The American Academy of Pediatrics has released its first ever policy statement on how racism affects the health and development of children and adolescents, saying racism is a significant social determinant of health clearly prevalent in society.The Academy is committed to addressing the factors that affect child and adolescent health with a focus on issues that may leave some children more vulnerable than others. Its statement, The Impact of Racism on Child and Adolescent Health, says racism is having a profound impact on the health status of children, adolescents, emerging adults, and their families.It says the impact of bias on the health of children is even starting before they are born, with poverty and poorer medical care affecting birth weights and health conditions in some minority groups.
"Although progress has been made toward racial equality and equity, the evidence to support the continued negative impact of racism on health and well-being through implicit and explicit biases, institutional structures, and interpersonal relationships is clear," the report states.
"Failure to address racism will continue to undermine health equity for all children, adolescents, emerging adults, and their families."
The statement stresses that the social environment in which children are raised shapes child and adolescent development, and pediatricians are poised to prevent and respond to environmental circumstances that undermine child health.
"The impact of racism has been linked to birth disparities and mental health problems in children and adolescents," it states.
"The biological mechanism that emerges from chronic stress leads to increased and prolonged levels of exposure to stress hormones and oxidative stress at the cellular level.
"Prolonged exposure to stress hormones, such as cortisol, leads to inflammatory reactions that predispose individuals to chronic disease. As an example, racial disparities in the infant mortality rate remain, and the complications of low birth weight have been associated with perceived racial discrimination and maternal stress."
The Academy looks to its own profession for action and even suggests some health practitioners might need to examine their own prejudices.
"Pediatricians and other child health professionals must be prepared to discuss and counsel families of all races on the effects of exposure to racism as victims, bystanders, and perpetrators," the report states.
"Pediatricians can implement systems in their practices that ensure that all patients and families know that they are welcome, that they will be treated with mutual respect, and that high-quality care will be delivered regardless of background using the tenets of family- and patient-centered care.
"To do this, it is critical for pediatricians to examine their own biases. Pediatricians can advocate for community initiatives and collaborate with government and community-based organisations to help redress biases and inequities in the health, justice, and educational systems. These strategies may optimise developmental outcomes and reduce exposure to adverse events that dramatically alter the lived experiences, health, and perceived self-value of youth."
The policy statement can be found at:
https://pediatrics.aappublications.org/content/144/2/e20191765
