Socioeconomic adversity and child health following the COVID-19 pandemic: A convergent integrated mixed-methods review of household and neighbourhood inequalities.

Children experience inequalities in health at household and neighbourhood level, even in wealthy countries. Measures to contain the COVID-19 pandemic such as school closures, followed by the cost-of-living crisis, did not affect all children equally. This review aimed to understand the impact of socioeconomic adversity on child health and development following the COVID-19 pandemic. Systematic literature searches used the SPIDER tool to identify studies, and a convergent integrated approach to combine and synthesise quantitative and qualitative data. A mixed methods appraisal tool was used to appraise for risk of bias. Three integrated findings were identified from 125 studies: 1. Socioeconomic adversity and unequal exposure to risk; 2. Community support and professional input as protective influences. 3. Structural and system-level requirements to address socioeconomic adversity. COVID-19 restriction measures were associated with worsening family finances and health of disadvantaged children who experienced cramped living conditions and insecure food and housing. COVID-19 amplified existing health inequalities. These inequalities could potentially be reduced through public health interventions such as improved availability of community services, greater consideration of sociodemographic factors in healthcare settings, and by professionals using their collective voice to influence policy development, for example through improved data sharing to help public-sector services make the best use of available data to support vulnerable families.