{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T22:35:45Z","timestamp":1780439745297,"version":"3.54.1"},"reference-count":57,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T00:00:00Z","timestamp":1674086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health\u2014National Institute of Minority Health and Health Disparities","award":["3U54MD007579-35S1 and U54MD007579"],"award-info":[{"award-number":["3U54MD007579-35S1 and U54MD007579"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Psychological sequelae are important elements of the burden of disease among caregivers. Recognition of the impact of adversity and stress biomarkers is important to prevent mental health problems that affect rearing practices and child well-being. This cross-sectional study explored social determinants of health (SDoH)-mediated stressors during COVID-19 and risks for mental health problems among caregivers of children with prenatal Zika virus exposure. Twenty-five Hispanic caregivers completed surveys assessing SDoH vulnerabilities, COVID-exposures and impact, post-traumatic stress disorder (PTSD) symptomatology, and provided a hair sample for cortisol concentration (HCC). Most caregivers had low education, household income &lt; $15,000\/year, and were unemployed. Stressors included disrupted child education and specialized services, and food insecurity. While most reported PTSD symptomatology, multivariate linear regression models adjusted for the caregiver\u2019s age, education, and the child\u2019s sex, revealed that caregivers with high symptomatology had significantly lower HCC than those with low symptomatology and those with food insecurity had significantly higher HCC than participants without food insecurity. The impact of COVID-19 on daily life was characterized on average between worse and better, suggesting variability in susceptibility and coping mechanisms, with the most resilient identifying community support and spirituality resources. SDoH-mediators provide opportunities to prevent adverse mental health outcomes for caregivers and their children.<\/jats:p>","DOI":"10.3390\/ijerph20031838","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T04:19:40Z","timestamp":1674101980000},"page":"1838","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Stressors and Impact of the COVID-19 Pandemic on Vulnerable Hispanic Caregivers and Children"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2590-6151","authenticated-orcid":false,"given":"Mary","family":"Rodr\u00edguez-Rabassa","sequence":"first","affiliation":[{"name":"Clinical Psychology Program, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA"},{"name":"RCMI Center for Research Resources, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA"},{"name":"Department of Pediatrics, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefan\u00eda","family":"Torres-Marrero","sequence":"additional","affiliation":[{"name":"Clinical Psychology Program, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"RCMI Center for Research Resources, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4786-9438","authenticated-orcid":false,"given":"Kamalich","family":"Muniz-Rodriguez","sequence":"additional","affiliation":[{"name":"Ponce Research Institute, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilyn","family":"Borges-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Ponce Research Institute, Ponce Health Sciences University, P.O. Box 7004, Ponce, PR 00732, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison A.","family":"Appleton","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, 1 University Place, Rensselaer, NY 12144, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8130-0026","authenticated-orcid":false,"given":"Larissa","family":"Avil\u00e9s-Santa","sequence":"additional","affiliation":[{"name":"Division of Clinical and Health Services Research, National Institute on Minority Health and Health Disparities, 6707 Democracy Blvd. Suite 800, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa I.","family":"Alvarado-Domenech","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ponce Health Sciences University, P.O. 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