pediatricians call for action to reduce the impacts of racism and improve the
health of all children
Racism has a
profound impact on children’s health. With the goal of helping all children
reach their full potential, the American Academy of Pediatrics (AAP) is
publishing new recommendations on ways to lessen the impact of racism on
children and teens.
In the policy
statement, “Racism and Its Impact on Child and Adolescent Health,” the AAP
calls on pediatricians to create welcoming, culturally competent medical
practices, to advocate for policies that advance social justice, and to engage
leaders in their communities to reduce health disparities. The policy will be
published in the August 2019 issue of Pediatrics and available online
has been made toward racial equality, the impact of racism on communities of
color is wide-reaching, systemic and complex,” said Maria Trent, MD, MPH, FAAP,
FSAHM, lead author of the policy statement. “A combination of strategies will
be needed to begin untangling the thread of racism throughout the fabric of our
society, and to improve the health of all children.”
experience the effects of racism from other individuals, as well as through the
places they live and learn, through limited access to resources and economic
opportunity, and how their rights are enforced or exercised. A growing body of
research has found that racism harms children’s mental and physical health.
children and teens who are the targets of racism are impacted the most, but
bystanders are also harmed. Studies have found that young adults who were bystanders
to racism as a child experience profound physiological and psychological
effects when asked to recall the event -- comparable to the effects experienced
by first responders after a major disaster. Research
has also examined the impact of racism on specific health measures, such as
pre-term birth, low birth weight and mental health.
pediatrician, I know that when children are stressed, it impacts their health
and development,” said Jacqueline Dougé , MD, MPH, FAAP, co-author of the
statement. " When children experience chronic stress, they are flooded
with stress hormones such as cortisol that, after prolonged exposure, leads to
inflammatory reactions. This
can harm children’s health in the short term, but also creates long-term health
problems like heart disease, diabetes, and depression.”
The AAP believes pediatricians
share a role in helping improve the conditions where children live, learn and
play, by listening to families, creating culturally safe medical homes and
advocating within their communities.
as child health professionals, that we examine our own biases and work with
families to gain their trust and confidence,” Dr. Dougé said. “We must be prepared to counsel
families of all races on the effects of exposure to racism. That includes
talking with victims, bystanders and perpetrators about managing their
circumstances and health.”
Dooley, MD, MPhil, FAAP and co-author of the statement, “In pediatric practice
I care for children and families who are exposed to racism in the school
system, the justice system, the public benefits system, the immigration system
and other environments. We must advance practices and policies that
empower pediatricians to engage with families and communities on this critical
challenge for child health.”
deep-rooted racial disparities to improve children’s health will require a
great investment, but the United States has developed ingenious solutions to
significant societal problems in the past. For instance, the Food Stamp
program, developed in the 1930s and revived in the 1960s, led to higher birth
weights in babies whose mothers were at risk of nutritional deficiencies. When
provided with food stamps three months prior to giving birth, the pregnant
women gave birth with babies who had better odds of surviving, as a result.
Similarly, expansion of child health insurance improved health care access for
children, with significant gains for black and Hispanic children.
“As a nation, we
have made great strides in tackling other major challenges, and this one should
be no different. This is an area where we can – and must – make a
difference,” said Dr. Trent.
In the policy
statement, AAP recommend that pediatricians:
a culturally safe medical home, using evidence-based tools to improve
their communications with families and training clinical and office staff
in culturally competent care.
community leaders to create safe playgrounds and healthy food markets to
reduce disparities in obesity and undernutrition in neighborhoods affected
for federal and local policies that support implicit bias training in
schools and robust training of educators to improve disparities in
academic outcomes and disproportionate rates of suspension and expulsion.
community-level advocacy to develop policies that advance social justice.
with first responders and community police and share expertise on child
and teen development and mental health, considering potential differences
in culture, gender and background.
AAP has taken
steps as an organization and advocate for children to address racism and be at
the forefront of positive change. In August 2017, AAP formed a task force to
address racism as a core social determinant of health for children and
adolescents. The Task Force on Addressing Bias and Discrimination is
charged with developing a plan to address common types of bias across a broad
spectrum. The group will develop materials for pediatricians and
parents, promote partnerships, and develop a policy agenda to build inclusive
communities and health care systems.
AAP also formed a provisional Section on Minority Health, Equity, and
Inclusion that aims to advance health equity among children and promote greater
inclusion and diversity in the pediatric workforce. In April 2018, the academy
published a policy statement, “AAP Diversity and Inclusion Statement,” that
committed to using policy, advocacy, and education to encourage inclusivity and
cultural effectiveness for all.
“This work is incredibly important for the AAP, for pediatricians, and for
children, and it will remain a priority for our organization,” said AAP
President Kyle Yasuda, MD, FAAP. “As a pediatrician, I know that when we help children grow up healthy and
with equal access to opportunities, we improve all of society.”
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds