Pandemic-Related Black Family Well-Being Across North Carolina County Tiers: An Exploratory Cross-Sectional Study

This exploratory cross-sectional study examined whether pandemic-related family well-being responses differed across North Carolina's 2021 county economic tiers among 178 Black parents. Survey responses were linked to county tier and included reported stress, emotional symptoms, food hardship, self-rated health, sleep change, work and parenting disruption, and parent-child interaction items. Primary analyses used the Kruskal-Wallis and chi-square tests; within-tier correlations and tier-stratified linear probability models were used for supplementary and descriptive purposes. Respondents across all tiers reported pandemic-related burdens, but most cross-tier comparisons were not statistically significant. One food-hardship item (p = 0.050) and one parent-child interaction item (p = 0.042) met the nominal 0.05 threshold, while one emotional symptom item approached significance (p = 0.074); these isolated findings did not form a consistent cross-domain pattern. The findings indicate that the county-tier classification was useful for organizing place-based comparisons but did not consistently differentiate response patterns in this sample. Larger, longitudinal studies using neighborhood- and household-level measures are needed before tier-specific or causal conclusions can be drawn.