August 20, 2019
This guest post was contributed by Dr. Maria Trent, Professor of Pediatrics at the Johns Hopkins University School of Medicine; Chairperson, Section on Adolescent Health, American Academy of Pediatrics; President, Society for Adolescent Health and Medicine
As a pediatrician, my job every day is to keep young patients healthy. But too often, I see teenagers of color whose lives have already been shaped by societal racism. This work is personal: as a mother, my heart breaks when I treat young people suffering from early trauma and chronic stress brought on by racism.
Progress has been made in working toward racial equality in America, but the impact of racism remains far-reaching, systemic, and complex—and it trickles right down to our children. We need a combination of strategies to begin untangling the thread of racism that runs through the fabric of our society and achieve health equity for children.
That’s why I am proud to have co-authored new research specifically on how racism impacts the health of children and adolescents, along with my colleagues Dr. Danielle Dooley and Dr. Jacqueline Dougé. The research—“The Impact of Racism on Child and Adolescent Health,” issued this month by the American Academy of Pediatrics (AAP)—puts a spotlight on the harmful effects of living with racism for children, and recommends ways that pediatricians can begin to make a difference.
From a health perspective, the physical and emotional impacts of racism on children are significant. Children who are the targets of racism experience chronic stress, they are flooded with stress hormones such as cortisol that, after prolonged exposure, leads to inflammatory reactions. This exposure to ongoing stress can harm their health in the short term, but also may create long-term problems like heart disease, diabetes, and depression.
Racism can shape a child’s health even before they are born. Research has examined specific health measures, such as pre-term birth, low birth weight, and mental health. Mothers who have reported lifetime experiences of racism are more likely to have adverse pregnancy outcomes. While children and teens who are the targets of racist behaviors are impacted most directly, their peers who witness the bullying and other forms of abuse are also harmed. Studies have found that being a bystander to these acts as a child can result in profound physiological and psychological effects when asked to recall the event as a young adult.
So what can we do? First, more research and data will help us gain a better understanding of the clinical effects of racism on children’s mental and physical health. As a society, we have made tremendous leaps in acknowledging structural racism. But the reality is that despite this awareness, the inequities persist in our society. Greater investment in research will enable us to pinpoint the health effects on children and ultimately develop strategies to intervene and prevent those long-term health consequences.
Second, doctors and other health providers have an important role in helping improve the conditions where children receive care. Our research is not just the Academy telling other people what to do, but really examining ourselves. Pediatricians and others who work with children need to be aware of the effects of racism on children’s development and how their own biases may contribute to their interactions with patients and families and the quality of care that they deliver. Doctors should work to create welcoming, culturally safe medical practices, advocate for policies that advance social justice, and create partnerships in their communities designed to reduce health disparities.
As our nation grapples with its long history of structural racism, our children are watching. Too many children and teens have already internalized everyday experiences of bias and discrimination — our words and actions matter. Their health depends on our ability as adults in their lives to create a better, safer future.
Read more about this research here: The Impact of Racism on Child and Adolescent Health.