The current study investigated the relationship between COVID-19-related anxiety and the health of children aged 5 to 18 in Mashhad, a city in northeastern Iran. According to the findings of this study, COVID-19-related anxiety impacted children's health. Other studies have revealed that COVID-19 disease causes emotions of uncertainty, fear, and isolation, as well as sleep difficulties, anorexia, depression, loneliness anxiety, post-traumatic stress disorder, and obsessive-compulsive disorder in children [43, 44]. On the other hand, quarantine regulations and social isolation have resulted in a lack of physical exercise in them[45]. This separation has restricted children's opportunities to acquire social behaviors and, in some cases, behavioral and emotional problems[46]. Other research has suggested that providing appropriate information about COVID-19 illness might relieve children's emotions of fear, worry, and doubt, as well as teach them good coping strategies[47]. According to the findings of the research, children's degree of awareness had a significant link with their anxiety, such that children who were more aware of this sickness experienced greater anxiety. Concerning the principles of crisis intervention, there is a need to appropriately increase awareness by addressing the idea of epidemic cessation. Increasing awareness through interventions such as social distance during the epidemic and obeying sanitary principles such as frequent handwashing with soap and water might help in this respect. Consequently, it is critical to pay attention to how children get the majority of their information, what methods should be used to improve awareness in children, and what variables, in addition to the degree of awareness, have influenced their anxiety [48]. According to the findings of a study conducted in the Netherlands, interaction with children by health care workers can decrease anxiety linked with the COVID-19 pandemic in children and its possible harmful effects[43]. Educating parents on how to control their negative emotions is also a crucial step in fostering and sustaining children's mental health in times of crisis. As a consequence, providing information about COVID-19 disease based on children's cognitive development, health attitudes, and age is essential [48, 49]. Yoga, meditation, exercise, and mental activity can help reduce the anxiety produced by COVID-19, and in order to fight the pandemic, parents and children must work together to diminish the harmful consequences of COVID-19-related anxiety on children's health [50].
In our study, there was a substantial variation in the mean score of children's health based on the kind of insurance coverage. Other research has found that having access to social insurance has a substantial impact on the number of times youngsters visit the doctor [51]. Furthermore, expanding public insurance coverage reduced deprivation at the communal level [52] as well as the financial burden on low-income households [53]. As previous studies have highlighted, this state can help to reduce poverty and inequality in society, as well as impact children's well-being. Children's well-being and health are critical for any society's future[53, 54]. Today's children are our future generation, and their well-being today lays the groundwork for their health during adolescence. Access to health system services, such as health insurance coverage, is a social and economic right, and health planners must plan carefully to enhance justice and equity in this area.
According to the findings of the current study, there is a strong relationship between parents' educational level and their children's health. Other studies have found that parental literacy has an impact on children's health and that it is important to engage in their development in order to enhance children's health[54-56]. Some studies have indicated that women's education levels have an influence on children's health[57], and others have found that maternal and paternal education are equally important in lowering child mortality in Indonesia[56, 58]. In developing countries, fathers generally have a greater level of education than mothers. Therefore education for fathers might be beneficial. Another way to describe the role of fathers' education is the low social position and empowerment of mothers, which has the ability to diminish mothers' influence over child health decisions. Fathers may take a more active part in certain sorts of child health decisions, such as specific measures like immunizations. Mothers, on the other hand, maybe more active in day-to-day decisions concerning public health and nutrition. The father's education has a stronger association with individual health habits, but the mother's education has a greater impact on long-term health indicators like height and weight [59, 60]. Parents with a greater level of education and income, as well as children from higher-income households, are healthier because they have access to higher-quality health care, better nutrition, and better living conditions. This research has underlined the need for increasing parental education via investment.
The current investigation found a strong relationship between the mean score of housing status and cardiac anxiety. Hence, those who lived in leased homes were more anxious. This issue has caused several issues in society. Despite this, research has shown that the coronavirus does not discriminate based on personal residence and affects leased homes just as often as homeowners. [61]. Perhaps the economic crisis caused by the COVID-19 pandemic, as well as issues like unemployment and a lack of financial support for households, has increased anxiety among renters. According to the findings of previous research, the cost of renting a property in Iran is high [24, 62], which may increase anxiety in leased families indirectly.
The current research was conducted during the pandemic. Due to special circumstances in Iran, such as lockdown, it was not feasible to complete the surveys in person. For that purpose, the surveys were sent to parents over the internet. Another drawback of this study was the use of questionnaires, as there is a risk of bias in self-report instruments. Regarding the aforementioned constraints and the study's final conclusions, it is proposed that in future studies, further research be performed to clarify the link between variables in other provinces and cities around the country to clarify the relationship between investigated variables. Various aspects related to children's health, such as parenting and self-care principles, as well as other degrees of anxiety in children should be examined.