) and Spanish (n=159). Participants were drawn from school sites in California located in zip codes of high social vulnerability according to the California Healthy Places Index. Participants in the focus groups expressed substantial COVID-19 fatigue and discussed experiences of structural barriers, misinformation, social stigma, and trauma. Analysis of survey responses revealed that burnout was significantly associated with structural barriers and misinformation. These findings support that COVID-19 can be understood as a traumatic event increasing burnout these findings support emerging that COVID-19 can be understood as a traumatic event increasing burnout.

During the COVID-19 pandemic, institutional mistrust impacted vulnerable populations, exacerbating disparities in social services. Many Spanish-speaking Hispanic/Latinos experienced food insecurity during the pandemic due to loss of income and ineligibility for support. Our objective was to determine what structural and demographic factors were associated with food insecurity among Spanish-speaking households and whether mistrust in institutions is associated with food insecurity. A survey was sent to parents of students from 32 schools in San Diego County. The level of mistrust ranged from 11 (trust a great deal) to 44 (not at all). We used a logistic regression model to assess the association between food insecurity and institutional mistrust by language participants chose to complete the survey. Among 1,331 participants, 32% (n=422) completed the survey in Spanish. Overall, 27.6% experienced food insecurity. Spanish-speaking participants experienced more food insecurity than English-speaking participants (41.7% vs. 21.0%, p<0.05). English-speaking participants had significantly higher institutional mistrust scores than Spanish-speaking participants. However, in our logistic regression model, the effect of food insecurity on institutional mistrust was significantly stronger for Spanish-speaking participants compared to English-speaking participants (aOR = 1.09, 95% CI 1.03 - 1.15). This stems from systemic factors such as immigration-related issues, discrimination, and lack of resources in their language, which impacts their ability to utilize services. Food insecurity among Spanish-speaking populations requires a multifaceted and culturally responsive approach that prioritizes building trust, increasing access to resources, and promoting community engagement.

COVID-19 vaccination trends for children aged 5-17 have fallen behind in comparison to older age groups in the United States; this is due to vaccine hesitancy and, potentially, the rise of institutional mistrust. Our objective was to determine whether institutional mistrust is associated with lower parental vaccination endorsement. We defined vaccination endorsement as having a child age 5+ who received at least one COVID-19 vaccine dose or being very likely to vaccinate their child aged 0-4 when eligible. We distributed an online survey among parents from 32 different schools in areas with high levels of social vulnerability relative to the rest of San Diego County. Mistrust reflected level of confidence in institutions using an aggregate score from 11 to 44. We built a multivariable logistic regression model to assess the association between mistrust and vaccination endorsement. Out of 290 parents in our sample, most were female (87.6%), reported that their child was Hispanic/Latinx (73.4%), and expressed vaccination endorsement (52.1%). In our logistic regression model, for every one-point increase in mistrust score, there was an 8% reduction in the likelihood of participants endorsing vaccination for their child. Other statistically significant correlates included parent vaccination status, child age, parent age, and Hispanic/Latinx ethnicity. Institutional mistrust can undermine public health interventions and, likewise, public health interventions can reduce the trustworthiness of the entity and foster mistrust. When mistrust is high, institutions can improve their trustworthiness by fostering collaboration with key stakeholders and aligning themselves with the interests and goals of their constituents.