Abstract
BACKGROUND: The COVID-19 pandemic imposed a substantial disease burden, yet few population-based studies assessed its long-term impacts on families. This study estimated the pandemic's impact on family income, employment, school interruption, food insecurity, and death of family members in Brazil. METHODS: Population-based household survey with 33.250 participants from 133 large cities in Brazil during May and June 2024. Households were selected using a multistage probability sampling design in each city. RESULTS: Among respondents, 14.7% [95% confidence interval (CI):13.8%; 15.6%] reported the death of a family member due to COVID-19; 48.6% (95% CI: 47.1%; 50.1%) experienced reductions in family income; 34.9% (95% CI: 33.4%; 36.4%) reported that at least one family member stopped working; in 21.5% (95% CI: 20.1%; 22.9%) of families, at least one member interrupted studies; and 47.4% (95% CI: 45.9%; 48.8%) experienced food insecurity during the pandemic. These outcomes were more frequent among families with low income and with six or more members, except for the death of a family member, which was more commonly reported in households with higher incomes and educational levels. Job losses, interruption of studies, and food insecurity were more common in families led by women. Indigenous people experienced a high prevalence of food insecurity. CONCLUSION: The COVID-19 pandemic exacerbated social and economic inequalities, with most impacts disproportionately affecting the poorest families, those led by women, and indigenous people. Conversely, the death of a relative was more commonly reported among the wealthiest families that include a larger number of older members.