Household Conflict in the Time of COVID-19: the Impact of Public Policy on Family Dynamics in Marginalized Urban Communities with High Infection Risk.

During public health emergencies, infection control policies play a critical role in curbing disease transmission. However, little is known about the ways in which these policies shape family dynamics. Challenges may be more pronounced among families living in low-income, high-risk urban communities. This study investigated conflicts related to COVID-19 within households, using data from a randomized control trial (n = 392) conducted between 08/2021 and 07/2022. The participants-primarily Latino or Black (95%), aged 18-54 (54%), and earning under $25,000 annually (63%)-were recruited from NYC public housing. Multilevel logistic regression analyses revealed that over half (55.9%) of households reported significant conflict over health decisions, going out, having visitors to the home, or NYC COVID-19 guidance. Conflict was more prevalent in larger households (with seven or more members, OR 2.73), households with teenagers (aged 14-17 only, OR 2.47), and those with family members experiencing high psychological distress related to COVID-19 (OR 2.26). These findings highlight the need for targeted public health messaging and interventions to mitigate household conflicts, reduce economic/psychological distress, and enhance family communication during disaster events.